Antibiotic Resistance Fact Sheet

Health care providers are increasingly aware of the problem of antibiotic resistance. Untreatable strains of Enterococcus and Staph aureus in intensive care units are on the increase in CDC's National Nosocomial Infections Surveillance System. Antibiotic resistance is a major contributor to the disease, death, and costs resulting from hospital-acquired infections. One report placed the annual cost of antimicrobial resistance among a single pathogen (Staphylococcus aureus) at $122 million. Resistance in Campylobacter and other foodborne pathogens is increasing, as seen in the CDC/FDA/USDA National Antimicrobial Resistance Monitoring System.

Overuse and misuse of antibiotics in medical care is related to patient expectation, the unavailability of rapid tests to distinguish untreatable viral infections from potentially treatable bacterial infections, and other factors.

Use of antibiotics in agriculture contributes to the burden of resistance, especially for food and waterborne pathogens such as Salmonella and Campylobacter. As much as 40% of all antibiotics used in the United States are as drugs added into the feeds for healthy animals, to promote efficient growth. In addition, fluoroquinolones, the drug of choice for Salmonella infections, were licensed for use in poultry in 1995. Poultry products are a leading source of human Salmonella and Campylobacter infections. Recognizing that resistance to fluoroquinolones in Campylobacter is on the increase, in October, 2000, the FDA Center for Veterinary Medicine called on drug makers to stop using these drugs in poultry.

Suggestions for Improvement

The American Public Health Association supports measures to address the problem of antimicrobial resistance. Specifically, in Policy Statement 9908, "Addressing the Problem of Bacterial Resistance to Antimicrobial Agents and the Need for Surveillance," APHA advocates the following:

• Education programs for providers and patients in the appropriate use of antibiotics, and avoiding antibiotics in the face of viral infections.
• Improved surveillance programs at the local and national level, with feedback to policymakers, health officials and providers.
• Withdrawal of all antibiotics given to healthy animals for economic reasons when those antibiotics are also used for people.

Related APHA Policy: 200112, 9915, 9908, 9517

Updated 03/03