• The U.S. government has released new objectives this month to prevent, treat, research, and boost awareness about antibiotic-resistant infections.
• Antibiotics are antimicrobial medicines that destroy bacteria.
• The more we take them, however, we can build up a tolerance to the medications and they may not work in the future.

More than 2.8 million antibiotic-resistant infections occur each year in America as a result of antibiotic-resistant bacteria, or superbugs. Those infections are responsible for 35,000 deaths per year.

The U.S. government has released new objectives this month to prevent, treat, research, and boost awareness about antibiotic-resistant infections.

“Combatting antimicrobial resistance is one of the most pressing challenges in medicine today. It threatens to pull medicine back to a pre-penicillin era,” said Dr. Amesh Adalja, a senior scholar at the Center for Health Security, Johns Hopkins Bloomberg School of Public Health.

Antimicrobial resistance includes antibiotic resistance, as well as resistance to viruses, fungi, and other microorganisms.

The National Action Plan for Combating Antibiotic-Resistant Bacteria updates the original plan published in 2015.

What’s antibiotic resistance?

Antibiotics are antimicrobial medicines that destroy bacteria. The more we take them, however, we can build up a tolerance to the medications and they may not work in the future. That causes doctors to prescribe a stronger antibiotic, if available. Otherwise, the bacteria can survive and go on to harm us.

“The more antibiotics are used, the less effective they become,” explained Dr. David Hyun, a senior officer on Pew’s antibiotic resistance project. “As bacteria are exposed to antibiotics, the bacteria adapt and become increasingly able to defeat the drugs. This evolution can happen gradually or quickly, but all antibiotic use accelerates the process.”

“When antibiotic resistance develops anywhere, it is a threat to people everywhere. Superbugs don’t respect borders,” he added.

Can we beat bacteria?

Bacteria naturally exist in the world, including in animals, the environment and in humans.

Antibiotics have been used for decades to treat infections when that bacteria start to grow out of control and affect our health. Some of those infections would have been fatal without antibiotics.

Deaths from antibiotic-resistant infections are down, but microbial pathogens continually evolve and find new ways to evade the drugs designed to kill them, the report stated.

Some of the report’s objectives include:

• lowering healthcare-associated antibiotic-resistant infections by 20 percent by 2025
• reducing community-acquired antibiotic-resistant infections by 10 percent by 2025
• creating 10 new resistance-related diagnostics projects by 2021
• ensuring 100 percent of acute care and 50 percent of critical access hospitals report to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Antibiotic Use Option
• developing 10 novel therapeutics by 2022

Sara Y. Tartof, PhD, an epidemiologist studying antibiotic resistance at Kaiser Permanente in Southern California, tells Healthline, that the plan has excellent recommendations for hospitals, governmental agencies, laboratories, researchers, drug companies, and others.

“We need strong and long-standing commitment from all of us before we get a handle on this. There is no magic antibiotic coming down the pipeline,” Tartof added.

What germs are the biggest threats?

Last fall, the CDC released its Antibiotic Resistance Threats in the United States report, which lists 18 germs based on various threat levels. It lists these superbugs as urgent threats:

• carbapenem-resistant Acinetobacter, which can cause pneumonia and wound, bloodstream, and urinary tract infections
• Candida auris (C. auris), a fungus that can cause severe infections when it enters the bloodstream
• Clostridioides difficile (C. diff), a bacteria that can affect the gastrointestinal tract and cause severe diarrhea, fever, and nausea
• carbapenem-resistant Enterobacteriaceae (CRE), a group of bacteria that includes E.coli
• drug-resistant Neisseria gonorrhoeae (N. gonorrhoeae), a bacteria that causes the sexually transmitted infection gonorrhea.

How to battle antibiotic resistance

You can work to avoid becoming resistant to antibiotics by trying to prevent infections and practicing regular handwashing.

You can help combat antibiotic resistance by asking your doctor if an antibiotic is necessary in the event that they suggest taking one, Adalja said.

And if you’re prescribed antibiotics, take them as directed.

“We all need to commit to reducing the overuse and misuse of antibiotics that fuels increasing resistance,” Tartof said. “We should not pressure our doctors for antibiotics, particularly when they recommend against it, even if we think it will help.”

Hyun noted that 1 in 3 antibiotic prescriptions — about 47 million prescriptions annually — are not necessary, Hyun said.

Unnecessary use puts patients needlessly at risk for adverse events, such as allergic reactions and C. diff infections, which can result in life threatening diarrhea and are deemed an urgent threat by the CDC.

“Antibiotics do not work against viruses, such as those that cause the common cold or the flu. Patients should also talk to their doctors about the risks if an antibiotic is prescribed, and ask if an antibiotic is really necessary,” Hyun added.

“Another role we have as consumers is to support companies that are committed to reducing unnecessary antibiotic use in animal food production, where overuse is also a big problem that can also affect human health,” Tartof said.

Will it work?

Hyun said the new plan “lacks essential details regarding specific policies and how key priorities will be achieved,” especially when compared with the 2015 plan. He called that a “missed opportunity.”

Some of the priorities Pew identified earlier this year were included in the plan at a high level.

But the updated plan doesn’t directly incorporate goals from the Food and Drug Administration’s (FDA) 5-year plan to improve antibiotic stewardship in animals, Hyun noted.

“We strongly support the prioritization of improving antibiotic prescribing in doctor’s offices and other outpatient healthcare settings, and increasing the number of hospitals reporting antibiotic use into CDC’s National Healthcare Safety Network,” Hyun said. “But the action plan lacks specific incentive strategies needed to help achieve these goals by 2025.”

Though the plan sends a signal that the United States is working to combat the growing threat of antibiotic resistance, Hyun thinks there is also a lot more work to be done in order for the United States to be prepared to combat the “existential threat” of antibiotic-resistant superbugs.

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