Overprescribing antibiotics creating 'superbugs.' (antibiotic-resistant pathogens)

Antibiotic-resistant pathogens are emerging at an alarming rate and treatment options are shrinking, warns Terrance O. Kurtz, chief epidemiologist at Des Moines (Iowa) General Hospital and associate professor of internal medicine at the University of Osteopathic Medicine and Health Sciences College of Osteopathic Medicine and Surgery. In fact, some pathogens have developed strains that are so resistant to antibiotics that physicians are resorting to experimental drugs in an attempt to eradicate these organisms.

"Resistance is nothing new, but it's more of a concern now than it was in the previous two decades because it is occurring so rapidly," Kurtz indicates. Drug resistance is increasing among viruses, bacteria, fungi, and parasites. The U.S. Centers for Disease Control and Prevention (CDC) has reported a significant increase in resistance to vancomycin hydrochloride, an antibiotic used to treat nosocomial (hospital) infections. How should physicians handle the problem of drug resistance? According to Anthony Silvagni, dean of the University of Health Sciences College of Osteopathic Medicine, they must slow the spread of resistance to antibiotics, especially considering the speed with which common pathogens are adapting to these drugs. "The incidence of penicillin resistance in Streptococcus pneumoniae is now 25 to 35%. Just a few years ago, there was no resistance at all."

Epidemiologists have discovered that growing resistance to potentially life-saving drugs can be attributed to misuse of broad-spectrum antibiotics; increasing use of prosthetics and invasive diagnostic and therapeutic procedures; growing consumer demand for antibiotics; patients, failure to follow instructions for antibiotic therapy; routine use of penicillin in cattle and chicken feed; and lax rules governing the use of antibiotics in other countries. While both physicians and patients are to blame for some antibiotic-resistance, "it's not always somebody's fault," says Robert M. Fleigelman, director of the Infectious Disease Section, St. Francis Hospital, Blue Island, III. "Not all antibiotic resistance is preventable. Any use of antibiotics can potentially lead to the development of resistance." Health experts agree, however, that misuse and overuse of antibiotics has contributed greatly to the growing problem.

Many hospitals have responded to concerns about misuse by establishing more stringent prescribing policies. In some institutions, broad-spectrum antibiotics...