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Addressing The Rising Concern Of Antibiotic Resistance With Surgical Prophylaxis

Antibiotic resistance is a growing global public health crisis. The Center for Disease Dynamics, Economics and Policy, and the Global Antibiotic Resistance Partnership’s report, The State of the World’s Antibiotics 2015, asserts that the current rates of global antibiotic use and antibiotic resistance are creating a dire situation.1 This report states that worldwide, there is a decline in antibiotic effectiveness with rising resistance to both first-line and last resort antibiotics.

Currently, the United States Centers for Disease Control and Prevention estimate that antibiotic resistance is responsible for more than 2 million infections and 23,000 deaths annually.2 The direct cost of antibiotic resistant infections is an estimated $20 billion and indirect costs due to loss of productivity are an estimated $35 billion.

A recent study by Teillant and colleagues at the Center for Disease Dynamics, Economics and Policy examined the potential consequences of increased antibiotic resistance on the 10 most commonly performed surgical procedures.3 The authors predict that antibacterial resistance may threaten the safety of many surgical procedures.

In this study, the researchers first reviewed published literature to determine the current efficacy of prophylactic antibiotics to prevent infections in the 10 most common surgical procedures.3 They then modeled the effect of reducing the effectiveness of antibiotic prophylaxis by various amounts from 10 to 100 percent. The study showed that currently, an estimated 38.7 to 50.9 percent of pathogens that cause surgical site infections are resistant to standard prophylactic antibiotics. They predicted that a 30 percent reduction in antibiotic efficacy due to the development of drug resistance would result in 120,000 additional surgical site infections and 6,300 additional surgery-related deaths.

The authors conclude that increasing antibiotic resistance presents a significant threat to the safety of many common surgical procedures.3 They highlight the need for further research as to how one should modify prophylactic antibiotic administration to combat the rising incidence of antibiotic resistance.

References

1.      Center for Disease Dynamics, Economics and Policy, and the Global Antibiotic Resistance Partnership. The State of the World's Antibiotics 2015. Available at http://cddep.org/publications/state_worlds_antibiotics_2015 .

2.      Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2013. Available at http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf .

3.      Teillant A, Gandra S, Barter D, Morgan DJ, Laxminarayan R. Potential burden of antibiotic resistance on surgery and cancer chemotherapy antibiotic prophylaxis in the USA: a literature review and modelling study. Lancet Infect Dis. 2015; epub Oct. 15.

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