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What is Antibiotic Resistance and Why is it a Problem?

Author: Tyler Merkeley, M.S. MBA, Broad Spectrum Antimicrobials (BSA) Program, Division of CBRN Countermeasures , Biomedical Advanced Research and Development Authority (BARDA), Office of Assistant Secretary for Preparedness and Response (ASPR)
Published Date: 6/10/2014 10:14:00 AM
Category: Medical Countermeasures; Public Health Preparedness;

Author: Tyler Merkeley, M.S. MBA, Broad Spectrum Antimicrobials (BSA) Program, Division of CBRN Countermeasures , Biomedical Advanced Research and Development Authority (BARDA), Office of Assistant Secretary for Preparedness and Response (ASPR)

Antibiotics are drugs that are used to treat bacterial infections. They work by killing or slowing the growth of bacteria. (Antibiotics have no effect on viruses or fungi. Drugs used to treat viral and fungal infections are referred to as antiviral and antifungal medications, respectively.).

Antibiotics are frequently prescribed by health practitioners to treat common infections in both out-patient and hospital settings. Unfortunately, bacteria have the ability to change or evolve so that they no longer respond to the antibiotic (in other words become antibiotic resistant) and, as a result, the drug becomes useless in treating the infection.
Screenshot of video embed for PBS Hunting the Nightmare Bacteria
Antibiotic resistant bacteria have caused infections across the country and across the globe. The number of these infections is increasing and the number of antibiotics that some bacteria are resistant to is also increasing to the point where some infections have been caused by bacteria that are resistant to every available antibiotic.

Antibiotic resistance will have a profound impact on the standard practice of medicine. Imagine a day when a simple cut on your hand or a basic cough leads to a life-threatening infection and your doctors have few or no antibiotics to treat your infection. Effective antibiotics are crucial to the practice of modern medicine. Without effective antibiotics, minor operations, cancer treatment, and many other medical treatments would be associated with much greater risk of dying due to infections that can no longer be treated. In addition, antibiotic resistance has the potential to complicate the response to public health emergencies such as hurricanes, earthquakes or influenza pandemics. Unfortunately, because of economic factors, very few pharmaceutical companies have active antibiotic development programs and the number of drugs in the development pipeline has declined sharply in recent decades.

The Centers for Disease Control and Prevention (CDC) released a report last year entitled, Antimicrobial Resistance Threats in the United States 2013, which reported that antibiotic resistant infections infect 2 million patients per year in the United States and cause 23,000 deaths annually. The economic impact of these infections is currently estimated at $20-35 billion annually and may climb higher as rates of antibiotic resistant infections increase. The report ranks the public health threat that specific drug resistant pathogens pose and classifies these threats, from highest to lowest threat, as “Urgent”, “Serious”, or “Concerning”. 

Urgent Threats

Source: Ranking and estimates provided from the CDC Report: Antimicrobial Resistance Threats in the United States 2013

Clostridium difficile.  Image courtesy of CDC Public Health Image Library.
Clostridium difficile ​Infections: 250,000 per year
Deaths: 14,000
Excess Medical Costs: $1,000,000,000 per year
Carbapenem-resistant Enterobacteriaceae.  Image courtesy of CDC Public Health Image Library.
Carbapenem-resistant Enterobacteriaceae ​Infections: 9,000 per year
Deaths: 600
Drug-resistant Neisseria gonorrhoeae.  Image courtesy of CDC Public Health Image Library.
Drug-resistant Neisseria gonorrhoeae ​Infections: 246,000 per year

As part of the response to this threat, ASPR’s Biomedical Advanced Research and Development Authority (BARDA) is partnering with industry to develop new antibiotics that will enhance our nation’s arsenal against antibiotic resistant organisms.

We face a perfect storm: a growing number of increasingly fierce bacteria amidst a decrease in the number of pharmaceutical companies engaged in antibiotic development. The list of approved antibiotics and the current antibiotic pipeline of new antibacterial drugs to treat these infections is insufficient to fully respond to this threat.

To counter these concerning trends, BARDA has been supporting the development of novel antibacterial therapies to treat life threatening drug resistant infections by establishing public-private partnerships with pharmaceutical and biotechnology companies. BARDA initiated these efforts in 2010 and they are beginning to show real progress.

Over the next few months, we will continue our series on “Combatting Antibiotic Resistance,” with an overview of BARDA's Broad Spectrum Antimicrobials (BSA) program; the type of incentives BARDA is using to revitalize the pipeline; our vision for the future, and ways you or your organization can help enhance our nation’s preparedness and response to this threat. To stay up to date as new blog posts are published, subscribe to the ASPR Blog RSS feed, follow @PHEgov on Twitter or Like us on Facebook.

 

 

 

 


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