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Slow Uptake Among Physicians of Effective Antibiotics to Treat Superbugs

Laura Joszt
New and effective antibiotics are rarely prescribed in carbapenem-resistant Enterobacteriaceae (CRE) infections, which are a family of the most drug-resistant bacteria.
"Cost is a limitation, but I'm not convinced it is the sole cause of our findings," said Clancy. "Clinicians may not be prescribing the new drugs due to concerns about accelerating antibiotic-resistance or because initial studies on their effectiveness were relatively small. We need to get at the root causes of the disconnect between what the doctors prescribe and what the pharmacists we surveyed believe they should be prescribing, and then find a solution."

The findings come just 2 months after research published in Nature Microbiology2 that found penicillin in combination with clavulanic acid, which is widely available, could be used to treat Methicillin-resistant Staphylococcus aureus, known as MRSA, which has become a widespread problem in hospital- and community-acquired infections.

"MRSA and other antibiotic-resistant infections are a major threat to modern medicine and we urgently need to find new ways to tackle them,” senior author Mark Holmes, PhD, MA, VetMB, of the Department of Veterinary Medicine at the University of Cambridge, said in a statement. “Developing new medicines is extremely important, but can be a lengthy and expensive process. Our works suggests that already widely-available medicines could be used to treat one of the world's major strains of MRSA."

The challenge is that public awareness of antibiotic resistance and the trouble it causes has grown. A Kaiser Family Foundation poll from June 2019 found that not only have 71% of Americans heard of antibiotic resistance and know what it means, but also 53% said overuse of antibiotics is a major problem.

As a result, 45% of adults admitted they have not taken their antibiotics as prescribed by a doctor. This sort of behavior has actually led to antibiotic resistance.

Dennis Gingrich, MD, FAAFP, professor, Department of Family and Community Medicine, Department of Humanities, Pennsylvania State College of Medicine, previously told The American Journal of Managed Care® that not taking the full course of an antibiotic as directed or using other people’s leftover antibiotics actually contributes to the increase in antibiotic resistance.

“These practices will increase the risk of antibiotic resistance by allowing the bacteria to be exposed to short ineffective courses of antibiotics that really just generate antibiotic resistant bacteria,” Gingrich explained.

References
1. Clancy CJ, Potoski BA, Buehrle D, Nguyen MH. Estimating the treatment of carbapenem-resistant enterobacteriaceae infections in the United States using antibiotic prescription data [published online July 28, 2019]. Open Forum Infect Dis. doi: 10.1093/ofid/ofz344.
2. Harrison EM, Ba X, Coll F, et al. Genomic identification of cryptic susceptibility to penicillins and β-lactamase inhibitors in methicillin-resistant Staphylococcus aureus [published June 24, 2019]. Nat Microbiol. doi: 10.1038/s41564-019-0471-0.

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