U.S. Efforts to Curb Antibiotic Resistance – Are We Saving Lives?
August 27, 2020
Sameer S. Kadri, M.D., and Helen W. Boucher, M.D.
N Engl J Med. 2020 Aug 27;383(9):806-808.
PMID: 32846058 | DOI: 10.1056/NEJMp2004743
Antibiotic resistance represents a major crisis that limits the care of many patients. Demonstrating that large-scale efforts to control this problem have saved lives would help secure the ongoing and expanded funding and support needed to sustain action. However, data causally linking national and global efforts to the burden of antibiotic resistance and to outcomes are lacking. Existing antibiotic-resistance surveillance systems aren’t designed to capture granular details on treatments and complications, and several countries suspected of having the highest rates of death attributable to antibiotic resistance don’t conduct surveillance. Furthermore, patients infected with antibiotic resistant pathogens are more likelyvto have coexisting conditions, to be critically ill, and to be immune suppressed than those with infections caused by susceptible pathogens. These factors make it difficult to accurately draw causal inferences between antibiotic resistance and mortality, let alone to quantify the lives saved by antibiotic-resistance countermeasures.