Key Findings

Since its launch in 2010, ResistanceMap has helped inform researchers, policymakers, and the public of important trends in drug resistance and antibiotic use. The rapidly decreasing effectiveness of antibiotics is a major public health concern, one that has been recently highlighted in an unprecedented consensus statement between CDDEP and 25 leading national health care organizations.

In this updated version, ResistanceMap presents both a sleeker user interface and new data and trend analysis. Click the tabs below to see snapshots from our latest findings.

Antibiotic Use – Summary

Our original analysis of antibiotic use trends between the years of 1999-2007 found an overall 12% decrease in per-capita antibiotic prescriptions. However, this decrease was not uniform across the US: we also found alarmingly high use patterns in the Southeastern US states.

Newly added data from the years 2007-2010 shows the continuation of the downward national trend and the deepening of regional differences. Nationally, prescriptions fell to an all-time low for the past decade, marking a 17% decline between 1999-2010. However, states in Appalachia and on the Gulf Coast continue to consume more than twice the amount of antibiotics per capita than those in the  Northwest and New England. More worryingly, this imbalance in rates of decrease appears to be accelerating.

High per capita antibiotic use rates in certain regions could be due to a variety of cultural, socio-economic and epidemiological causes. Additional research must be done to better understand the driving factors behind antibiotic overuse and tailor information campaigns accordingly. Interventions are urgently needed on a local level to promote rational prescribing on part of physicians and to educate consumers about the need to conserve antibiotics.

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Resistance in the US - the Drug Resistance Index

Most recent analysis of resistance trends in the US reveals both encouraging and discouraging findings. In concerning news, certain kinds of bacteria that cause urinary tract infections (UTIs) are becoming more difficult to fight with our current arsenal of antibiotics. UTIs are the second most common type of infection, accounting for about 8.6 million visits to health care providers each year.

Using our Drug Resistance Index, a tool that can be used to track antibiotic resistance in various settings, we found that the overall share of drug-resistant UTI-causing bacteria increased by over 30% between the years 1999-2010. The most alarming aspect of this picture is the lack of new drugs in development that could replace the diminishing pool of effective treatments, particularly for the sturdier family of Gram-negative bacteria, which can cause common UTIs as well as deadly hospital infections.

On the positive side, rates of resistance in skin infections - mostly caused by Gram-positive bacteria such as S. aureus - seem to have peaked in the mid 2000s and have been declining since. This could be the result of naturally occuring ecological trends, as well as enhanced infection control interventions and newly developed antibiotics specifically targeted at these organisms.

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Global Resistance - North America and Europe

The United States compares unfavorably with European nations in terms of resistance against clinically important Gram-positive bacteria. Some of these “superbugs,” like vancomycin-resistant Enterococcus (VRE), are more common in hospital settings and affect the critically ill. Others, such as methicillin-resistant Staphylococcus aurea (MRSA) and drug-resistant S. pneumonia, are frequently encountered in the community.

Unfortunately, highly-resistant Gram-negative organisms - although less prevalent in North America than in Europe - are emerging nationally and posing grave challengest to patients and clinicians due to the limited availability of new therapies against these types of pathogens. Fortunately, our treatment arsenal against Gram-positive infections is more effective, as several new antibiotics - including linezolid, daptomycin and ceftraoline - have been developed in the past decade to target these bacteria.

In addition to promoting the development of new pharmaceuticals, we need to adopt proven infection control strategies such as those from the Netherlands, Israel, or from individual health care facilities in the U.S. to control resistant outbreaks before they spread to the community and reach endemic proportions.

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