Taking antibiotics you don’t really need might kill you

September 16, 2013

Here's something else to be scared of: drug-resistant superbugs.

According to a new report from the Centers for Disease Control and Prevention, "more than two million people are sickened every year with antibiotic-resistant infections, with at least 23,000 dying as a result."

Oh, and those numbers are probably too low: "The estimates are based on conservative assumptions and are likely minimum estimates."

The basic issue here is that we're using too many antibiotics — both on ourselves and our animals. The CDC doesn't mince words here:

The use of antibiotics is the single most important factor leading to antibiotic resistance around the world. Antibiotics are among the most commonly prescribed drugs used in human medicine. However, up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. Antibiotics are also commonly used in food animals to prevent, control, and treat disease, and to promote the growth of food-producing animals. The use of antibiotics for promoting growth is not necessary, and the practice should be phased out.

They've even got a helpful graphic showing how overuse of antibiotics leads to killer superbugs:

Like a lot of things in health care, there isn't a lot of rhyme or reason to the overuse of antibiotics. One way you see that is to look at the tremendous variation in antibiotic prescriptions by state. It is very hard to imagine that North Dakota and Louisiana need to be prescribing antibiotics at twice the rate of California and Colorado.

It wouldn't be such a big deal for diseases to be developing resistance to the antibiotics we have if we were coming up with new antibiotics at a sufficiently quick clip. But — and this is the really scary part — the antibiotics pipeline has slowed down. This is, perhaps, the most unnerving graph in the whole report: It shows the sharp drop in applications for new antibacterial drugs  over the last three decades.

To make a policy point here, Washington spends a lot more time arguing about how to finance health insurance than how to deliver health. But if you're securely in the middle class with employer-sponsored health insurance, these debates probably don't affect you much. What does affect you is the possibility of dying of a hospital-acquired superbug when you go in for a routine surgery at age 62.

These kinds of quality issues get a lot less attention in the Beltway, but given that about 85 percent of Americans have health insurance of some sort or another, they probably affect more people. And, in theory at least, preventing superbugs shouldn't be the kind of thing that Democrats and Republicans disagree over.

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Neil Irwin | September 16, 2013