Antibiotic Resistance: How Serious Is the Problem, and What Can Be Done?

Abstract

Antibiotic resistance and the resulting risk for ineffective treatment of infections are serious and growing problems. The national and international efforts by governments and nongovernmental organizations are many and high-powered. For example, the Transatlantic Task Force on Antimicrobial Resistance was established by joint presidential declaration in 2009 by the European Union and US presidencies. It issued recommendations in 2011 for collaborative efforts to fight antibiotic resistance. In the US, the federal Interagency Task Force on Antimicrobial Resistance updated its “A Public Health Action Plan to Combat Antimicrobial Resistance” document in 2011. Despite these and many earlier efforts, antimicrobial resistance continues to increase, as does public awareness of the issue. In this Q&A article, 5 experts with different roles have been asked to address several questions about antibiotic resistance, including questions focusing on how to best combat this growing problem. We frequently see frightening reports about antibiotic resistant bacteria in the media. How serious is the problem of antibiotic resistance? David Hooper: Antimicrobial resistance in bacteria is a serious problem in healthcare today. Although most patients with infection will not necessarily have a resistant one, bacterial resistance can occur in a substantial minority of infected patients and particularly those who have other underlying health conditions, frequent hospitalizations, or recurrent exposures to antimicrobial agents. Methicillin-resistant Staphylococcus aureus (MRSA)8 is widespread in patients in hospitals and is sufficiently common in the community that for patients with serious infections, alternative antimicrobial agents, such as vancomycin, must be part of treatment until specific microbiologic data about susceptibility are known. Resistance to vancomycin also occurs commonly in Enterococcus species, another common hospital pathogen. Perhaps most concerning is the emergence in some patients of multidrug-resistant infections with gram-negative bacteria, for which few or no active therapies are currently available. Alfred DeMaria: I agree that antimicrobial-resistant pathogens …