So-called “superbugs” — bacteria that are resistant to drugs — aren’t something to worry about for the future. They’re already here.
Thanks to decades of unmitigated use of antibiotics and antibacterial products, 35,000 people in the US die each year from infections that are immune to treatment, according to the Centers for Disease Control and Prevention (CDC). And while that number has actually declined by 28% since 2012, a new study published in the BMJ found that up to 43% of antibiotic prescriptions in the US are either unnecessary or “inappropriate.”
Antibiotics are antibacterial agents designed to eradicate bacterial infections or, at least, prevent multiplying — a fact that hasn’t stopped many doctors from prescribing the drugs even for viral illnesses, such as the flu, which antibiotics do not treat. As a result, the viral pathogen remains untouched. Meanwhile, bacteria already present in the body become exposed to the drugs, giving them another opportunity to evolve and strengthen their defenses against medicine.
Study authors analyzed notes from more than 28,000 outpatient appointments during 2015 using data from the National Ambulatory Medical Care Survey, which asks physicians to describe their patients’ visits and treatments during a specific period of time. They found that antibiotics were provided during 13.2% of these visits, and concluded that just 57% of those prescriptions were given correctly. However, another 25% of those patients were given antibiotics under false pretense, while doctors’ notes for the remaining 18% of cases were not clear enough to determine the effectiveness of the treatment. Doctors find this particularly worrisome.
“Antibiotic prescribing without making note of the indication in a patient’s medical records might be leading to a significant underestimation of the scope of unnecessary prescribing,” said Oregon State University researcher Michael Ray, who led the study. “When there’s no indication documented, it’s reasonable to think that at least some of the time, the prescription was written without an appropriate indication present.”
Researchers also found that medical specialists were more often to blame for wrongfully prescribing antibacterial drugs compared with primary care physicians.
The CDC also reports that some 2.8 million Americans each year contract antibiotic-resistant infections, including strains of gonorrhea, tuberculosis and bacterial pneumonia, and survive. Those illnesses then go on to become stronger and spread farther, forcing doctors to turn to increasingly aggressive treatments, which may come with their own health consequences.
For example, the growing threat of a “super” strain of gonorrhea has forced doctors to turn to the powerful drug ertapenem, an intravenous antibiotic used to treat the most severe bacterial infections. Possible side effects of ertapenem, according to the Mayo Clinic, include diarrhea, headache, depression, confusion and, ironically, infection.