Those Rotten ‘Routine Antibiotics’

When you’re sick and have an infection, it’s reassuring to know there’s something your doctor can prescribe to quickly get you well again.

But we must be vigilant: If our physicians prescribe an antibiotic, that antibiotic must be absolutely necessary. And we should quit demanding antibiotics for every little scrape and sniffle — because this has backfired.

“The antibiotics we used to routinely [prescribe] are no longer reliably working,” said an infectious disease expert.

A report this week in JAMA Internal Medicine outlines a worrying trend about how some antibiotics, especially broad spectrum agents, are being regularly prescribed at U.S. hospitals. These are last-line-of-defense antibiotics — which means if you develop an immunity to them, there’s nothing else right now that doctors can give you.

“The antibiotics we used to routinely [prescribe] are no longer reliably working,” said Meghan May, Ph.D., an associate professor of microbiology and infectious diseases at the University of New England College in Maine. In part, that’s due to an overuse of antibiotics — and due to the fact that bacterial infections can become severe and potentially deadly very quickly.

“Physicians often have to make an educated guess at which antibiotic is most likely to work. Increasingly, physicians are relying on these so-called ‘drugs of last resort’ as their best educated guess, because it is now more likely that a hospital-acquired infection is going to be resistant to first-line antibiotics,” May told LifeZette.

Vancomycin, carbapenems, colistin, and combined doses of β-lactams and β-lactamase inhibitors are typically the antibiotics being referred to when you hear the term “broad spectrum agent,” according to May.

“As we grow increasingly reliant on these drugs, resistance to them will continue to develop. If we do not continue to discover new antibiotics to serve as the frontier ‘drugs of last resort,’ we run the risk of having patients with untreatable infections. I’m gravely concerned about this possibility,” she added. “We are not far off from untreatable strains circulating in hospitals, and that is terrifying.”

“We are not far off from untreatable strains circulating in hospitals, and that is terrifying.”

While antibiotics are prescribed frequently in the U.S., often their use is appropriate, added May. It’s also important to note, she said, that the study focused on antibiotic use in a hospital setting — where the circulating bacteria are far more likely to be multi-drug resistant than anything in the community.

Her best advice to patients: If you experience repeated antibiotic treatment failures, you should ask for a culture and sensitivity analysis.

“This involves taking a specimen, growing the bacterial agent and identifying it, and determining what antibiotics it is resistant or susceptible to,” she said. “This enables a clinician to make the best possible treatment choice to resolve the infection.”

It may mean a last-resort drug should be used. Other times it may mean that a different first-line drug would be effective. It is critical, May believes, that the most informed treatment choice possible is made.

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The United Nations General Assembly is holding a historic meeting Wednesday to discuss a plan to fight antibiotic-resistant superbugs.

Antimicrobial resistance (AMR) has become one of the biggest threats to global health and it endangers other major priorities, such as human development, the World Health Organization reports on its website. Worldwide, common infections are becoming resistant to the medicines used to treat them. The result? Longer illnesses and more deaths.

This is only the fourth time in the history of the U.N. that a health topic has been discussed at the General Assembly (HIV, noncommunicable diseases, and Ebola were the others).

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“By the year 2050, it’s been estimated that more people will die from these kinds of infections than die from cancer today,” said Keiji Fukuda, special representative for antimicrobial resistance in the office of the WHO’s director general, the CBC reported.