Everyone is weary of the coronavirus pandemic and ready to be done with it. So the news that a new pandemic is already slowly unfolding is unwelcome. But unless we pay attention and do what we can to reverse the growing trend of antimicrobial resistant infections, they could end up causing even more death and disability than COVID-19.
Ever since the middle of the 20th century, when penicillin and later antibiotics were introduced, doctors have been able to cure most infections that would have been life-threatening a century earlier. Viruses are something of an exception, because antivirals weren’t developed until much later. We still have no effective compounds against many viruses. But public health experts are warning that too many pathogens have developed resistance to the medicines that used to knock them out. Sometimes even the drugs of last resort don’t work. How big is the problem?
Part of the reason that pathogens have evolved to resist even new antibiotics and antifungal drugs is overexposure. Using them too frequently contributes to the problem. Eventually, doctors may end up trying to treat antimicrobial resistant infections that don't respond to any medication.
However, prescriptions for people are not the whole problem. Even more alarming, too many of these antimicrobial compounds are being used in agriculture and aquaculture. The pork industry routinely uses nearly as much antibiotic as human medicine does. This kind of exposure offers bacteria the perfect opportunity to evolve. Can we reduce our reliance on drugs in food production? Dr. Marty Makary offers some straightforward steps each of us can take to combat the problem, as well as larger-scale changes that can make a difference.
We also turn to Dr. Makary to discuss the topic of his first book, Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care. The zone of silence surrounding medical errors has prevented as much progress being made on this front as you might expect. Dr. Makary shocked his colleagues several years ago when he published an analysis in the BMJ demonstrating that medical errors are the third leading cause of death in the US. How can that be changed?
Marty Makary, MD, MPH, is a surgical oncologist, a New York Times bestselling author and a leading voice for transparency in health care. He is the recipient of the 2020 Business Book of the Year Award for The Price We Pay. A professor at the Johns Hopkins Bloomberg School of Public Health, he has published over 250 scientific articles on the re-design of health care.
He has been elected to the National Academy of Medicine and is Editor-in-Chief of Medpage Today. Dr. Makary has written for The Wall Street Journal, The New York Times, USA Today and is a frequent medical commentator on Fox News. His current research focuses on the underlying causes of disease, which is why we are discussing antimicrobial resistant infections. He is also investigating vulnerable populations and relationship-based medicine.
The photo of Dr. Marty Makary is courtesy of Johns Hopkins Medicine.
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