Why overuse of antibiotics is a massive, ‘staggering’ problem in health care

JUDY WOODRUFF: A new report out from the U.S.
Centers for Disease Control highlights that we are still losing the battle against so-called
superbugs, bacteria that are resistant to nearly all the antibiotics. As William Brangham tells us, the scope of
the problem is bigger than previously estimated. WILLIAM BRANGHAM: The CDC’s new report shows
that, while overall deaths from these superbugs are decreasing, new infections are rising. Federal health officials say it shows how
far we still have to go. These superbugs exist largely because of the
overuse and misuse of antibiotics, which allows the targeted bacteria to develop defenses
against them, which makes those lifesaving drugs less and less effective. According to the CDC, about 35,000 people
die every year from these infections. The majority of these deaths are from people
getting infected in hospitals and other health care settings. More than 2.8 million new infections occur
every year. That’s about one new infection every 11 seconds. For more on all this, I’m joined now by Arjun
Srinivasan, who works on infection control at the CDC and helped put together this report. Dr. Srinivasan, thank you very much for being
here. Before we get into some of the granular details
of this report, I wonder if we could talk about the broader scope of this problem. I mean, I think, by any public health measure,
almost three million infections every year is a lot of infections. DR. ARJUN SRINIVASAN, Centers for Disease Control
and Prevention: Yes. And thanks for having me, William. It is. It’s a huge number. It’s a staggering burden. And that burden is really why we have been
calling attention to this problem for several years. The burden is larger than we thought it was. We knew that our report in 2013 was a conservative
estimate. We recognized it was likely an underestimate. It was the best information we had at the
time, and now we have better information, and we have put out a new number. And that number really continues to show that
this is a significant problem. It’s a massive problem. It’s a threat to patients in hospitals. It’s a threat to people in the community. It is a serious threat that we have to address. WILLIAM BRANGHAM: Some of these infections,
we know, are life-threatening. Some of them are not. Can you just describe, what kinds of infections
are we talking about? DR. ARJUN SRINIVASAN: These antibiotic-resistant
infections, as you mentioned, they run the full gamut of different types of etiologies,
of different types of infections that they cause. And they do range in severity. Some of them cause skin infections that may
be readily treatable by draining the infection and a short course of antibiotics. Some of them cause very serious infections,
life-threatening infections. And, as you mentioned, we know that roughly
35,000 people every year don’t survive one of these infections. So it’s a huge gamut. But for each individual person, this is a
serious occurrence, right? This is pain, it’s suffering. So it’s important that we not underestimate
or that we trivialize any one of these 2.8 million infections. For the person who gets it, it’s a serious
infection. WILLIAM BRANGHAM: One thing that obviously
stands out is the declining number of deaths. It’s an 18 percent overall reduction, nearly
30 percent in hospitals alone. I think that is straight-up good news. What is driving that decline? DR. ARJUN SRINIVASAN: Those declines are absolutely
good news. It is really encouraging. And for some people who have seen this report,
it a little bit flies in the face of what we have come to expect, what conventional
wisdom is with antibiotic resistance. There was a lot of suspicion out there, and
people who said, once resistance begins to develop, there’s just nothing you can do,
you will never see it go back down. This report shows that you can, in fact, put
the genie back in the bottle to a certain extent. We’re seeing the number of deaths have gone
down. The number of infections with many of these
important pathogens, especially in health care, has gone down. What’s driving that? We really do think it’s the hard work of people,
especially in hospitals, where we have seen the biggest decreases. It’s the day-in and day-out work of people
paying attention to cleaning their hands, wearing gowns and gloves when it’s necessary
to care for these patients, working to improve antibiotic use. Some of these things are — seem relatively
simple. None of them are easy to do every day taking
care of every single patient. But that hard work is paying off, and we really
want to acknowledge the work that people are doing and encourage them to keep at it. Those efforts, your efforts are making a difference. Keep it up. It’s saving lives. WILLIAM BRANGHAM: You mentioned this issue
of better antibiotic use. This obviously dovetails with one of the reasons
why these superbugs emerged in the first place. For individuals who might be listening out
there, what would you tell them about best practices for themselves, for their family,
for their communities? DR. ARJUN SRINIVASAN: You know, antibiotics are
lifesaving medications. They improve the quality of life. And when you have an infection that needs
an antibiotic, you definitely need an antibiotic. And that’s why we’re here, right? We want those antibiotics to be available
and effective when we need them. But we know too often in the United States,
both in hospitals and in outpatient settings, in doctor’s offices, we are prescribing antibiotics
when they’re not needed. And it’s really important for people to know
that, if you take an antibiotic when you don’t need one, you are exposing yourself to all
sorts of potential side effects from antibiotics. These are medications that have significant
side effects. When you need them, obviously, those side
effects are risks worth taking. But when you don’t need them, you are exposing
yourself to all of those side effects with no benefit. So, really, one of the key messages has been
and continues to be, don’t demand an antibiotic if your provider thinks you don’t need one. You don’t want an antibiotic if you don’t
need it. WILLIAM BRANGHAM: All right, Dr. Arjun Srinivasan
at the Centers for Disease Control, thank you very, very much. DR. ARJUN SRINIVASAN: Thank you so much.

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