Mapping Antibiotic Use and Resistance

New data reveals troubling trends in the pharmaceutical fight against bacteria.

By | November 17, 2011

NovamoxinWIKIMEDIA COMMONS, BMRAMON

Though rates of antibiotic use across the United States have been decreasing, people in Southeast regions of the country take about twice as many antibiotics as residents of the Northwest, according to a new analysis that tracked use of the drugs from 1999 to 2007. West Virginia, Kentucky, Tennessee, Louisiana, and Alabama were the five states with the highest antibiotic use, while Alaska, Oregon, California, and Washington had the lowest use rates. As a whole, the United States had a lower combined resistance score—meaning antibiotic-resistant pathogens are less of a problem—than some countries in Eastern and Southern Europe, but had a higher score than many Nordic countries and European powers, such as the UK and Germany.

While overall antibiotic use in the United States dropped by 12 percent during the study period, according to the report published yesterday on the website of the Center for Disease Dynamics, Economics & Policy (CDDEP), prescribing rates for a powerful class of antibiotics known as fluoroquinolones increased by 49 percent. The alarming thing from an epidemiological standpoint is that fluoroquinolones are now seven times less likely to work against Escherichia coli than they were in 1999. Meanwhile, the market share of penicillins, which have long been the most popular of antibiotics, has declined by 28 percent, with doctors instead prescribing increasingly powerful antibiotics.

In conjunction with releasing this resistance data, Extending the Cure, a project of the CDDEP, also published a paper this week detailing a new method for tracking trends in antibiotic resistance. Appearing in BMJ Open, the study describes how the Drug Resistance Index (DRI) operates something like a Consumer Price Index for antibiotic resistance, aggregating information about trends in E. coli and Acinetobacter baumannii resistance and antibiotic use into a single measure of antibiotic resistance over time. The researchers calculated that DRI in the United States for E. coli rose from 0.25 to 0.30 from 1999 to 2006, and the DRI for Acinetobacter spp. increased from 0.41 to 0.48 over that same time period.

“Mapping the geography of antibiotic use and summarizing their effectiveness with a Drug Resistance Index bring us one step closer to the solutions we urgently need in order to curtail this public health crisis,” said Ramanan Laxminarayan, director of Extending the Cure and author on the BMJ Open paper. “If we do nothing, resistance will continue to develop and our most valuable antibiotics ultimately will fail.”

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Comments

Avatar of: chrblee

chrblee

Posts: 1

November 17, 2011

Perhaps it's time to think about moving the clock back.

The nitrofurans were developed before the natural products and derivatives that are presently called antibiotics came into widespread use.

Nitrofurans apparantly don't induce resistance. Unfortunately, most are genotoxic (at least to microorganisms) or have a genotoxic alert via their metabolites; this seems to be their mode of action.

They are banned in animal feed because of the genotoxic residues, but not always in humans...

A certain calculated level of cancer risk is accepted for diagnostic ionising radiation, but the rules seem to be more complicated for drugs. Since the situation with antibiotics is becoming critical it might be worth re-examining nitrofurans and any other old products that have been superseded, in case they could be deployed in times of crisis.

Possibly, nitrofurans could serve as a lead for the development of new antimicrobial compounds. How to get approval and finance for such a project is left as an exercise for the reader.

Avatar of: quatra

quatra

Posts: 1

November 17, 2011

It should be a biological fight, not a pharmaceutical one. Phages are the natural enemies of bacteria and each type of bacteria has one, or more of them. Bacteria cannot become resistant to the phages. The problem is that there's no money to be made, so nobody is really interested in investing in research. The Soviet Union had successful a program going on about 30 years ago.

Avatar of:

Posts: 0

November 17, 2011

Perhaps it's time to think about moving the clock back.

The nitrofurans were developed before the natural products and derivatives that are presently called antibiotics came into widespread use.

Nitrofurans apparantly don't induce resistance. Unfortunately, most are genotoxic (at least to microorganisms) or have a genotoxic alert via their metabolites; this seems to be their mode of action.

They are banned in animal feed because of the genotoxic residues, but not always in humans...

A certain calculated level of cancer risk is accepted for diagnostic ionising radiation, but the rules seem to be more complicated for drugs. Since the situation with antibiotics is becoming critical it might be worth re-examining nitrofurans and any other old products that have been superseded, in case they could be deployed in times of crisis.

Possibly, nitrofurans could serve as a lead for the development of new antimicrobial compounds. How to get approval and finance for such a project is left as an exercise for the reader.

Avatar of:

Posts: 0

November 17, 2011

It should be a biological fight, not a pharmaceutical one. Phages are the natural enemies of bacteria and each type of bacteria has one, or more of them. Bacteria cannot become resistant to the phages. The problem is that there's no money to be made, so nobody is really interested in investing in research. The Soviet Union had successful a program going on about 30 years ago.

Avatar of:

Posts: 0

November 17, 2011

Perhaps it's time to think about moving the clock back.

The nitrofurans were developed before the natural products and derivatives that are presently called antibiotics came into widespread use.

Nitrofurans apparantly don't induce resistance. Unfortunately, most are genotoxic (at least to microorganisms) or have a genotoxic alert via their metabolites; this seems to be their mode of action.

They are banned in animal feed because of the genotoxic residues, but not always in humans...

A certain calculated level of cancer risk is accepted for diagnostic ionising radiation, but the rules seem to be more complicated for drugs. Since the situation with antibiotics is becoming critical it might be worth re-examining nitrofurans and any other old products that have been superseded, in case they could be deployed in times of crisis.

Possibly, nitrofurans could serve as a lead for the development of new antimicrobial compounds. How to get approval and finance for such a project is left as an exercise for the reader.

Avatar of:

Posts: 0

November 17, 2011

It should be a biological fight, not a pharmaceutical one. Phages are the natural enemies of bacteria and each type of bacteria has one, or more of them. Bacteria cannot become resistant to the phages. The problem is that there's no money to be made, so nobody is really interested in investing in research. The Soviet Union had successful a program going on about 30 years ago.

Avatar of:

Posts: 0

November 19, 2011

i think some pharma industries and physicians are playing with lives of human being, many time we see that for common cold also they will prescribe very powerfull or third /fourth generation antibiotics as if like they have been given a target for completing turnover of some perticular brand, they are not even thinking about coming generations, small childrens are also being treted with high doses of antibiotics 

Avatar of:

Posts: 0

November 19, 2011

i think some pharma industries and physicians are playing with lives of human being, many time we see that for common cold also they will prescribe very powerfull or third /fourth generation antibiotics as if like they have been given a target for completing turnover of some perticular brand, they are not even thinking about coming generations, small childrens are also being treted with high doses of antibiotics 

Avatar of: ravi_c4u

ravi_c4u

Posts: 1

November 19, 2011

i think some pharma industries and physicians are playing with lives of human being, many time we see that for common cold also they will prescribe very powerfull or third /fourth generation antibiotics as if like they have been given a target for completing turnover of some perticular brand, they are not even thinking about coming generations, small childrens are also being treted with high doses of antibiotics 

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