~ The Social Diary ~

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Some Antibiotics Are Out of Work

by The Social Diary Health Expert Columnist Ruth S. Jacobowitz
Column #17, March 17th, 2007

          I noticed lately that some antibiotics don’t work for me as well as they once did. I mentioned this to my internist as we change medications for the third time. She told me that my situation is not uncommon, so naturally I began to research antibiotic resistance.

          I suppose that I should explain that when I was in sewing class in the eighth grade, I was laughing with a straight pin in my mouth and I laughed it right down. You can imagine the scenario. The school called my mother, my mother called our doctor as she sped to pick me up and, following his instructions, took me to the Emergency Room at the nearest hospital. After a wretched procedure, an endoscopy—pretty new and rough in those days--I was kept in the hospital for days on massive doses penicillin given intravenously.

          Then I went home still on penicillin and told not to talk for a few weeks. Me? Not talk? No way. So I managed to scream on a roller coaster in Kennywood Park in Pittsburgh, Pennsylvania—my childhood home. Then for years, you could tell the weather by talking to me. I sounded raspy when it was going to rain. As I grew older, I tried to convince people that I sounded sexy, not raspy, but no luck.

          From then on all my medical charts indicated that penicillin would no longer work for me. Then about fifteen years ago, on Keflex, I had a terrible drug-reaction that needed a diminishing dose of cortisone to correct. So since then, the chart says no penicillin and no cephalosporins. My antibiotic possibilities diminished further.

          What I learned over the years that some bacteria have found ways to outwit the effects of antibiotics. The thinking is that widespread use of antibiotics in the more than fifty years since they were discovered, has created evolutionary changes in bacteria that enables them to survive antibiotics. These changes present us with big problems. Sometimes we can’t get rid of an infection on the first, or even the second, antibiotic prescription. And it heightens the risk of our acquiring infections in the hospital.

          I checked with the Center for Disease Control and Prevention (CDC) to find out how serious the problem is in hospitals and learned that about two million hospitalized patients in the U.S. alone get an infection in a hospital and that about 90,000 of those patients die each year as a result of the infection. Why? Because more than 70 percent of the bacteria that cause infections in hospitals are resistant to at least one of the drugs that are commonly used to treat them and patients infected with these drug-resistant organisms are more likely to have long hospital stays and need treatment with other antibiotics that may be less effective, more toxic, and more expensive.

          So I am not alone in having to switch antibiotics when the first or second doesn’t work. The problem of antibiotic resistance is growing. A couple of years ago, the prestigious New England Journal of Medicine reported that 5 to 10 percent of hospitalized patients acquired an infection during their stay and that the risk of a hospital-acquired infection has steadily risen in the past few decades and continues to rise. And lest you think that hospitals are the only places we have to deal with, strains of antibiotic resistant bacteria thrive in other settings such as locker rooms.

          This serious problem is being addressed in several ways. Efforts are underway to improve infection control, to develop new antibiotics, and to encourage more appropriate use of these important drugs. The Food and Drug Administration (FDA) is trying to encourage the development of new antibiotic drugs and to speed up their approval.  In the meantime, no one really has good information on the extent of antibiotic resistance. Each hospital does monitor its own resistance, but its extent nationwide is not really known. And, of course, how many individuals are there, like me, who have to rely on the newest drug to get rid of the simplest sinus infection?

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** Ruth S. Jacobowitz is a health writer, lecturer and patient advocate. Her newest book, Final Acts—a novel, is a medical legal feminist thriller that takes place in a hospital setting. Visit Ruth on www.ruthjacobowitz.com .

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