According to a recent National Institutes of Health (NIH) report, doctors in the United States are still relying on older, less effective, toxic medicines to fight new, highly drug-resistant bacterial infections. The outdated treatment can cost lives and a lot of money to provide care for patients who may have been better served by the new antibiotic medicines.
This is happening despite the Food and Drug Administration (FDA) giving the green light to seven next-generation antibiotics designed specifically to combat infections caused by tough “gram-negative” bacteria. The National Institute of Health says these bacteria are among “the world’s most significant public health problems, due to their high resistance to antibiotics.”
Gram-negative bacteria are central to the global rise in antibiotic resistance, rendering standard treatments less effective and complicating the management of common infections. The World Health Organization reports significant resistance rates among key pathogens, with projections suggesting a dramatic increase in resistance to critical antibiotics by 2035.
Methicillin-Resistant Staphylococcus Aureus, commonly known as MRSA, is one of the most dangerous adversaries in the battle against the spread of infectious disease. MRSA is a staph bacterium of significant concern for patients in long-term care facilities and residential community settings, where the spread of disease and its complications are more difficult to treat and manage.
The stakes are particularly high for poor Black patients, who often face systemic disparities in healthcare access and outcomes. The underuse of next-gen antibiotics in these communities not only perpetuates existing inequalities but also exposes Black patients to higher risks of complications and mortality from resistant infections.
MRSA threatens our wellness in several ways. Patients may suffer from skin and soft tissue infections, which can range from relatively mild conditions like boils and abscesses to more severe infections requiring surgical intervention.
MRSA can also lead to more serious, invasive diseases, including bloodstream infections (bacteremia), pneumonia, and endocarditis (an infection of the heart’s inner lining). These conditions are particularly concerning because they can be life-threatening, especially in individuals with weakened immune systems or in hospital or healthcare settings where MRSA can spread more easily.
Due to its resistance to multiple antibiotics, MRSA infections can result in higher mortality rates compared to non-resistant staph infections. Treatment failures or delays can exacerbate this risk.
MRSA infections often lead to longer hospital stays, increased medical costs, and a higher likelihood of complications, including the potential for the infection to spread to other parts of the body or cause sepsis—a life-threatening response to infection.
Chronic Infection Risk: Individuals with MRSA infections might experience recurrent symptoms or become carriers of the bacteria, which can lead to chronic infection risks and the potential to spread the bacteria to others.
Given the danger MRSA poses, coupled with the development of next-generation antibiotics, one might wonder why the medical community is reluctant and slow to offer patients these newer, safer and more effective treatments.
The NIH report points to several contributing factors, chief among them being cost. Next-generation antibiotics come with a price tag approximately six times higher than their older counterparts. This stark price differential places them out of reach for many hospitals, especially smaller, rural ones operating under stringent budget constraints. The math conflicts with the budget for these institutions. The result often is a preference for cheaper, albeit less effective, options.
Another significant barrier is the availability of diagnostic lab tests. Hospitals equipped to swiftly determine the most effective antibiotic treatment for a patient’s specific infection are more likely to utilize these advanced medicines. Speedier diagnosis could, therefore, pave the way for broader adoption of next-gen antibiotics.
The study, which was spearheaded by Dr. Sameer S. Kadri and jointly funded by the FDA and the NIH Intramural Research Program, underscores the sneaky nature of gram-negative bacteria. These pathogens are adept not only at resisting a wide array of drugs but also at transmitting their resistance traits to other bacteria, thereby compounding the challenge of managing infections.
Dr. Kadri’s report does offer patients hope. By dissecting the reasons behind healthcare professionals’ reluctance to embrace new antibiotics and addressing these issues head-on, “we can make strides in combating antibiotic resistance. Strategies to make these drugs more affordable and to expedite the availability of diagnostic tests could play a pivotal role in encouraging their use,” said Dr. Kadri.