Antibiotic use in the United States is dropping, but it is dropping
most slowly in states that use the drugs the most – widening regional
gaps that may be putting people in some Southeastern states at
heightened risk for infections that no longer respond to antibiotics, a new analysis shows.
Researchers aren't just guessing at the danger: They also
have new data showing that urinary tract infections have became more
resistant to antibiotics and that the problem is worst in regions where
use is highest.
"We are seeing a widening gap between states,"
says Ramanan Laxminarayan, director of the private Center for Disease
Dynamics, Economics & Policy, Washington, D.C. Prescription records
show that people in Kentucky, West Virginia, Tennessee, Mississippi,
and Louisiana took about twice as many antibiotics as people in Alaska,
Hawaii, California, Oregon, and Washington in 2010, says a report
released by the center today.
Lab reports show urinary tract infections were 30% more likely to resist antibiotic treatment in 2010 than in 1999.
report is one of several coming this week as government and private
groups unite to call for more action on what they say is a growing
threat: Drugs for many bacterial infections are becoming ineffective
because they are so often taken when they are not needed — allowing bugs
that cause everything from pneumonia to sexually transmitted diseases
to adapt and survive future attempts at treatment.
Much of the overuse is for colds, flu and sore throats caused by viruses — illnesses that antibiotics can't help.
antibiotics use differs by state is unclear. The South has higher rates
of poverty, smoking and chronic illnesses, and some of those factors
might lead doctors to prescribe more antibiotics for respiratory
illnesses because they are worried about complications, says Nancy
Morden, an assistant professor at the Dartmouth Institute for Health
Policy & Clinical Practice in New Hampshire.
But a recent
study of Medicare patients found that differences in gender, age, race
and health status did not explain regional differences in antibiotic
prescribing very similar to those found in the new study, says Yuting
Zhang, a researcher at the University of Pittsburgh, who led the
In any case, there's no evidence the extra
antibiotics help or that lower use hurts people, Laxminarayan says. He
says states with the lowest use typically devote the most public health
resources to teaching doctors and patients to use the drugs correctly.
are taking heed: Nationwide antibiotic use dropped 17% between 1999 and
2010, the report says. And a new survey out today from the Pew
Charitable Trusts and the U.S. Centers for Disease Control and
Prevention (CDC) shows 79% of adults know they can harm their own health
by taking unneeded antibiotics.
But just 47% know that doing so
could harm others, including family members and people in their
communities who might pick up their hard-to-treat bugs, says Allan
Coukell, director of medical programs for Pew.
resistance is not just a personal or even a regional issue, says Jeffrey
Levi executive director of the Trust for America's Health in
Washington, D.C.: "We need to to establish some standards of practice
across the country," he says. Resistant bacteria spread from person to
person and place to place, he says, "and there are consequences for
Levi's group is one of two dozen health organizations that signed a consensus statement with
the CDC, released today, calling for consumers, healthcare workers,
policy makers and pharmaceutical companies to work together to make
better use of existing antibiotics and develop new ones.
The statement also calls for limiting the use of antibiotics in animals raised for food.
have saved millions of lives and transformed modern medicine," but "how
we use these precious drugs must fundamentally change," says Arjun
Srinivasan, who directs a program to prevent healthcare-related
infections at the CDC. Srinivasan spoke during a teleconference kicking
off an annual campaign to raise awareness of proper antibiotic use.