Doctors Are Losing the Fight Against "Superbugs"

The Center for Global Development in Washington, D.C., warned that doctors are rapidly losing their ability to treat “superbugs,” as well as far more common diseases, due to the rapid increase in resistance to antibiotic drugs.

In a report released this week, the nonprofit policy-research group urged the World Health Organization to take the lead in reversing what it calls "a decade of neglect of drug resistance." The CGD also called on physicians, drug companies, governments, and philanthropies to get more involved in the fight.

"Drug resistance is a natural occurrence, but careless practices in drug supply and use are hastening it unnecessarily," Rachel Nugent, chairwoman of the CGD group that issued the report, said in a statement.

Methicillin-resistant staphylococcus aureus, or MRSA, the so-called superbug that has killed thousands of patients worldwide over the past three decades, is virtually non-existent in Norway. There, less than 1 percent of all staph infections are due to the bacteria, making Norway’s MRSA rates the lowest in the world.

In comparison, almost two-thirds of all staph infections in the U.S. are due to MRSA. In fact, more people in the U.S. die each year from MRSA than HIV/AIDS. In Japan, which has the world’s highest MRSA rates, 80 percent of all staph infections are due to MRSA, and in the U.K. the rate is 45 percent. MRSA also added about $6 billion to U.S. healthcare costs in 2009.

Norway’s stunning ant-MRSA efforts began 25 years ago. Since then, Norwegian doctors have drastically cut the number of antibiotics they prescribe, so patients are far less likely to develop resistance to the drugs. The World Health Organization has described antibiotic resistance as one of the world’s primary public health threats. Overuse has caused mutations in many diseases, including MRSA, making the conditions harder and, in some cases, impossible to treat.

Norwegian hospitals routinely screen incoming hospital patients and isolate those with MRSA. Medical staff members are also routinely checked for MRSA infections and those who test positive are ordered to stay home from work.

Various programs that use one or both of those techniques have resulted in dramatic declines in MRSA infections, showing that it may be possible to bring the Norwegian disease-control program to other countries. A hospital in the U.K. that cut back on antibiotic use saw a drop in MRSA cases from 45 to one in just five years, while a screening program in U.S. Veterans Affairs hospitals has resulted in a 50 percent reduction in MRSA infections.

According to the CGD, there is a strong link between the volume of drug use and emergence of drug resistance, particularly in settings with weak safeguards for appropriate use and monitoring of effectiveness. “In countries where people consume the highest amounts of antibiotics, 75 to 90 percent of strep pneumoniae strains are already drug-resistant,” according to the report.

The CGD urged prescribers and patients to be more diligent in using medications appropriately.

To combat drug resistance, the federal Centers for Disease Control offers a set of tools and guidelines for clinicians to prevent drug resistance in various healthcare settings. The American College of Physicians also urges doctors to change their prescribing practices and only prescribe antibiotics for patients when a bacterial infection is present. It acknowledges, however, that that can be be difficult because patients so often demand that their doctors prescribe antibiotics when they are not needed. This ACP brochure can help explain the need for caution to your patients, and inform them on the proper way to use antibiotic drugs.