With each passing decade, bacteria that are resistant to multiple antibiotics
have become increasingly common. Until recently, if an infection proved
resistant to first-line therapy, an alternative or combination was generally
available. This is no longer the case.
According to the U.S. Centers for Disease Control (“CDC”), the emergence
and re-emergence of infectious disease organisms contributed to a 58% increase
in U.S. per capita mortality from infectious diseases between 1980 and 1992,
making infection the third leading cause of death, behind heart disease and cancer.
The incidence of drug-resistant infections is reaching crisis levels in many
hospitals, in part because antibiotic resistant organisms frequently lurk
in the hospital setting.
In hospitals, Methicillin resistant Staphylococcus
aureus (“MRSA”) has become resistant to nearly all
antibiotics. Vancomycin has become the drug of last resort to treat
this problem. Vancomycin resistant Enterococcus (“VRE”)
strains have also emerged as untreatable disease agents. Since vancomycin
resistance is transferable, there is high expectation that the trait
will move to S. aureus. Already, strains of MRSA insensitive
to vancomycin have appeared, where lack of an antibiotic to treat
has been associated with patient deaths. In recent years, the imminent
threat to public health from untreatable infectious diseases has
attracted the attention of clinicians, microbiologists, and the
popular press (see Articles and Scientific
Publications).
The figure below illustrates the prevalence of multi-resistant bacteria to
antibiotics that were once front-line treatments.
Susceptibility of Multi-Resistant Staphylococcus aureus (MRSA)
to Antibiotics Other Than Glycopeptides
|
Antibiotic
|
Percent of Strains Resistant
|
| Gentamicin |
92-98 % |
| Minocycline |
92-98 % |
| Tetracycline |
92-98 % |
| Erythromycin |
92-98 % |
| Netilmycin |
30 % |
| Sparfloxacin |
40 % |
| Ciprofloxacin |
42 % |
| Chloramphenicol |
57 % |
| Trimethoprim |
11-15 % |
| Fusidic acid |
11-15 % |
| Rifampicin |
11-15 % |
|
Source: The Complete Guide to Anti-Infectives, Scrips, 1999.
|
