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Blair Horner: Taking On Superbugs

For years the world’s health experts have sounded the alarm about the growing threat of antibiotic-resistant bacteria.  The more antibiotics are used, the faster bacteria evolve to resist them, giving rise to so-called “superbugs” – bacteria that are extremely difficult or impossible to treat with existing drugs.

According to the World Health Organization, unless something is done, by the middle of this century more people will die from antibiotic resistant infections than die of cancer.  In America, nearly three million people get sick each year from antibiotic-resistant infections.  At least 35,000 die.  The diseases they contract are difficult – sometimes impossible – to treat with antibiotics because they are caused by drug-resistant "superbugs."

The U.S. Centers for Disease Control and Prevention (CDC) has called the growing “superbugs” menace one of the “biggest public health challenges of our time.”  A new study, published this month in the peer-reviewed journal JAMA Network Open, found more than half of antibiotics prescribed in hospitals were not done so consistent with scientific recommendations, a shocking finding that fuels the concern that inappropriately prescribing medications in hospitals is contributing to antibiotic resistance. 

Researchers found that over half the patients shouldn’t have received antibiotics based on best practice guidelines.  Those guidelines didn’t support prescribing antibiotics to four out of five patients who were treated for community-acquired pneumonia and over three-quarters of patients who were treated for a urinary tract infections. 

Studies have shown patients with antibiotic-resistant infections are at an increased risk of worse clinical outcomes, such as severe disease and death, compared with patients with infections that can be treated with antibiotics.

But the overuse of antibiotics – and the resulting increase in resistance – is not just a problem for typical health treatments.  Early in the COVID-19 pandemic, hospital officials reported that it is common for COVID-19 patients to be prescribed antibiotics.  Even though antibiotics won’t cure viral illnesses including COVID-19, physicians concerned about secondary bacterial infections may nevertheless prescribe antibiotics to COVID-19 patients, sometimes before a bacterial infection exists.

In a study that was released in February, researchers found that a majority of COVID-19 hospital admissions led to one or more antibiotics being given to patients.  Their findings strongly suggest that overprescribing of antibiotics occurred during the first six months of the pandemic.

Recently, New York started to take steps to address the rising threat posed by antibiotic-resistant “superbugs.”  Legislation has been approved that requires all nursing homes and hospitals to develop stewardship programs to reduce the misuse and overuse of antibiotics.

The overwhelming majority of New York hospitals are reported to be following the stewardship guidance set by the CDC.  Yet when it comes to nursing homes, based on the New York Attorney General’s recent report, infection control measures are inadequate.  Poor infection controls can contribute to the growth of antibiotic-resistant infections.

Mandating stewardship programs is only one step.

Two-thirds of human-important antibiotics are sold for use on farm animals and the CDC estimates that nearly one-quarter of all antibiotic-resistant “superbugs” originate in farm settings.

Experts warn that without swift action, these kinds of infections will become more prevalent -- and one of the main causes is the overuse of medically important antibiotics in animal agriculture.  Livestock producers routinely give antibiotics to animals to help them survive crowded, stressful and unsanitary conditions.

Research shows that workers on these farms are up to 15 times more likely to harbor a strain of the antibiotic-resistant bacteria known as MRSA than individuals who don't work with animals.

Livestock workers shouldn't have to be our canaries in the coalmine of antibiotic-resistant infections.  Approximately two thirds of medically important antibiotics sold in the U.S. are intended for use in livestock and poultry.  But if we want to keep lifesaving antibiotics effective, healthy farm animals shouldn't be routinely receiving human-important antibiotics.

Now that lawmakers have tackled the rise of antibiotics in hospitals and nursing homes, they need to finish the job.  Nearly one-quarter of all “superbugs” originate on farms.  It’s time to take on that problem too.

Blair Horner is executive director of the New York Public Interest Research Group.

The views expressed by commentators are solely those of the authors.They do not necessarily reflect the views of this station or its management.

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