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The Complicated Fears of an Infectious Future

Should we fast-track approval for new antibiotics meant to target superbugs? An alarmist New York Times article would have you think so.


The New York Times nearly made me choke on my Cheerios yesterday morning with an alarming front-page story about how "infectious disease docs are frantic." Doctors, the story says, are frantic because they lack drugs to fight outbreaks of antibiotic-resistant "superbugs" that kill and mutilate their victims at alarming rates. In response, influential lawmakers and officials in the public and private sector are pushing for legislation that would allow new antibiotics targeting superbugs to sail past some of the usual FDA steps for approval for direct testing on very sick patients. And the Health and Human Services Department could pay up to $200 million over five years to GlaxoSmithKline to develop these medications under a new agreement.

Yet despite the article’s alarming tone, recent studies have revealed a broad-based decline in serious infections (PDF), Methicillin-resistant Staphylococcus aureus (a nasty version of what is commonly known as "staph") chief among them. The versatile staph pathogen may be evolving ever more rapidly, but isn’t necessarily infecting more widely. And that’s because hospitals are getting better at the little but important things, like making sure medical professionals wash their hands, or even better, wearing gloves. They still suck at it overall—sometimes skipping as many as 50 percent of opportunities according to some surveys—but progress is progress, and one that probably deserved mention in the piece.

But one hopes hospitals continue to improve their hygiene toward preventing infections in the first place, since the cultural push-pull involved in coordinating the nation's antibiotic usage could quickly become more complicated. A 2012 piece in the New England Journal of Medicine speculated on this point:

[S]omehow and improbably, antibiotics threaten to become villains, joining that other reviled miracle, the vaccine. Indeed, already the fervor of the anti-antibiotics crowd resembles the idée fixe of the unfortunately large group of patients and clinicians who stubbornly and emphatically oppose vaccination, which has saved many more lives than any other medical invention, including penicillin and its descendants.

They may be overstating the opposition, but it’s easy to imagine concerns over the use of antibiotics in the livestock we eat (contributing to the spread of ever-more drug resistant pathogens in humans) bleeding into more general hesistancy among the public to use antibiotics, even when absolutely necessary.