EDITORIAL: When antibiotics stop working

Sept. 20--In 2010, a survey was taken of doctors in Britain asking them to name the most important medical advance of the past 50 years. There were lots of potential candidates, from vaccines to cholesterol-lowering drugs to MRI scans. But none of them measured up to something we often taken for granted: antibiotics.

We can't take it for granted anymore, because antibiotics are steadily losing their effectiveness. The growth of resistant bacteria has become a serious public health problem. These strains now cause 2 million illnesses and 23,000 deaths a year in this country.

No one wants to go back to the days when common infections killed. But without strong measures, that's the way we're headed.

On Thursday, the White House issued a new national strategy for addressing the threat, along with a report from the President's Council of Advisors on Science and Technology calling it a "crisis." These should be just the first steps in heading off a formidable danger.

The White House does not underplay the issue. "As more strains of bacteria become resistant to an ever-larger number of antibiotics, our drug choices will become increasingly limited and expensive and, in some cases, nonexistent," it warns.

The danger is not just that doctors won't be able to knock out illnesses for patients who get sick. It's also that even the simplest surgery would become dramatically more dangerous. "The safety of many modern medical procedures is dependent on the ability to treat bacterial infections that can arise as post-treatment complications," notes the White House.

The biggest cause of the problem is overuse of antibiotics. Americans use them at more than double the rate of Germany and the Netherlands. Doctors sometimes prescribe them for illnesses that are not bacterial in origin, making them useless except as placebos.

The federal Centers for Disease Control and Prevention estimates that as much as 50 percent of those given to humans are unwarranted. Patients sometimes contribute to the development when they stop taking their pills before finishing the recommended course of treatment.

The other major source of misuse is in agriculture. Some 70 percent of all antibiotics are used in agriculture -- not to cure diseases but to promote faster growth of livestock. The European Union has banned such use of antibiotics.

But the Food and Drug Administration has taken only modest steps to curb it, and the administration plan is similarly timid. Mae Wu, an attorney for the Natural Resources Defense Council, argues that under this latest blueprint, "the dangerous, low-dose, routine use of medically important antibiotics can continue without restriction."

The White House panel does have some sound ideas. It proposes a $20 million prize for anyone who can create a diagnostic test that doctors could use to identify resistant infections. It calls for larger economic incentives to stimulate the development of new drugs, including government funds. In 2012, Congress passed a bill extending patent protection for antibiotics designed for resistant bacteria. But the council says the change was too modest to make a noticeable difference.

In the end, the federal government needs to take steps to curb overuse of these vital medicines and to foster a new generation of drugs to overcome bugs that have gotten too tough to handle. And it needs to do so as quickly as possible. We can put off action, but the germs won't rest.

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