Antibiotic Resistance and its Impact on Persons With Diabetes People with diabetes develop common infections at different rates than non …
Antibiotic Resistance and its Impact on Persons With Diabetes
For more than half a century, antibiotic drugs have ensured that
potentially life-threatening bacterial infections are treatable Today,
however, more and more bacterial infections fail to respond to antibiotic
treatment A federal task force recently warned that antibiotic resistance
is a growing menace to all people and concluded that if nothing is done,
treatments for common infections will become increasingly limited and
expensive-and, in some cases, nonexistent
Antibiotic resistance poses a threat to everyone, but people with diabetes
are at particular risk Diabetes has become an epidemic illness in the
United States affecting approximately 16 million people It is now the
seventh leading cause of mortality in this country, causing nearly 200,000
deaths annually It is an illness that can be treated, but not cured
People with diabetes develop common infections at different rates than non-
diabetics, and these infections are often more serious Diabetics also
develop types of infections that differ from those encountered by non-
diabetic people For example, nearly 30,000 diabetics die each year
from
complications of the flu and pneumonia, nearly three times the mortality
rate in people without the disease Often, when a diabetic contracts
pneumonia, the bacterium causing this illness is a more dangerous strain
than the ones affecting non-diabetics Many serious illnesses, such as
Salmonella and others, that affect diabetics, tend to be multi-drug
resistant making treatment all the more difficult
Finally, some diabetics have greater problems with skin and soft-tissue
infections, such as chronic foot ulcers and infection of the underlying
bone, because diabetes can limit blood flow and the bodys ability to fight
infection As a result, diabetic patients may require weeks or months of
broad-spectrum antibiotics The viability of such antibiotics therefore is
critical to this vulnerable population
Although careful use of antibiotics can result in the emergence of
antibiotic-resistant bacteria, inappropriate use greatly accelerates this
process The more often bacteria are exposed to antibiotics, the more
resistant they become Because bacteria reproduce rapidly, these antibiotic-
resistant bacteria can spread efficiently Unlike higher organisms,
bacteria can transfer DNA to
other bacteria that are not their offspring,
and even to members of completely unrelated bacterial species In effect,
bacteria can teach one another how to outwit antibiotics
Antibiotic resistance carries a significant economic toll as well as a
medical one The congressional Office of Technology Assessment calculated
that resistance in just six types of bacteria increased hospital treatment
costs by 13 billion as of 1995 Few new drugs are now in the pipeline,
and any new antibiotics will be considerably more expensive than
existing ones; research and development costs for a new drug may top 800
million, by some estimates, while prescription costs are likely to far
exceed those for older, generic medicines
Although the misuse of antibiotics in human medicine has been well
publicized, less attention has been paid to the serious overuse of
antibiotics in agriculture By one estimate, 80 percent of all antibiotics
and related drugs antimicrobials sold in the United States are used in
livestock production The lions share-roughly 70 percent of the total-are
fed to healthy farm animals to promote growth and prevent diseases that
would otherwise result from the unsanitary conditions
found in overcrowded
agricultural facilities About half of those drugs are identical or
closely related to medicines used in treating humans
Because of the growing health crisis of antibiotic resistance, which could
render these wonder drugs useless in treating infections, the American
Medical Association now opposes the routine feeding of antibiotics to
healthy farm animals The American College of Preventive Medicine, the
American Public Health Association, and the World Health Organization have
taken similar positions A National Academy of Sciences report estimates
that eliminating all such uses in poultry, cow, and swine production would
cost US consumers only about 5 to 10 per person annually
The Centers for Disease Control and Prevention has observed that
decreasing inappropriate antibiotic use is the best way to control
resistance Key steps in doing so include adoption of policies aimed at
ending the inappropriate use of antibiotics in agriculture, as well as
continued implementation of programs to educate patients, parents and
physicians about the need to use antibiotics more sparingly
In particular:
Congress should phase out the routine feeding of medically
important
antibiotics to healthy livestock and poultry and other inappropriate uses
of vital antibiotics in agriculture S 2508, introduced by Sen Edward
M Kennedy, and HR 3804, introduced by Rep Sherrod Brown, would
accomplish these objectives
Producers and marketers of meat and poultry should voluntarily agree to
stop selling or buying meat produced with routine feeding of antibiotics
to healthy animals, and pharmaceutical companies should stop producing
antibiotics for such use in animals
Finally, those who decide which meat products to purchase - whether an
individual shopper buying a few pounds of meat during a weekly trip to
the grocery store, or a food-service corporation that purchases millions
of pounds in a single transaction - should select meat produced without
the inappropriate use of antibiotics
Unless we act now, we face a future of untreatable bacterial infections
Persons with diabetes will be among the first to pay the price
For a full report on antibiotic resistance and vulnerable groups, see
wwwkeepantibioticsworkingcom/vulnerable
