"The CDC says 88,000 Americans a year die of infections they catch in the hospital.."

 WHO Issues Antibiotic Alert

By LAURAN NEERGAARD
© The Associated Press

 WASHINGTON (AP) - The World Health Organization warned Monday that increasingly drug-resistant infections in rich and developing nations alike are threatening to make once-treatable diseases incurable.

Scientists have been urging action for years to fight the growing problem of infections becoming impervious to treatment. The WHO's new report adds to the alarm.

”We're losing windows of opportunity,” said WHO infectious diseases chief Dr. David Heymann.  “It's something we have to really address immediately or we're going to start losing our antibiotics.”

”This is a major problem for us, and it isn't going to go away,” added Dr. Jeffrey Koplan, director of the U.S. Centers for Disease Control and Prevention, who helped WHO unveil the report.  “We use the same antibiotics as other countries do,” so resistance in one country is bad news for everybody.

Bacteria, parasites and viruses all naturally evolve to fight treatment. It's classic survival of the fittest: Bugs exposed to drugs that don't kill them become stronger, able to withstand subsequent treatment attempts, and pass on that drug resistance to their next generation.

Misuse of medications, particularly antibiotics, speeds this process.

In developed countries, people often overuse antibiotics, demanding them for viruses like colds. The body always harbors germs, so each unneeded antibiotic dose is an opportunity for them to evolve. U.S. and Canadian doctors are estimated to overprescribe antibiotics by 50 percent, the WHO report said.

Impoverished developing countries have the opposite problem. Many patients can't afford the full course needed to cure an infection. Antibiotics may be sold at market stalls where people buy a few doses without a doctor's exam.  In Vietnam in 1997, researchers found more than 70 percent of patients were prescribed inadequate doses to cure serious infections.

Then there's misinformation: In the Philippines, people mistakenly use low doses of an anti-tuberculosis drug as a  “lung vitamin,” WHO said.

Animals add to the problem. Half the world's antibiotics are used on the farm, sometimes to treat illness but mostly to help healthy animals grow bigger. That encourages drug-resistant germs that cause food poisoning, WHO said.

What effect does all this have? Among the report's sobering examples:

Gonorrhea was once easily curable with penicillin and tetracycline.  “Today, you can't touch it anywhere in the world with those drugs,” Heymann said. Poor nations can't afford more expensive alternatives and, to make matters worse, untreated gonorrhea is fueling spread of the AIDS virus.

In Estonia, Latvia, and parts of Russia and China, more than 10 percent of tuberculosis patients have strains resistant to two powerful medicines. Overall, up to 2 percent of the world's 16 million TB sufferers have multi-drug resistant strains, particularly frightening because TB is airborne, spread when people cough.

Malaria, the mosquito-spread infection that kills a million people a year, is resistant to the top medication 80 percent of the time.

Some 5,000 Americans may have suffered longer-lasting food poisoning in 1998 from drug-resistant germs in chicken.

Nobody counts deaths from drug-resistant infections. The CDC says 88,000 Americans a year die of infections they catch in the hospital, and many are resistant to at least one antibiotic, complicating treatment attempts.

Wiser use of antimicrobial drugs is the solution, the WHO said. It recommended increased funding to help poor countries afford enough antibiotics, and education for poor and rich nations alike to avoid misuse.

WHO also recommended that human antibiotics not be used as growth promoters for animals.  Europe already has banned several such drugs. The U.S. Food and Drug Administration has debated stricter rules here for several years, but is under industry pressure not to tighten animal drug restrictions.

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AP-NY-06-12-00 1051EDT