The antibiotic resistance crisis: part 1: causes and threats

Abstract

Decades after the first patients were treated with antibiotics, bacterial infections have again become a threat because of the rapid emergence of resistant bacteria-a crisis attributed to abuse of these medications and a lack of new drug development.

Figure 1

Developing Antibiotic Resistance: A Timeline of Key Events PDR = pan-drug-resistant; R = resistant; XDR = extensively drug-resistant Dates are based upon early reports of resistance in the literature. In the case of pan-drug-resistant Acinetobacter and Pseudomonas, the date is based upon reports of health care transmission or outbreaks. Note: penicillin was in limited use prior to widespread population usage in 1943.

Figure 2

Antibiotic Prescriptions per 1,000 Persons Of All Ages According to State, 2010 The frequency with which doctors prescribe antibiotics varies greatly from state to state. The reasons for this variation are being studied and might suggest areas where improvements in antibiotic prescribing (fewer unnecessary prescriptions) would be most helpful.

Figure 3

Number of Antibacterial New Drug Application Approvals Versus Year Intervals The number of new antibiotics developed and approved has decreased steadily over the past three decades (although four new drugs were approved in 2014), leaving fewer options to treat resistant bacteria. * Drugs are limited to systemic agents. Data courtesy of the CDC and the FDA Center for Drug Evaluation and Research.