CDC's Associate Director: We’ve Reached ‘The End of Antibiotics, Period’
The associate director of the Centers for Disease Control and Prevention, Dr. Arjun Srinivasan, says there is no longer any question that we’ve reached “the end of antibiotics period.”
We have overmedicated humans and livestock to the point that bacteria have grown so resistant to antibiotics that we are now in “the post-antibiotic era,” Srinivasan told PBS’s “Frontline.”
“There are patients for whom we have no therapy, and we are literally in a position of having a patient in a bed who has an infection, something that five years ago even we could have treated, but now we can’t,” he said.
Without the advent of antibiotics there would be no organ transplants, bone marrow transplants, chemotherapy, or stem cell transplants. Patients requiring these kinds of treatment have weakened immune systems and are highly vulnerable to infection. Any medical treatment that lowers immunity would be extremely risky without antibiotics.
“So they have really transformed the practice of medicine, perhaps unlike any other drug that’s available to us,” explained Srinivasan.
But bacteria evolves and quickly solves the roadblocks we put in front of it. This is why doctors warn about over-prescribing antibiotics to patients. The more we give bacteria to work with, the more quickly it evolves and becomes drug resistant.
“The more you use an antibiotic, the more you expose a bacteria to an antibiotic, the greater the likelihood that resistance to that antibiotic is going to develop. So the more antibiotics we put into people, we put into the environment, we put into livestock, the more opportunities we create for these bacteria to become resistant,” said Srinivasan.
“We also know that we’ve greatly overused antibiotics and in overusing these antibiotics, we have set ourselves up for the scenario that we find ourselves in now, where we’re running out of antibiotics,” he added.
He used Methicillin-resistant Staphylococcus aureus (MRSA) as an example. The bacteria is often picked up by people living in close quarters like dormitories, gyms, shelters, even military recruits in basic training. A current outbreak in Florida infected three players for the NFL’s Tampa Bay Buccaneers. Once solved by beta-lactam antibiotics, MRSA is only responsive to one antibiotic today.
He said doctors desperately reaching for old antibiotics that are less safe than newer generations.
“We’re using a lot of colistin,” he said. “And we’re using more of it every year. It’s very toxic. We don’t like to use it. It damages the kidneys. But we’re forced to use it in a lot of instances.”
The strain seen today is very different from the same infection from a decade ago.
“In hospitals, when you see MRSA infections, you oftentimes see that in patients who have a catheter in their blood, and that creates an opportunity for MRSA to get into their bloodstream,” said Srinivasan. “In the community, it was causing a very different type of infection. It was causing a lot of very, very serious and painful infections of the skin, which was completely different from what we would see in health care.”
He called for strict regulation and stronger leadership on the issue.
“We’re not doing it enough. We know that there’s a lot of overuse, of misuse of antibiotics, and what’s discouraging about that is it’s been an issue for a very long time,” he said.