Antibiotic resistance poses growing threat to fragile health systems

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cddepWhile one of the most significant life-saving medical breakthroughs of the last century, the use of antibiotics to fight and prevent infections is becoming one of the greatest medical challenges in this century, including, at growing rates, in countries least equipped to monitor and respond to new health threats, a report released today says.

The report, The State of the World’s Antibiotics 2015 from the Center for Disease Dynamics, Economics & Policy, tracks trends of growing antibiotic resistant strains of bacteria, including those causing MRSA (methicilin-resistant Staphylococcus aureus), diarrheal diseases, gonorrhea, salmonella, pneumonia and bronchitis, in high-income countries as well as low-and-middle income countries. In the latter category, the report notes, the problem, as well as the need for capacities to address it, is just beginning to be recognized.

The report attributes the growing problem to two factors — increasing use of antibiotics in humans, and in animals. It notes that rising incomes worldwide have led to greater availability of antibiotics which in turn leads to more widespread use, both appropriate, and inappropriate, and while appropriate use can be life-saving, inappropriate use feeds resistance. In addition, the report says, increased demand for meat products has led to more antibiotic use in agriculture, again fueling resistance in humans.

The report estimates that antibiotic resistance causes 23,000 deaths  in the U.S. alone, and 25,000 deaths in Europe annually, and notes that data on the incidence, toll and costs of antibiotic resistance in Africa are hard to come by. It refers, however, to study results indicating that resistant infections are adding to infant and child death rates in Tanzania and Mozambique, and cites rising rates of antibiotic resistant gonorrhea in Uganda, Tanzania and Ghana, and the spread in Africa of multidrug resistant typhoid and Salmonella, In Nigeria, the report says, 43 percent of hospitalized HIV patients in had C. difficile, bacteria that causes diarrhea, is naturally resistant to antibiotics, and proliferates when antibiotics kill beneficial bacteria in the intestinal tract .

Overuse of the drugs in hospitals to compensate for lack of standard infection control capacities contributes to antibiotic resistance, the report says. Among the six measures recommended in the report to counter antibiotic resistance are improvements in water, sanitation, vaccine coverage, information to health workers and policymakers and hospital infection control capacities and practices.

The report was released along with an interactive ResistanceMap, showing trends of antibiotic resistance by bacteria, antibiotic use, and by country.

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