Superbugs Are a 'Costly War We Can't Win': Doctors
Germs are perfect machines of evolution. Their ability to mutate and survive attempts (by humans and nature) to destroy them has led to some being called "superbugs."
Resistant to existing antibiotics, superbug-related infections worldwide result in thousands of deaths each year—an estimated 99,000 in the U.S. alone for each of the past 10 years.
These bacteria not only take a tragic toll on human life but involve major costs. A new study by MPHonline.org reports that superbugs are responsible for $20 billion in excess health care costs in the U.S. annually, as well as $35 billion in lost wages and other societal costs from the almost eight million days that infected patients spend in the hospital.
"We are in a crisis situation," said Dr. Cesar Arias, an associate professor of infectious diseases at the University of Texas Health Science Center.
"The World Health Organization says this is one of the top three health threats to the world in this century, and I can't argue with that," said Arias, who has researched and written extensively on superbugs.
The main threats are the six labeled under the acronym ESKAPE—notably MRSA and, more recently, CRE, which has been found almost exclusively in hospitals and other health care facilities. But other pathogens, such as the one that causes gonorrhea, are also resistant to antibiotics. Tuberculosis-resistant strains have broken out in locations ranging from Los Angeles and to parts of India.
According to medical experts, the main cause for the resistance is that antibiotics are increasingly given to patients for common viral ailments such as colds and flu, for which antibiotics are ineffective anyway.
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Some 190 million doses of antibiotics are given in U.S. hospitals every day and nearly 133 million are prescribed daily by doctors in the U.S. according to the American College of Physicians. Half of the latter are considered unnecessary.
This over-prescribing only helps the bacteria change and endure while making antibiotics obsolete, according to Alan Christianson, a specialist in naturopathic medicine.
"We have a clear case of too many antibiotics being used and not enough new ones in the system to fight these bacteria," Christianson said. "We haven't had any new antibiotics in the pipeline over the past 10 years, and it takes time to get one in, so we're way behind the curve on this."
Many large drugmakers such as Johnson & Johnson and AstraZeneca have said publicly that they have reduced or stopped research funding for new antibiotics, citing the costs. Developing more expensive drugs, such as one for HIV, is better for the bottom line.
The curtailment comes as MRSA kills an estimated 19,000 people every year in the U.S., compared with the 17,000 who die from AIDS, according to the Centers for Disease Control.
"These firms want to know that they will make an antibiotic that will work economically, and there is no guarantee," Christianson said. "There's a lot of trial and error to find the right one. There's really no money in antibiotics."
Smaller drug firms have picked up some of the slack, said the University of Texas' Arias said, but it's not enough.
'We need the Federal Drug Administration to speed up the process and loosen restrictions on approving new drugs," said Arias. "It's too slow now, and we really need a cooperative effort between science and the government on funding for new drugs. It's going to take a whole new approach to fight this."
Patients and doctors have to be part of the solution, too, said Dr. G. Richard Olds, dean of the school of medicine at the University of California-Riverside.
"Pharmaceutical companies like to push drugs in advertising to make money, and a patient often thinks if a doctor doesn't prescribe antibiotics he's a bad doctor," Olds said. "But the medical profession has to be precise when it comes to handing out drugs—we have to use them appropriately and for the right reasons," he added.
Warnings about the superbugs are not new, but the intensity has picked up. Last month, Britain's top health official said that resistance to antibiotics poses a "catastrophic threat to medicine and could mean patients having minor surgery risk dying from infections that can no longer be treated."
And the president of the Society for General Microbiology recently called for urgent action to develop new antibiotics.
For now, people are warned to wash their hands, eat healthfully and avoid unnecessary prescriptions for common ailments. Anyone given a prescription is advised to finish it to fully kill the bacteria. Hospital patients and visitors should check that proper hygiene procedures are observed by the medical staff.
As for eradicating superbugs—that won't happen, according to Olds.
"It's a never-ending arms race between us and the bacteria," he said. "We can never win this. Whatever we develop they will likely figure a way to get around it. The good news is that we are still doing some cutting-edge research. But the bacteria are, too."