PRINCETON, New Jersey — A new study conducted by researchers at Princeton University, and in colleges around the world, found that the use of antibiotics to treat infectious diseases has risen 36 percent since 2000.
The study received funding from the Bill and Melinda Gates Foundation and the U.S. Department of Homeland Security to assess the rising threat of antibiotic-resistant bacteria globally.
Using sales data from hospitals and pharmacies from 2000 to 2010, the researchers measured trends in antibiotic drug usage in 71 countries. They discovered that the largest part of the 36 percent increase came from the BRICS Nations: Brazil, Russia, India, China and South Africa.
In these nations, consumption rose 76 percent from 2000 to 2010.
The overuse of antibiotics to fight infections, especially in populous China and India, is deeply troubling. According to the National Institute of Allergy and Infectious Diseases, excessive exposure to antibiotic drugs allows bacteria, viruses and other agents to adapt to survive the drugs’ effects. This antimicrobial resistance makes previously lethal antibiotics much less effective over time.
The World Health Organization has already detected antimicrobial resistance in many diseases around the world. Drug resistant K. pneumoniae and Streptococcus strains, which cause pneumonia, have been detected in all of the WHO’s six world regions. E. coli and Staphylococcus, which cause blood infections, have also developed antimicrobial resistance in five of the six regions.
Along with these more common organisms that affect the world, disease that primarily exist in developing nations also are becoming harder to cure. Drug resistant tuberculosis, for example, appears in 3.6 percent of new cases and 20.2 percent of previously-treated cases worldwide, reports the WHO.
Of the patients treated in 2010, only 48 percent were cured following antibiotic treatment.
Rising rates of drug-resistant organisms, especially tuberculosis, threaten global health and the progress of modern medicine. In the developing world, where many people lack access to quality medical care, even small infections can lead to severe illness and death.
Through modern methods of transportation, drug-resistant infectious agents can move across the entire world, endangering people in countries where those agents had previously been eliminated.
A resurgence of tuberculosis and malaria is possible even in developed nations.
The WHO believes that if the problem of antimicrobial resistance is not addressed, “a post-antibiotic era-in which common infections and minor injuries can kill-is a very real possibility.”
What can the global community do to help curb rising antibiotic use? Laws will need to be implemented around the world to restrict the over-the-counter sale of antibiotics, and patients will need to limit their use only for necessary cases. Doctors will also need to be educated about the dangers of drug resistance.
In countries like China and India, implementing such programs must be a top priority.
India is taking steps to combat antimicrobial resistance. A new law implemented in March prevents pharmacists from giving antibiotics to patients without prescriptions and forces drug providers to post warning labels about the dangers of overuse. Doctors are also required to keep records of patients and prescriptions to prevent fraud.
In China, however, the rising use of antibiotics is not well addressed. About 80 percent of Chinese patients are given antibiotics, including those with infections like sore throats, which are not effectively treated by antibiotics.
A 2009 study in The Lancet estimated that China has the highest rate of antimicrobial resistance development in the world.
Part of the problem in China is that patients do not know the risks of antibiotics and demand them too frequently. In addition, the Chinese government subsidizes only 8 percent of hospital costs, which forces doctors to sell more antibiotics to stay operational.
China has tried to implement guidelines for antibiotic prescription, but enforcement has been lax. With a population of over 1 billion, China must take action to prevent excessive antibiotic use before they become a threat to the entire world.
Programs for education about the dangers of antibiotics and laws to prevent excessive sales must be implemented around the globe to prevent drug-resistant diseases from spreading. This health threat must be a global priority, and efforts to stop rising antibiotic use are urgently needed.
– Ted Rappleye
Sources: The Lancet, WHO, NIAID, The Hindu, British Medical Journal
Photo: Barnes Jewish