Antibiotic resistance threatens to reverse gains in life expectancy and undermine surgical advances like joint replacements — and misconceptions about the problem may be making it worse, the World Health Organization warned on Monday.
A multi-country survey conducted by the WHO uncovered dismaying — and dangerous — misunderstandings about the problem, which arises when bacteria mutate into new strains that can withstand most or all the antibiotics in the modern medicine chest. Those bacteria, often dubbed “superbugs,” can be deadly.
Concerted action is needed to stem the rising tide of resistance, the Geneva-based global health agency said. Without it, some procedures that are now routine in health care may be too risky to undertake, said Dr. Keiji Fukuda, the WHO’s special representative for antimicrobial resistance.
“Antibiotics are really one of the miracles of the time that we live in. They are a global good. And they are also a global good that we cannot take for granted,” Fukuda told reporters.
“By reducing the ability to handle infections, we are really talking about the ability to treat many chronic diseases — diseases like diabetes, like cancer. Patients who have these kinds of diseases are susceptible to infections. … Consequently people are going to have infections for longer. More people are going to die. It’s going to cost more.”
Resistant bacteria cause 23,000 deaths and more than 2 million illnesses in the US each year, according to the Centers for Disease Control and Prevention. A British report last year predicted the global death toll from superbugs could reach 10 million a year by 2050.
The WHO survey found people don’t understand the problem. A third of survey respondents thought they should stop taking an antibiotic prescription when they start to feel better — a practice that helps to drive resistance, because bacteria that haven’t been killed by the initial doses may multiply and mutate.
Overuse of antibiotics also spurs resistance, and the survey found more troubling news in that arena: Nearly two-thirds of respondents thought antibiotics were effective treatments for colds and the flu, even though those illnesses are caused by viruses — which are immune to the drugs. And one-quarter of respondents felt it was OK to take antibiotics that had been prescribed for someone else, as long as they were being used to treat the same illness.
Other questions revealed that respondents didn’t understand how resistance works. Two-thirds thought people who take their drugs correctly are not at risk, and 44 percent felt that that resistance is only a problem for people who regularly take antibiotics. In fact, a person who has never taken antibiotics could be infected with a resistant strain of bacteria and so could a person who only takes the drugs as directed.
The way resistance plays out also eluded most people, with 76 percent believing it means antibiotics stop working for them because their bodies become resistant to the drugs. In fact, it’s the bacteria that become resistant. They can then spread to infect other people.
The survey did suggest that people are open to potential solutions. Seventy-three percent of respondents said farmers should reduce the amounts of antibiotics used in food production. Agricultural use of antibiotics is enormous, exceeding human use many times over. The drugs are mostly used to promote growth of livestock, not to treat sick animals.
A few countries — Denmark and the Netherlands among them — have stopped using antibiotics as growth promoters, said WHO’s director-general, Dr. Margaret Chan, who noted farmers are able to charge premium prices for their meat as a result.
Fukuda said the WHO hopes to see signs of progress over the next five to 10 years, with countries uniformly adopting good practices for the prescription and use of antibiotics. That should lead to a decline in the numbers of people hospitalized with and deaths caused by antibiotic resistant infections. But he cautioned there is tough slogging ahead.
“To turn this around in all parts of the world is going to take us decades. And it’s not going to be a one-time action. We’re going to have to sustain it. It’s basically a race against the pathogens that we deal with,” Fukuda said.
The survey was completed by more than 10,000 people in 12 countries. Two countries from each of the WHO’s six regional divisions were selected to be surveyed. The United States was not among the countries selected.