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Antibiotic resistance a growing threat, WHO reports

World Health logo
 

Improper drug use to blame

June 12, 2000
Web posted at: 12:15 p.m. EDT (1615 GMT)

WASHINGTON (CNN) -- Sore throats and ear infections, ailments once easily treatable, may soon become immune to antibiotics, as malaria and tuberculosis have become in some countries, officials of the World Health Organization said Monday.

WHO's annual report on infectious diseases, "Overcoming Antimicrobial Resistance," paints a comprehensive picture of the dwindling effect penicillin and other antibiotics have in fighting once simple bacterial infections.

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People throughout the world "may only have a decade or two to make use of many of the medicines presently available to stop infectious diseases," said Dr. David Heymann, executive director of WHO's program on communicable diseases.

Better strategies for drug treatment needed

WHO officials said poorly planned or haphazard use of medicines has caused drugs to lose effectiveness almost as quickly as scientists have been able to discover them.

Antimicrobial resistance is a naturally occurring biological phenomenon -- bugs develop resistance to drugs that don't kill them -- but the process is amplified by misuse and neglect of antimicrobial drugs. Antimicrobial resistance can reduce the power of once life-saving medicines to that of a sugar pill.

"We currently have effective medicines to cure almost every major infectious disease," said Dr. Gro Harlem Brundtland, WHO's director-general. "But we risk losing these valuable drugs and our opportunity to eventually control many infectious diseases because of increasing antimicrobial resistance."

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In developing countries, resistance commonly stems from under-use of drugs, WHO officials said. For example, some patients may begin an antibiotic regimen, begin to feel better before finishing all of the medicine, then save the remaining tablets for another time because of high cost. Surviving microbes in the body are then able to build immunity to these drugs.

In the United States, the situation stems from overuse. Officials of the Centers for Disease Control and Prevention (CDC) have estimated one-third of the 150 million prescriptions written for antibiotics each year are unnecessary, resulting in bacterial strains that become tougher than the antibiotics being used against them.

About 14,000 people are infected and die each year as a result of drug-resistant microbes picked up in U.S. hospitals, WHO reported. Globally, WHO said drug-resistant bacteria account for up to 60 percent of hospital-acquired infections.

Farm, household uses contribute to problem

Overusing antibiotics in food production in wealthy countries also contributes to increased drug resistance, according to the WHO report. About 50 percent of antibiotic production is used to treat sick animals and encourage growth in livestock and poultry.

Another area of concern in the United States is the quest for a germ-free home. Many Americans consistently use antibacterial soaps and solutions to clean their hands and homes. Physicians at the CDC have said regular soap and water is effective protection.

Members of the American Medical Association are meeting in Chicago to discuss the issue and may issue a recommendation to discontinue use of these solutions at home.

Major diseases becoming resistant

The WHO report describes how almost all major infectious diseases are slowly becoming resistant to existing medicines. For example, in Estonia, Latvia and parts of Russia and China, more than 10 percent of tuberculosis patients have strains resistant to two of the most powerful TB medicines.

Doctors in Thailand are now unable to use three of the most common antimalaria drugs. Elsewhere in Southeast Asia, resistance to penicillin has been reported in 98 percent of gonorrhea strains. Typhoid was cured 10 years ago by three inexpensive drugs. Now those drugs are largely ineffective, said the WHO report.

The most effective strategy, the report concludes, is to "get the job done right the first time" by killing microbes before they can develop resistance.

To achieve that goal, doctors in poorer countries must encourage patients to finish their medications and doctors in wealthier countries must prescribe antibiotics only when necessary, said WHO officials.

"If the world fails to mount a more serious effort to fight infectious diseases, antimicrobial resistance will increasingly threaten to send the world back to a pre-antibiotic age," said Brundtland.



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RELATED SITES:
World Health Organization
U.S. Centers for Disease Control and Prevention


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