Thu August 9, 2012
List Of Drug-Resistant Infections Continues To Grow
Originally published on Fri August 10, 2012 11:02 am
MELISSA BLOCK, HOST:
Included on that growing list that Rob just mentioned: some strains of tuberculosis, strep, typhoid fever, malaria and MRSA - which is a staph infection. Mutations of these have outpaced new drug development. For more on drug-resistant infections, we're joined by Dr. Arjun Srinivasan. He works on this issue with the CDC. Dr. Srinivasan, welcome to the program.
DR. ARJUN SRINIVASAN: Thank you so much for having me.
BLOCK: We heard in Rob Stein's piece that overprescribing antibiotics is one of the problems. What do you do about that? What do you tell doctors - or patients, for that matter?
SRINIVASAN: Well, there's a lot that we can do about that, fortunately. I think there's - obviously - a shared responsibility, both from patients and from doctors. As patients, we need to be informed consumers. We should never demand antibiotics when our doctors don't think we need them. And as medical providers, we need to consider very carefully, when we are writing a prescription for an antibiotic. We need to make sure that the patient actually needs the antibiotic. And if they do, we need to make sure that we're up on the latest information so we're giving exactly the right drug for - at exactly the right dose, for exactly the right time.
BLOCK: And when an infection becomes increasingly drug-resistant, as we're seeing, what else can doctors do besides cutting back on prescribing antibiotics?
SRINIVASAN: Yeah, that's a great point that you're raising because there's a lot that can be done. In addition to improving the way we prescribe antibiotics, we need to improve the way we control infections, particularly in hospitals and other health-care settings. We can do a lot to prevent the spread of these organisms. And what we commonly see is that one patient will develop an infection with an antibiotic-resistant organism, but then that organism will get into the environment. It'll get onto the hands of health-care workers, and then it will be spread from one patient to another. So another very effective step is to ensure that we're following what we call good infection control in our health-care facilities.
And that means starting with hand-washing; making sure people wash their hands, and use the alcohol-based hand sanitizer. It's encouraging people - requiring them to wear gowns and gloves, when those things are required. And what's been shown, time and time again, is that if we're very aggressive about following these measures, we can really reduce the spread of these organisms in health care.
BLOCK: Dr. Srinivasan, do you agree with people who say that the practice of giving antibiotics to livestock - you know, putting it in the food chain - is contributing to this?
SRINIVASAN: Well, I think that it's a complex problem - anti-microbial resistance and the relationship between, you know, human use and agricultural use. And I think that while we need to improve the way we use antibiotics in livestock, we can't say that that's the exclusive solution to our problem. We know that there is a great deal of overuse of antibiotics in people as well.
BLOCK: What about the role of drug companies in this? Are they doing enough to develop new drugs that would help with this problem?
SRINIVASAN: Right. Well, you know, in talking with people who are familiar with drug companies, I think what you often hear is that first and foremost, this is a very complex issue. It's not simple to develop new antibiotics. Another thing that you hear from drug companies is, of course, that these are drugs for which there is not a substantial profit margin. And as drug companies, they have shareholders to whom they are responsible, and they have a duty to try and develop drugs that are going to make money for their shareholders.
BLOCK: Would you say that there's a role for government in convincing the drug companies, through one form or another, that it's worth their while to come up with these antibiotics?
SRINIVASAN: I think there's a growing sense that all of us - it's a shared resource; you know, all of us need these antibiotics. We liken them to roads, in many ways. And as such, there needs to be a collaboration, if you will, between governments and between the drug companies, to try to solve this problem. And I think there's a growing sense that the only way we're going to really develop the number of new drugs that we need, is for government and industry - all of us - to work together.
BLOCK: Dr. Srinivasan, thanks so much for talking with us today.
SRINIVASAN: Thank you.
BLOCK: Dr. Arjun Srinivasan is a medical epidemiologist with the Centers for Disease Control, in Atlanta. Transcript provided by NPR, Copyright NPR.