The end of antibiotics?

It was the real-life scenario physicians and pharmacists had feared. A woman entered the ICU with a high fever and low white blood cell count. Urgent laboratory testing revealed she had a bacterial blood infection highly resistant to antibiotics. On top of cancer, she was now also fighting to survive sepsis, a potentially fatal disorder that occurs when the body's immune system kicks in to fight an infection, but instead goes into overdrive and damages its own tissues and organs. Antibiotic resistance among cancer patients like her is the focus of MD Anderson’s antibiotic stewardship team, which is dedicated to promoting the best use of antibiotics for our patients. A quest to slow down the progression of antibiotics resistance Frank Tverdek, Pharm.D., a clinical pharmacy services manager who’s part of the team, says stewardship became necessary as organisms evolved beyond antibiotics’ effectiveness. Another team member, Micah Bhatti, M.D., Ph.D., assistant professor in Laboratory Medicine, explains it this way: The more antibiotics you put people on, the more likely future infections are resistant to antibiotics. “Antibiotics have this long history of being relatively safe,” Bhatti says. “But we’re learning that’s not the case. They have repercussions.” The type of bacteria infecting the ICU patient – Klebsilella oxytoca – is often associated with previous antibiotic therapy. Like many cancer patients, the woman in the ICU likely received antibiotics to treat or prevent infection while undergoing chemotherapy, but the bacteria evolved to resist commonly used antibiotics. “One of the hopes of stewardship is that it helps slow down the progression of antimicrobial resistance through appropriate use of antibiotics,” Bhatti says. Eliminating the...