The Antibiotics Crisis

We've all probably taken antibiotics at some point, and given it little thought. When an illness has gone on for a little too long, these miracle drugs often seem like a harmless magic bullet, able to cure anything. Some have even called antibiotics the greatest medical advance ever. But now, public health officials are warning that our decades-long love affair with these drugs is rendering them useless. When one doesn't work, we are given another. Increasingly, however, doctors are running out of options.

"Crisis" is not too strong a word for describing what has happened to antibiotics. As our use of the drugs rises every year in the United States, bacterial resistance has risen right alongside it: there isn't a single known antibiotic to which bacteria have not become resistant.

As just one example: staphylococcus aureus, or a staph infection, has become ever harder to treat. Staph bacteria can spread like mildew in a damp basement in hospitals when equipment, clothing, or even hands aren't washed and sterilized properly. (Hospitals are loath to admit it, but this happens in every hospital in the United States -- even in the very best ones.) There was a time, a long time, when staph could be knocked out almost immediately by antibiotics. These days, there's no guarantee that any antibiotic can save you.

Every year, more than ninety thousand Americans die from similar infections that have become resistant to antibiotics. That stunning figure is higher than the death toll from AIDS, car accidents and prostate cancer combined.

Seven decades since the discovery of antibiotics, it's clear that science still cannot keep pace with bacteria. Dr. Stuart Levy, a professor of molecular biology at the Tufts School of Medicine and one of the world's leading medical authorities on antibiotics, says the cause of the crisis is not in dispute: we are simply using too many antibiotics.

And the place where this is happening most often is in the primary care office. Some of the reasons are obvious: antibiotics seem like a quick fix; doctors are frequently in a rush and it's easy to write a prescription; doctors may think it's better to be "safe than sorry." But Dr. Rita Mangione-Smith, an investigator at the Seattle Children's Hospital Research Institute, says the real reasons are more subtle than that. "When a physician believes a parent wants an antibiotic, they are significantly more likely to inappropriately prescribe," she said. And that has a lot to do with American consumer culture, and the view of patients as "customers." "There's a huge amount of concern among physicians that their patients have high levels of satisfaction," said Mangione-Smith. Otherwise, "they'll leave your practice and go somewhere else."

And people aren't the only ones taking too many antibiotics. About seventy percent of all antibiotics purchased in the United States are for farm animals, which are fed these drugs by the ton in order to help them to grow faster. But bacteria in animals can develop resistance just like in humans, and this resistance can spread into the community.

But while the threat of resistance continues to escalate in the U.S., HDNet's "Dan Rather Reports" program found a different tact in Norway. That country some time ago embarked on a nationwide education and regulation drive to greatly reduce antibiotic use for both people and animals. Norwegian doctors boast that patients there use just one-third of the antibiotics, per person, as Americans do. In real world terms, that's making a huge difference: Norway has the lowest rate of antibiotic resistant infections in the developed world.

This demonstrates, Norwegian specialists say, what can -- and must -- be done. Bacteria's winning momentum in the war against antibiotics can be reversed, but only if the world acts, and acts quickly.

Dan Rather Reports airs Tuesdays on HDNet at 8 p.m. and 11 p.m. ET