Antibiotic Resistance: A Growing Health Threat
Davies, Julian, Forum for Applied Research and Public Policy
Worldwide concern about the increasing incidence of antibiotic resistant microbes in hospitals and in the community is increasing. Indeed, the threat of emerging infections, which receives intermittent but graphic depiction in the popular press, is small compared to the threat of reemerging infections in the form of well-known pathogens that have become resistant to multiple classes of antibiotics. As Dianne Murphy and Gary Chikami clearly demonstrate ("Microbial Menace," FORUM, Winter 1998), the problem of antibiotic resistance is firmly ensconced and is not going to go away.
The authors' well-argued evaluation of the situation and its possible consequences, however, offers several strategies - including surveillance, education, and hygiene - that will at least prevent things from getting significantly worse. Similar initiatives have been recommended and put into force in many countries, particularly in Scandinavia, and there are preliminary indications that such measures are effective in reducing the incidence of resistant bacteria. The Swiss government has also banned the use of antibiotics in cattle as of January 1999 - better too little, even late, than not at all. It is essential that these and other measures be instituted as often as possible to slow the rate of evolution and dissemination of antibiotic resistance genes.
Murphy and Chikami deal with all aspects of antibiotic resistance, including the increasing threat of antibiotic resistant bacteria in the food chain that are pathogenic to humans. The recent report of an outbreak of drug resistant Salmonella typhimurium DT104 in Denmark, which caused one death and a score of hospitalizations, serves to emphasize the urgency of the situation. …