For 2016, President Obama has requested more than $1.2B to fight antibiotic resistance. The main goal of this antibiotic stewardship program is to “slow the emergence of resistant bacteria and prevent the spread of resistant infections”. Even today, this problem is critical, as The Centers for Disease Control and Prevention (CDC) estimates that in the United States, drug-resistant bacteria cause 2 million illnesses and 23,000 deaths. Unfortunately, a recent study shows that we are only in the early stages of this antibiotic resistant problem and that by 2050, if nothing is done, 10 million people each year worldwide would die by these “super bugs” and it would cost the world economy $100 trillion. The same study predicts that these “super bugs” would kill 22% more people than cancer.
Besides death, there are many side effects from misuse and overuse of antibiotics, creating the need to improve education to both the masses and the general medical profession. Some of these side effects include:
- The effects of antibiotic treatment in early-life shows it can result in long lasting changes in the gut microbiome as well as increased weight and bone growth in mice
- One million patients a year are hospitalized for sepsis, a complication of infection that can lead to organ failure, which can be brought on by antibiotic resistance
- Healthcare associated infections are a significant cause of death in the United States and the rest of the world, with methicillin-resistant strains of S. aureus (MRSA) showing up in Europe at 20%, the United States at 33-55% and in India from 30-80%
- Overuse of antibiotics and use of certain antibiotics have shown to kill helpful bacteria in the body, leading to therapeutic development of drugs to protect the gut microbiome when antibiotics are administered
Clearly, great strides need to be made for the world to combat the threat of antibiotic resistance. The main White House objectives are two fold, the first focuses on detection and includes the following objectives: development of advanced and rapid diagnostic tests, development of new antibiotics/other therapies, improved international collaborations and strengthened surveillance. The second set of objective are focused on managing misuse of antibiotics: reduce inappropriate antibiotics use by 50% in outpatient settings and 20% in inpatient settings, establish a state by state antibiotic resistance prevention program and eliminate the use of medically important antibiotics in food-producing animals. The field of metagenomics will play a significant role in these efforts.