Potential burden of antibiotic resistance on surgery and cancer chemotherapy antibiotic prophylaxis in the USA: a literature review and modelling study

Research Area: Antibiotic Resistance
Type: Article

The Question

What is the efficacy of antibiotic prophylaxis for surgery and cancer chemotherapy on preventing infections and infection-related deaths in the United States? How would decreased antibiotic efficacy due to antibiotic resistance contribute to additional deaths and infections at different rates of reduced efficacy?

What we found

We estimate that between 38·7% and 50·9% of pathogens causing surgical site infections and 26·8% of pathogens causing infections after chemotherapy are resistant to standard prophylactic antibiotics in the USA. A 30% reduction in the efficacy of antibiotic prophylaxis for these procedures would result in 120000 additional surgical site infections and infections after chemotherapy per year in the USA (ranging from 40000 for a 10% reduction in efficacy to 280 000 for a 70% reduction in efficacy), and 6300 infection-related deaths (range: 2100 for a 10% reduction in efficacy, to 15 000 for a 70% reduction). We estimated that every year, 13 120 infections (42%) after prostate biopsy are attributable to resistance to fluoroquinolones in the USA. 

Why it matters

The declining efficacy of prophylactic antibiotics could jeopardize six million medical procedures each year in the United States. Antibiotic resistance is a growing and dire public health problem, and will only worsen if nothing is done to curb the problem. For surgical and cancer chemotherapy patients, who rely on prophylaxis to protect them from potentially life-threatening illnesses, declining antibiotic efficacy could turn routine procedures into life-threatening ones.

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