AHCJ Atlanta panel discusses antibiotic resistance

The rise of deadly, drug-resistant superbugs is one of the world’s most pressing public health concerns. The dangerous development is driven by overuse and misuse of antibiotics in medicine and agriculture, resulting in a dramatic increase in people infected with antibiotic-resistant bacteria.

By 2050, 10 million people globally could die from drug-resistant bugs, which could lead to a loss of productivity of $100 trillion.

“Antibiotic resistance is the most underestimated epidemic in the United States,” said Maryn McKenna, award-winning journalist and AHCJ board member, during a recent AHCJ Atlanta chapter panel discussion titled “Innovative approaches to antibiotic resistance.” McKenna was joined on the panel by Joshua Weitz, a quantitative biologist at Georgia Tech; Michael Bell, a physician and deputy director of the Division of Healthcare Quality Promotion at the CDC; and Cassandra Quave, a medical ethnobotanist at Emory University.

U.S. pharmaceutical companies sell four times as many antibiotics for use in livestock as they do for use in humans, said McKenna, who is the author of the new bestseller “Big Chicken: The Incredible Story of How Antibiotics Created Modern Agriculture and Changed the Way the World Eats.” Inevitably, she added, antibiotics used in agriculture end up in the food chain as well.

McKenna also took a brief look back at how enthusiasm for antibiotics began, when penicillin saved thousands of soldiers wounded on the battlefields of World War II. The situation today is different. While the U.S., although inadequately, has “some degree of control over antibiotic-resistant bacteria, there are no controls whatsoever in the developing world,” said McKenna. “At the same time, the demand for protein is rising rapidly.”

Weitz, a professor in the School of Biological Sciences at Georgia Tech, studies the possible benefits of bacteriophage, or simply phage, to fight against antibiotic-resistant bacteria.

Phage, a virus that infects and replicates within bacteria, has “an amazing, and very complex ability to disrupt a large number of bacteria,” said Weitz, adding that the rise in antibiotic resistance “may push us towards more research into phage.”

While, right now, phage is largely looked at as a remedy of last resort, “there are some indications that the FDA is interested,” said Weitz.

Quave, curator of the Emory University Herbarium and assistant professor of Dermatology and Human Health at Emory University, criticized the current state of diagnostics.  “We’re completely lacking a quick turnaround of results,” she said. “Right now, we don’t even have rapid diagnostic techniques to differentiate viral from bacterial infections.”

Quave’s lab studies how botanical ingredients used in traditional medicine can improve treatment options for multidrug-resistant infections—plant compounds like blackberries, wormwood leaves, and fig tree bark.

She urged pharmaceutical research to develop new, and innovative antibiotic agents. “We haven’t had a new class of antibiotics since the 1980s,” she said. “We’re in a drought right now.”

Bell agreed with Quave’s assessment. Resistance to drugs has always been an issue, he said, but that there was a plan B — reserve antibiotics, which are drugs of last resort. An expert on drug-resistant pathogens and hospital-acquired infections, Bell added, “But now, we see more and more cases where we have nothing.”

One of the reasons for this is the U.S. health care system, Bell said, where patients often move between different hospitals, ambulatory surgery centers, and outpatient facilities. “It’s hard to control the spread of infections in this system where people move all over the place.”

Bell added that the goal should be to “identify multi-drug-resistant bacteria as quickly as possible and contain them before they spread” — ideally through a combination of data management, effective networks, and targeted action.

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