Fighting the Rise of Antibiotic-Resistant Superbugs
If you’re sick and take medicine like an antibiotic, you expect it to work. What happens when it doesn’t? In the last 10 years, the rapid rise of resistant “superbugs” is a major cause of medications not working properly. Superbugs, also known as multi-drug-resistant microbes or germs, can cause serious infections that may become difficult or impossible to treat.
The pharmaceutical industry develops medications to destroy infectious microbes like bacteria, viruses, fungi, or parasites. While these microbes are typically wiped out by medications, antimicrobial resistance (AMR) means the medication may have little or no effect against the microbes. These microbes can then develop into superbugs. As superbugs continue to grow stronger, they can cause further infections and more symptoms. These symptoms can lead to other medical complications, longer hospital stays, and potentially even death.
Antibiotic medications account for most AMR cases compared to antifungals, antivirals, and anti-parasitic drugs. Over 40% of frontline antibiotics used to treat common urinary, gut, blood, and sexually transmitted bacterial infections have lost their effectiveness in the past five years. In the United States, 2.8 million antimicrobial infections occur each year, resulting in over 35,000 deaths and costing our health care system billions of dollars annually.
The risk of drug-resistant superbugs is highest in people with weakened immune systems, underlying chronic conditions, frequent hospitalizations, frequent antibiotic use, residents of long-term care or other health care facilities, and those working in health care settings.
Why is the resistance to superbugs growing?
These superbugs can learn resistance to medications by building physical shields against drugs, producing enzymes to block or break down drugs, and sharing crucial information they’ve learned with other microbes to join the fight against the drugs through gene sharing. It is estimated that almost 30% of antibiotic prescriptions are unnecessary and contribute to the rising levels of AMR. Overuse of antibiotics creates a “survival of the fittest” effect, which causes the stronger bacteria who survive the antibiotics to grow, learn, and thrive.
Antibiotic prescriptions spiked during the Covid pandemic, when they were commonly prescribed to help prevent a potential secondary infection. The risk of hospital-acquired AMR infections increased by 30% and continues to be higher than pre-Covid levels, as superbugs have become stronger and more resistant.
Antibiotic overuse also occurs if someone with a viral infection, such as the common cold or flu, is prescribed one. An antibiotic only works on a bacterial infection and is useless for killing a virus or helping decrease symptoms. Unnecessary antibiotic use can also destroy beneficial bacteria in the gut and may cause gastrointestinal symptoms.
Incomplete dosing can also lead to a higher risk of AMR. This happens when a person doesn’t take the full round of antibiotics, and the strongest bacteria may continue to live and multiply in the body.
Use and overuse of antibiotics in livestock and plant agriculture can increase AMR in humans as well. Another source of AMR infections comes from food products, especially when handling or eating meat, seafood, milk, or eggs that are undercooked or raw. In addition, untreated or unprocessed waste can also spread AMR.
While there are some new and promising antibiotics and other drugs in development, it is a small pipeline compared to the rising rate of superbugs. The development of antibiotics can take years, and the risk of failure can be high during clinical research or with manufacturing or regulatory hurdles. This also makes developing new antibiotics less attractive financially for pharmaceutical companies.
What are the ways to help prevent antimicrobial resistance?
The two main ways to fight superbugs are to stop germs from spreading and use medications the correct way.
Hand Hygiene
Hand hygiene is a first-line defense in stopping germs from spreading. Wash your hands frequently for 20 seconds with soap and water, especially before eating, after going to the bathroom, or handling raw meat, trash, or chemicals, to prevent spreading germs. While hand sanitizer can help, make sure to use a brand with 60-95% ethyl alcohol or isopropyl alcohol to effectively kill germs.
Food Safety
Superbugs in our food supply include salmonella, Escherichia coli (E. coli), and shigella. Tips to prevent food borne illness include cooking meat to appropriate temperatures, washing produce thoroughly, avoiding cross contamination during food prep, refrigerating foods promptly, and storing foods properly. Staying up to date on food recalls is also important. Information on recalls can be found at fda.gov/safety/recalls-market-withdrawals-safety-alerts.
Vaccinations
Stay up to date with vaccinations such as flu, RSV, and pneumonia to help prevent bacterial and viral infections.
Practice Safe Sex
Barrier methods, such as the use of condoms, lower the risk of drug-resistant sexually transmitted infections, including drug-resistant gonorrhea.
Be Wise with Antibiotic Use
Use antibiotics wisely to avoid overuse. You should not take antibiotics for viruses such as colds, flu, and most coughs. Talk to your provider about holding off on antibiotics if they think the infection might be viral and consider watchful waiting. The watch-and-wait approach is to monitor symptoms for two to three days to see if symptoms start to subside. Your provider may offer a delayed antibiotic prescription that can be filled later if symptoms are not improving. This strategy can be helpful for earaches, sinus infections, and some severe colds and coughs.
It is also important to finish the entire prescription of antibiotics, even if you feel better. Stopping early means the strongest bacteria can survive, multiply, and cause the sickness to return. It can also help the bacteria learn to fight the medicine, so it doesn’t work as well, or at all, the next time it’s prescribed.
Don’t share or use someone else’s antibiotics. It’s illegal, and sharing or taking unused antibiotics increases the risk of AMR, as it exposes the microbes to a low or incorrect dosing, allowing surviving germs to adapt and resist future treatments.
Reducing the risk of AMR takes a combined effort of the pharmaceutical industry to continue to develop new and effective medications, and health care organizations to prioritize safe and proper medication prescribing, compliance, and best practices for infection prevention and treatment. As individuals, using medications responsibly and preventing infections before they start are two important ways to keep our immune systems strong and more capable of winning the fight against superbugs.
