Friday, March 16, 2012

The post-antibiotic era isn’t coming soon. It is already here.


A speech Margaret Chan gave in Copenhagen recently is now attracting media attention. One semantic point—we should stop talking about the post-antibiotic era as if it were in the future. For the ICU patient dying of pan-resistant Pseudomonas pneumonia, or the person removed from a transplant list due to pan-resistant Acinetobacter infection, the post-antibiotic era is now!

As you read Dr. Chan’s address, which focuses on EU efforts, think about how our fragmented healthcare system and dysfunctional political environment affect efforts to prevent and control resistance. Are you interested in tracking how antibiotics are used in the United States? Sorry, we don’t have those data. Would it be useful to expand our surveillance for antimicrobial resistance to a truly nationwide program? Nah, that won’t happen—CDC and public health budget cuts may make it impossible to sustain even the existing Emerging Infections Program. Would you like to see more funding of research to determine which prevention approaches are most effective, and which antibiotic treatments provide the best outcomes (and which are unnecessary)? Not likely, in the current climate.

In combination with underfunding of prevention, the current political hysteria over the Affordable Care Act is likely to have a major negative impact on antimicrobial stewardship and antimicrobial resistance control. The current opposition narrative—where any suggestion that “less is more” is a hidden agenda to install death panels to kill us all (“no antibiotics for you!”)—is anathema to good antimicrobial stewardship.

1 comment:

  1. I was contacted by a national daily newspaper about this. Need to ensure a measured educational message is put over otherwise "you will die from a sore throat soon" is what is heard and reported!

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