ACP-CDC advice on antibiotic use relevant in light of discovery of superbug

A recently detected case of rare Escherichia coli infection highlights the need for better use of antibiotics.

The CDC recently announced the first known case in the U.S. of a superbug that cannot be killed by an antibiotic. A patient showed the presence of a rare kind of Escherichia coli infection that is resistant to virtually all antibiotics, including colistin, an older antimicrobial agent currently reserved for treating pan-resistant gram-negative organisms. Inappropriate use of antibiotics is an important factor contributing to the spread of antibiotic-resistance infections.

ACP and the CDC issued advice for prescribing antibiotics for acute respiratory tract infections (ARTIs) in adults in Annals of Internal Medicine in January 2016. According to unpublished CDC data, an estimated 50% of antibiotic prescriptions may be unnecessary or inappropriate in the outpatient setting, which equates to over $3 billion in excess costs. Antibiotics also are responsible for the largest number of medication-related adverse events and the cause of about 1 in 5 visits to emergency departments for adverse drug reactions.

Beginning in fall 2016, the CDC's Antibiotic Resistance lab network will provide the infrastructure and lab capacity for 7 to 8 regional labs, and labs in all states and 7 major cities/territories, to detect and respond to resistant organisms recovered from human samples. State labs will be able to detect new forms of antibiotic resistance—including mutations that allow bacteria to survive the effects of last-resort drugs like colistin—and report these findings to the CDC in near real-time. With this comprehensive lab capacity, state health labs and regional labs that are part of the network will be able to investigate emerging resistance in ways currently unavailable, generating better data for stronger infection control among patients to prevent and combat future resistance threats.

More information is available at the National Action Plan for Combating Antibiotic Resistant Bacteria.