History Repeats

From the New England Journal of Medicine, an excerpt...

Antibiotic-Resistant Bugs in the 21st Century — A Clinical Super-Challenge
Cesar A. Arias, M.D., Ph.D., and Barbara E. Murray, M.D.

"In March 1942, a 33-year-old woman lay dying of streptococcal sepsis in a New Haven, Connecticut, hospital, and despite the best efforts of contemporary medical science, her doctors could not eradicate her bloodstream infection. Then they managed to obtain a small amount of a newly discovered substance called penicillin, which they cautiously injected into her. After repeated doses, her bloodstream was cleared of streptococci, she made a full recovery, and she went on to live to the age of 90.1 Sixty-six years after her startling recovery, a report2 described a 70-year-old man in San Francisco with endocarditis caused by vancomycin-resistant Enterococcus faecium (VRE). Despite the administration, for many days, of the best antibiotics available for combating VRE, physicians were unable to sterilize the patient's blood, and he died still bacteremic. We have come almost full circle and arrived at a point as frightening as the preantibiotic era: for patients infected with multidrug-resistant bacteria, there is no magic bullet."

Read the whole article at http://content.nejm.org/cgi/content/full/360/5/439?query=TOC

Interestingly, this is the headlining topic of the most recent FDA newsletter, just out, written for the public at large. Some excerpts...

Antibiotic Resistance: How Misuse of Antibiotics Could Threaten Your Health

• Antibiotics have saved countless lives but misuse and overuse of these medicines, have contributed to a phenomenon known as antibiotic resistance. This resistance develops when potentially harmful bacteria change in a way that reduces or eliminates the effectiveness of antibiotics.
  

• Antibiotic resistance is a growing public health concern worldwide. When a person is infected with an antibiotic-resistant bacterium, not only is treatment of that patient more difficult, but the antibiotic-resistant bacterium may spread to other people.

• When antibiotics don’t work, the result can be

* longer illnesses
* more complicated illnesses
* more doctor visits
* the use of stronger and more expensive medicines
* more deaths caused by bacterial infections

• Although antibiotics kill bacteria, they are not effective against viruses. Using antibiotics against viral infections

* will not cure the infection
* will not keep other individuals from catching the virus
* will not help a person feel better
* may cause unnecessary, harmful side effects
* may contribute to the development of antibiotic-resistant bacteria

Read the whole newsletter at http://www.fda.gov/cdrh/fdaandyou/issue16.html

Antibiotic overuse is a problem. The bacteria are winning.