A New Yorker’s Guide to Antibiotics for Crohn’s and Colitis
By Sarah Riedel and Elizabeth Chiang • September 15, 2018, 10:30:00PM In a world where bacteria are increasingly the focus of our modern day lives, the antibiotic regimen that is used to combat a variety of conditions like colitis and other inflammatory bowel diseases is a matter of utmost importance.
As a result, there’s a good chance you’ve seen the phrase “antibiotic resistant” or “antimicrobial resistant” written about your health in the last week.
And while the term is commonly associated with an emerging class of microbes, it has also been a staple of the mainstream medical literature for over a century.
But now, a new paper from the American Medical Association (AMA) has found a way to better understand how this phenomenon is affecting medicine today.
“We’re not trying to be anti-medicine,” said Dr. David Ludwig, the lead author of the study, published online in the Annals of Internal Medicine.
“The goal of the paper is to clarify what the impact of these new antibiotics on our ability to diagnose and treat diseases has been.”
The paper found that while antibiotic resistance is not as widespread as it once was, a growing number of infections are resistant to all available drugs.
“A good example is [antibiotics] in the gut,” Ludwig said.
“That’s where most of the antibiotics are found.”
The AMA researchers analyzed the prevalence of antibiotic-resistant infections in the United States from 2014 to 2018, using data from the Centers for Disease Control and Prevention’s National Health Interview Survey, and compared it with data from data from a database maintained by the National Institute of Allergy and Infectious Diseases (NIAID).
Their data also revealed that over the last decade, the rate of antibiotic resistance in the U.S. has risen by almost 1 percent per year, from 6.6 percent in 2014 to 9.1 percent in 2018.
“I think what’s really interesting is that we’re seeing an increase in resistance in all of these infections,” Ludwig added.
“It’s not a new phenomenon.
It’s been happening for some time, but we haven’t seen it increase in frequency or severity.”
What’s new is that it’s happening more rapidly than it has in the past, Ludwig said, and it’s likely to be worse in the future, as new antibiotics become more available and resistant strains emerge.
While there’s been a lot of concern that the rise in antibiotic resistance would lead to a pandemic, Ludwig points out that there’s not really evidence to suggest this is the case.
“If you look at the past few years, antibiotic resistance has been more a concern in general, but I think there’s some evidence that it may be more pronounced in the first few years,” Ludwig told Healthline.
“So I think we’ll see it continue for a while, maybe until the pandemic.”
What is new about this is that resistance has now spread to other parts of the body, like the kidneys and lungs, which is why Ludwig said this is especially worrisome because it could have a significant impact on the health of people with chronic diseases like diabetes and heart disease.
And that’s because these infections are particularly common in people with underlying health problems like cancer.
The study also found that antibiotic-resistance is also present in a subset of people, but the researchers didn’t know how much of them had the infection.
“One thing that’s important is that there are a lot more people with these infections than we thought,” Ludwig explained.
“For example, we don’t know if there’s an increase of resistance in those people with asthma or other lung conditions.”
The authors say that while the number of antibiotics being prescribed in the US has risen in recent years, the number that are actually used is still in a constant state of decline.
“There’s not much that can be done to prevent the growth of antibiotic resistant bacteria, so there’s no need to rush through new antibiotics,” Ludwig cautioned.
“But if we can get some of these resistance genes into our bodies, it could be a good thing.”
And, Ludwig believes, even though resistance to some of the drugs we currently use has been found in humans, we’re only just beginning to understand how widespread this is.
“Most antibiotics have a broad spectrum of resistance, so it’s hard to say whether there’s just a very small percentage of people who are resistant,” Ludwig noted.
“Even if the resistance is very limited, there could be many people with the same resistance gene and very few of us.”
How can we prevent it from happening?
Ludwig points to the fact that some of those resistance genes have already been found to be transferred between people and animals, making them more resistant to a wide variety of drugs.
That means that as we get ever more efficient at making drugs, it will become more and more difficult for drugs to be made from resistant bacteria.
“What this means is that in the longer term,