By Brenda Flanagan
This IV’s dripping one of medicine’s most powerful antibiotics into Sally Hindes’ arm: Daptomycin. She’ll need 35 infusion treatments.
“It’s inconvenient, but if it’s going to cure my infection, that’s what I have to do,” said Hindes.
“She has an infection and this antibiotic is extremely important for her,” said Nathan Hindes, her husband.
It’s important because Daptomycin is a weapon of last resort in the never-ending arms race that pits antibiotics against bacteria that constantly evolve ways to beat the latest medicine. Dr. Ted Louie says physicians often encounter these superbugs, especially when treating elderly patients.
“They’re placed on the usual oral antibiotic and then it doesn’t work so they wind up in the hospital, and we have to pull up the stronger IV stuff, OK. So this happens a lot. If I lose that one antibiotic that works, then I have nothing left. So it’s fairly scary,” Louie said.
The Centers for Disease Control report antibiotic-resistant bacteria kill more than 23,000 people a year in the U.S.
The World Health Organization noted, “The rise in antibiotic resistance stems from how we are using – and misusing – these medicines” and this week launched a counter offensive. The organization ranked antibiotics into three categories ranging from commonly prescribed meds like amoxicillin to drugs like Daptomycin, that it recommends should be reserved only for the toughest cases. Dr. Louie agrees.
“If a bacteria’s resistant to every single antibiotic then we have nothing to offer, so it’s extremely important,” Louie said.
“We’re seeing deaths because of these pan-resistant bacteria, so hospitals need support, physicians need support, researchers need support to make sure that we can stop the spread of these highly resistant pathogens,” said UCLA Dr. James McKinnell.
McKinnell studied a quarter million cases of pneumonia, not as a complication but in otherwise healthy people. He found the first course of antibiotics didn’t work in more than one in four cases.
“For us to find out five percent of patients had to go to the hospital, that was unexpected. And three percent went to the ER. Again, unexpected. Those are much more severe outcomes than we would’ve traditionally thought from community associated pneumonia, where the patient was actually given antibiotics,” he said.
McKinnell says the study showed patients older than 65 had a tougher time shaking off pneumonia, as did people who smoked. But resistant bacteria are the real trouble.
“When we’re treating these resistant infections mortality is higher, the likelihood that a patient is going to end up in a nursing home after the course of infection is higher and we have to use broader and more aggressive antibiotic therapies,” McKinnell said.
Doctors are urged to prescribe only what’s absolutely necessary, even when patients push for prescriptions.
“Most people will be OK with that and some won’t, and yes, I forced to give antibiotics on occasion when I really don’t want to,” McKinnell said.
Experts advise patients to be more patient if your doctor doesn’t automatically prescribe antibiotics. Think of it as taking your best shot in the antibiotics arms race.