Current antibiotics are losing steam when it comes to battling urinary tract infections (UTIs) new research from Extending the Cure (ETC) — a project of the Center for Disease Dynamics, Economics & Policy — contends.
ETC researchers employed an antibiotic-resistance tracking index and found that, over time, current UTI medication regimens (of which there are five classes) lost their overall effectiveness, with bacteria perseverance and presence rising by 30 percent from 1999 to 2010.
"Without proper antibiotic treatment, UTIs can turn into bloodstream infections, which are much more serious and can be life-threatening," said Ramanan Laxminarayan, director of Extending the Cure, in a news release. "These findings are especially disturbing because there are few new antibiotics to replace the ones that are becoming less effective. New drug development needs to target the types of drug-resistant bacteria that cause these infections."
Approximately 8.6 million visits to health care providers are made each year on behalf of UTIs, making the affliction the second most common type of infection in the country. And because of the condition’s high profile, regional trends regarding the use of UTI antibiotics were all the more alarming to the ETC cohort.
Among these troubling tendencies were:
- Since 1999, the percentage of antibiotic prescriptions filled nationwide has dropped by 17%. However, high-consumption states are lagging in this positive trend and are seeing the smallest decrease in prescriptions, resulting in a widening use gap. Researchers found staggering geographic variation -- residents of Appalachian and Gulf Coast states, where antibiotic use rates are highest, take about twice as many antibiotics per capita as people living in Western states.
- In 2010, the five states with the highest rates of antibiotic use in the nation were Kentucky, West Virginia, Tennessee, Mississippi, and Louisiana. The maps show higher-than-average use of antibiotics in other regions of the country, as well.
- In 2010, the five states with the lowest antibiotic use in the nation were Alaska, Hawaii, California, Oregon, and Washington. Other Western and New England states also showed lower-than-average use.
- In contrast to the difficulty in treating UTIs, our ability to treat skin infections, another common reason for outpatient visits, has improved since the peak of drug-resistant infections caused by methicillin-resistant Staphylococcus aureus (MRSA) in the mid 2000s¬. At its height, MRSA caused 19,000 deaths a year, but infection rates have declined due to increased awareness and research efforts directed at new therapies and interventions. The new findings underscore the need to refocus the attention of drug developers and policymakers on certain species of drug-resistant organisms, such as the ones analyzed in the study, called Gram-negative bacteria.
- National use of fluoroquinolones – an antibiotic class commonly used to treat respiratory infections such as pneumonia – increased between 2000 to 2007, but fell by 24 percent from 2007 to 2010. This significant decrease could be due to a black box warning the Food and Drug Administration placed on levaquin, a type of fluoroquinolone which had serious side effects, Extending the Cure suggests. Despite their safe reputation, antibiotic side effects account for over 140,000 ER visits annually, according to a 2008 CDC study.
"While nationally, people are starting to use antibiotics more judiciously, the new findings also show the message might not be reaching everyone. People continue to consume antibiotics at much higher rates in certain parts of the country, and the problem appears to be getting worse," Laxminarayan said. "We're hoping public health officials and health care leaders will be able to use ResistanceMap and the Drug Resistance Index to better target their education efforts to reduce inappropriate use."
ETC plans to develop a policy recommendation report next year based on their findings.
The results in their entirety can be found via the ETC’s online ResistanceMap.