Sunday, January 19, 2014

Life in a post-antibiotic era: A scary time global emergence of pathogens resistant to a range of antimicrobial treatment is a reality threatening the foundations of modern medicine. The WHO, CDC, ministries of health, and NGOs around the world now warn of a post-antibiotic era:
If current trends continue unabated, the future is easy to predict. Some experts say we are moving back to the pre-antibiotic era. No. This will be a post-antibiotic era. In terms of new replacement antibiotics, the pipeline is virtually dry, especially for gram-negative bacteria. The cupboard is nearly bare. . . A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill. Some sophisticated interventions, like hip replacements, organ transplants, cancer chemotherapy, and care of preterm infants, would become far more difficult or even too dangerous to undertake.
The implications of this potential are astonishing, both in terms of health and economics. According to a recent CDC report, already each year in the US at least 2 million people acquire serious bacterial infections resistant to one or more antibiotics. More than 23,000 people die each year as a direct result of these infections, and many more succumb from conditions complicated by resistant infections. As resistance becomes more prevalent, these numbers will only increase.

While the total economic cost of antibiotic resistance to the US economy has been difficult to calculate, estimates quoted in the CDC report are as high as $20 billion in excess direct healthcare costs, with additional costs to society for lost productivity as high as $35 billion a year (in 2008 dollars). Other nations suffer similar or worse impacts. We can only expect that the costs will increase as infections resistant to antibiotics increase in incidence. 

I recently came across a report from the World Economic Forum, Global Risks 2013, that explores the issue of antibiotic resistance from a global economic perspective. The study frames many of the issues thoughtfully, and proposes some macro-level actions. Getting the issue before world leaders who have the power to do something in response to the threat, such as the members of the WEF, is a good first step. Although not a topic on the agenda for this week's meeting, hopefully, some of the conversation in Davos will include how to make progress against the threat of antibiotic resistance. A sustainable global approach might avert the looming disaster. A post-antibiotic era must be averted.    

(image source: Wikipedia)

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