A lot of common surgical procedures and cancer chemotherapy could be rendered “virtually impossible” if antibiotic resistance is not tackled urgently, US researchers have warned.
They say they have the strongest evidence yet that rising antibiotic resistance could have disastrous consequences for patients undergoing surgery or cancer chemotherapy.
“A lot of common surgical procedures and cancer chemotherapy will be virtually impossible if antibiotic resistance is not tackled urgently”
Their estimates, published in The Lancet Infectious Diseases journal, suggest up to half of infections after surgery and over a quarter of infections after chemotherapy are caused by organisms already resistant to standard prophylactic antibiotics in the US.
Worryingly, the findings also predict that just a 30% reduction in the efficacy of preventive antibiotics given routinely before, during, or after these procedures could result in 120,000 more infections and 6,300 infection-related deaths every year in the country.
The researchers – from the Center for Disease Dynamics, Economics and Policy in Washington DC – reviewed trials conducted between 1968 and 2011, examining the efficacy of antibiotic prophylaxis in preventing infections and related deaths after 10 of the most common surgical procedures and blood cancer chemotherapy.
They calculated the additional number of infections and infection-related deaths under different scenarios of reduction in the efficacy of antibiotic prophylaxis.
Additionally, they estimated the proportion of infections caused by bacteria that are resistant to currently used standard prophylactic antibiotics.
The authors found that between 39% – after caesarean section – and 50-90% – after transrectal prostate biopsy – of surgical site infections were caused by organisms resistant to recommended antibiotic prophylactic regimens.
Additionally, 27% of infections after blood cancer chemotherapy were resistant to standard antibiotics.
Further modelling estimated that a 10% drop in the efficacy of antibiotic prophylaxis could, at best, result in 40,000 additional infections every year in the US, or 280,000 in a pessimistic scenario – a 70% drop in efficacy.
Infection-related deaths could increase by 2,100 in an optimistic scenario, or even 15,000 in a pessimistic scenario.
Study author Professor Ramanan Laxminarayan said: “A lot of common surgical procedures and cancer chemotherapy will be virtually impossible if antibiotic resistance is not tackled urgently.”
He added: “Not only is there an immediate need for up-to-date information to establish how antibiotic prophylaxis recommendations should be modified in the face of increasing resistance, but we also need new strategies for the prevention and control of antibiotic resistance at national and international levels.”