Prudent Use of Antibiotics Key to Halting Drug-Resistant Bacteria

While powerful, broad-spectrum antibiotic medications have helped eradicate numerous types of bacterial infections over the past two decades, their widespread use since the 1980s has led to the rise of new bacteria strains that are resistant to commonly prescribed antibiotics. At a scientific symposium hosted by bioMerieux Inc. (St. Louis), infectious disease expert George Eliopoulos, director of office house staff affairs at Beth Israel Deaconess Medical Center (Boston) and associate professor of medicine at Harvard Medical School (Boston), encouraged physicians to use antibiotics judiciously and refrain from prescribing them unless clinically warranted.

"We're seeing disturbing problems with stubborn nocosomial infections due to bacteria like pseudemonas aeruginosa which are resistant to widely used third-generation cephalosporin antibiotics and quinolones," said Eliopoulos. "In the past, we could depend on these agents to be much more effective than they are now. As this trend continues, it means our health care system must invest more money for research to develop new anti-infective drugs and new resistance detection methods."

Eliopoulos further explained that as resistance problems increased in the 1990s, physicians relied more and more on vancomycin, a powerful antibiotic that normally is used when staphylococci bacteria are resistant to other antibiotics. The increasing numbers of resistant staph infections led to greater dependence on vancomycin, and eventually, the most frequent use of vancomycin was associated with new strains of resistant enterococci, another resistant bacterium.

Studies have shown that there are more than 250,000 cases of nocosomial pneumonia in US hospitals each year, adding almost $6,000 per case to hospital costs. And some forms of resistance may be difficult to detect by previously used methods. "We're learning an expensive lesson that the old rules for interpreting lab results in this area sometimes no longer apply," said Eliopoulos.

Until medical science discovers exactly how antibiotics foster resistance, Eliopoulos hopes the introduction of new antibiotics in the near future and the development of more sensitive lab tests to detect resistance will stem the tide of resistant bacteria. "To control the problem today, we strongly urge prudent use of antibiotics, especially vancomycin, and greater emphasis on educating medical staff about infection control practices," he said. "I'm encouraged, however, that primary care doctors are informing their patients about potential resistance problems associated with antibiotic therapy, and patients are beginning to understand that antibiotics have their drawbacks."

bioMerieux Inc. specializes in infectious disease diagnostics and industrial microbiological controls.

For more information: Albert A. Luderer, Senior VP of Research, Development, and Business Development, bioMerieux Inc., 595 Anglum Dr., Hazelwood, MO 63042-2395. Tel: 314-731-8500. Fax: 314-731-8700.