Alarming increase in antibiotic failure rates

Alarming increase in antibiotic failure rates

Have you ever been prescribed an antibiotic that proved ineffective in treating an infection? If so, you are not alone. Widely prescribed, antibiotics are failing to defeat common infections and doing so at an alarming rate, according to a new study.

Researchers at Cardiff University found that the failure rate for antibiotics increased by 12 percent during a 22-year-period — from 1991 to 2012. The study, published in the British Medical Journal, examined 11 million courses of antibiotic treatments to measure how often the medication failed to treat four common illnesses – upper and lower respiratory tract infections, skin and soft tissue infections and middle-ear infections.

Data for the study were pulled from the Clinical Practice Research Datalink, a research database that encompasses nearly 700 primary care practices in the United Kingdom and includes drug prescriptions, medical history, test results and hospital referrals for more than 14 million patients.

Antibiotic treatment failure was defined when a patient required an alternative antibiotic drug within a month, admitted to the hospital due to an infection within 30 days, suffered complicating factors relating to infection or died from infection related conditions.

The Centers for Disease Control and Prevention estimates at least 2 million people are found to be resistant to antibiotics in the United States each year, and at least 230,000 people die each year as a direct result of their infections.

Lead researcher, Professor Craig Currie from Cardiff University, said, “There is a strong link between the rise in antibiotic treatment failure and an increase in prescriptions.”

“Between 2000 and 2012, the proportion of infections being treated with antibiotics rose from 60 percent to 65 percent. This is the same period in which we see the biggest increase in antibiotic failure rates. These episodes of failure were most striking when the antibiotic selected was not considered first choice for the condition treated.”

“More often than not, antibiotics are failing in outpatient settings because they are not being used to treat bacterial infections but viral infections, which does not become cured with antibiotics,” said Joseph Levato, pharmacy clinical coordinator at Advocate Christ Medical Center in Oak Lawn, Ill. “Symptoms of a virus and bacterial infection can overlap, which causes many patients to be given antibiotics to treat a viral infection.”

The data suggest that primary care physicians can help contain rises in antibiotic treatment failure by managing patients’ expectations and carefully considering whether each antibiotic prescription is justified, researchers conclude. If a decision is made to prescribe an antibiotic, the choice should follow current guidelines regarding first line drugs, study investigators say.

Dr. Stephen Sokalski, chief of infectious disease and epidemiology at Christ Medical Center, says the reason for antibiotic failure in a hospital setting is different than outpatient.

“When patients are critically ill and the cause of infection is unknown, an antibiotic might be given to the patient that isn’t effective in treating the bacteria and they must be switched to a different antibiotic. Critically ill patients will benefit from broad-spectrum antibiotics that combat a range of bacteria at the same time.”

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Comments

8 Comments

  1. Courtney Torres October 3, 2014 at 9:29 am · Reply

    It’s very scary to hear how patients are not able to get proper treatment with certain antibiotics.

  2. So what is the medical profession doing to solve this? Appears not much. some sort of penalty should be imposed on those prescribing antibiotics for viruses.

  3. Toni Mooney Gardner October 3, 2014 at 12:29 pm · Reply

    Excellent information!

  4. it would be interesting to know what part insurance companies play in this role as often the physicians first choice of antibiotic is not covered by the patients insurance plan forcing the phyician to change his plan of care.

  5. N…I have never, ever had an antibiotic not covered by my insurance plan, especially when there is a clear established protocol that the antibiotic prescribed is the ‘first line’ drug of choice.
    In fact, most pharmacies these days have FREE antibiotic programs.
    HOWEVER, since two of my children have antibiotic allergies, they quite often can’t receive the ‘first line’ drug of choice.
    My daughter, who was prone to respiratory infections in the early years of her life, developed a cephalosporin allergy and therefore could not be given Ancef, which is a ‘first line’ drug of choice for pneumonia in the hospital.
    My son (and I) are allergic to penicillin and that rules out many ‘first line’ drugs for both of us…
    I’d be MORE interested in what part OTHER factors come into play besides patient insurance.
    You have to realize that when there is a ‘first line’ drug of choice, it is usually well documented and has been around for a long time for treating illnesses. Insurance companies don’t usually have much to say/concern about those types of prescriptions. They are more concerned with the second and third tier choices of meds that have lesser proven success rates and higher price tags.
    I have spent a lot of years in the medical insurance claims industry, so I’m familiar with both sides of the issue…

  6. The problem is not the prescribing physicians, or the fact that I didn’t finish my course of antibiotics, the problem is that the corporations who raise animals used to feed us and give us milk are giving antibiotics to prevent disease in the animals because they are kept in such cramped quarters.We then eat and drink food and milk with low levels of antibiotics in them and we become immune to their effects. But let’s not blame corporate America. Ever wonder why kids are so big now, or girls start menstruating earlier? They give the animals steroids too. Much like whatever a pregnant woman ingests goes to the fetus or a mother breastfeeding passes on nicotine or alcohol to her child, the same is true of animals – why? We are all mammals, the biology is the same.

  7. I agree that antibiotics are probably overused, and have been for some time. My elder child is now 26, and every time she got otitis media as a child, she went on the “pink stuff” (Ceclor). It probably wasn’t necessary every time. I wish instead they had had some sort of symptomatic treatment that would alleviate the pain (Tylenol/Motrin didn’t touch it for her), and could just wait the infection out rather than giving antibiotics so readily.

    That said, I trusted my doctor then and still do.

    Agree also that they MUST stop feeding antibiotics to animals in such irresponsible ways. That will come back to bite us and maybe that day is already here.

    For that matter, why do we habitually say, “the patient failed the drug” (or choice of treatment) instead of “the drug failed the patient”?

  8. Thanks a lot for the blog article.Really thank you!

About the Author

Julie Nakis
Julie Nakis

Julie Nakis, health enews contributor, is manager of public affairs at Advocate Children's Hospital. She earned her BA in communications from the University of Iowa – Go Hawkeyes! In her free time, she enjoys spending time with friends and family, exploring the city and cheering on the Chicago Cubs and Blackhawks.