Where You're Most Likely to Develop an Antibiotic-Resistant Infection

How sick is your state?

November 30, 2012

Will those drugs even work 10 years from now?

There are tons of good reasons to move to Hawaii, and here's one more. According to a new report from the Center for Disease Dynamics, Economics & Policy (CDDEP), a health policy think tank, it's one of the states where you're least likely to get a prescription for an antibiotic and, therefore, you're least likely to encounter antibiotic-resistant bacteria.


CDDEP has been tracking antibiotic use since 1999 in order to predict antibiotic effectiveness and determine which diseases are being caused by stronger strains of antibiotic-resistant bacteria.

Overall, they found, the rate of antibiotic prescriptions in the U.S. has declined by 17 percent in the past decade, but doctors are now turning to more powerful classes of antibiotics because penicillin and older, weaker antibiotics are no longer proving effective, says Ramanan Laxminarayan, MD, director of CDDEP and one of the lead researchers of the new report.

Do You Really Need That Antibiotic?

People in the Southeast are the most likely to receive a prescription for antibiotics, the report found, with Tennessee, Kentucky, Mississippi, Louisiana, and West Virginia seeing the highest increase in antibiotic prescription rates in the country. In this region, the average person will get more than one antibiotic prescription per year. States along the Pacific Coast—Alaska, Hawaii, California, Oregon, and Washington—saw the lowest increase. The average rate of antibiotic prescriptions in that area is one for every two people.

Why does it matter? In many cases, these antibiotics aren't needed, at least according to the Centers for Disease Control and Prevention (CDC), whose claims are that 50 percent of prescribed antibiotics are unnecessary. "Those numbers come from a small study, but even if it was 30 percent that was not necessary, there's still room to reduce antibiotic use," says Dr. Laxminarayan.

Overuse is also costly. People are paying for drugs that are doing them no good, and those drugs come with a whole bevy of unpleasant side effects, including a rise in antibiotic-resistant bacteria that trigger conditions like urinary tract infections (UTIs), which the report also found were becoming untreatable. The prevalence of UTIs, which are the second most common type of infection in the U.S., that don't respond to antibiotics increased 30 percent between 1999 and 2010, according to the CDDEP's data.

Are Antibiotics Making You Fat?

The good news is that drug-resistant skin infections like MRSA have dropped about 25 percent from their peak in 2005 to 2010.

Still, a growing number of hospital-specific infections are on the rise, and some are resistant to every antibiotic currently approved by the Food and Drug Administration (FDA), says Dr. Laxminarayan. "These infections respond to none of the drugs that we have, and once you get one, there's not much you can do about it," he adds. In other words, antibiotic-resistant bacteria are getting more fatal.

"One of the major drivers of this is that people expect antibiotics when they go to the doctor's office," he says, adding that he hopes this report will raise awareness about the real dangers of indiscriminate antibiotic use. The CDC recently kicked off an educational campaign about antibiotic resistance in an effort to encourage patients to follow doctors' orders about these vital drugs and teach healthcare providers better management techniques for antibiotic-resistant diseases.

Not mentioned in the report, nor by the CDC, was the fact that, according to the FDA, 80 percent of antibiotics used in the U.S. are now used on factory farms to speed growth and to ward off the diseases bred in the confined, filthy conditions in which animals live. In a recent blog post, Margaret Mellon, senior scientist at the Union of Concerned Scientists, wrote, "It just doesn't make sense for the CDC to urge parents of sick children not to ask for precious antibiotics when they are not needed, while producers of cattle, swine, and poultry continue to use the same drugs just to save a few pennies or avoid the transition to modern management systems."

Confronting the problems of antibiotic resistance, she adds, will take a concerted effort on all fronts. Here's what you can do about the problem.

 • Don't ask for an antibiotic. "Wait for your doctor to prescribe one," says Dr. Laxminarayan, because you could be suffering from an infection cause by a virus, not a bacterium, and it won't respond to antibiotics, anyway.

• Buy organic meat. You're supporting an animal production system that bans routine use of antibiotics in animals raised for meat and, studies have shown, as a result you're likely to eat meat with lower levels of antibiotic-resistant bacteria—such as those responsible for hard-to-treat UTIs. That's one reason Why Women in Particular Shouldn't Eat Factory-Farmed Chicken.

• Stay up-to-date on the issues. Consumers Union has set up a website, meatwithoutdrugs.org, where you can sign petitions to grocery stores and legislators demanding that they do their part to force animal producers to ban the use of antibiotics for feed promotion and protection against filth, and save them only for when animals get sick.

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