Preparedness for Future Pandemics Requires Effective Antibiotics

Since the coronavirus that causes COVID-19 started spreading rapidly in early 2020, it has illustrated the global devastation that pandemics can inflict and the critical need for more robust public health preparedness. As leaders look ahead for ways to prevent and better respond to future pandemics, they must recognize the critical role that antibiotics play in protecting health and security.

Antibiotics do not treat viral infections such as COVID-19, but these medications have played a vital role in protecting patients with the virus—especially those requiring hospitalization and intensive care such as intubation, mechanical ventilation, or other procedures that carry an increased risk of secondary infection. That demand has come at a time when certain bacteria—so-called superbugs—are becoming more resistant to the antibiotics available and the pipeline to produce new ones is not working as it needs to.

Effective antibiotics, then, have been more essential than ever to control infection in the day-to-day delivery of care in hospitals and other health care settings that have been chronically overcrowded and under-resourced over the past two years. According to the Centers for Disease Control and Prevention, the pandemic led to a significant increase in health care-associated infections in 2020 following years of decline.

These infections included rising rates of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, which causes dangerous and hard-to-treat staph infections because of the high levels of resistance to many antibiotics commonly used to treat such infections.

Additionally, a CDC investigation into a December 2020 superbug outbreak at a COVID-19 hospital unit in New Jersey highlighted “that multidrug-resistant organisms can spread rapidly in hospitals experiencing surges in COVID-19 cases and cause serious infections.” The flood of cases that overwhelmed hospital resources and exposed patients to these potentially deadly infections only made the problem worse.

Growing resistance to the antibiotics needed to treat these infections often translates into complications in care and worse patient outcomes. Increasingly, patients may survive the medical condition that brought them to the hospital only to die as a result of a drug-resistant superbug. Pew research has shown high rates of antibiotic use among hospitalized COVID-19 patients, which likely accelerated the emergence and spread of superbugs.

Ultimately, any public health emergency is likely to strain hospitals and health care systems and increase the risk of drug-resistant infections. Without effective antibiotics, these superbugs will only exacerbate the deadly consequences of future pandemics.

Unfortunately, according to the World Health Organization’s most recent analysis, medical professionals and health care providers are quickly running out of effective antibiotics, and there are far too few new drugs in development with the potential to treat increasingly resistant bacterial infections. This stagnant pipeline is largely due to the broken market for these drugs and a lack of economic incentives. Already, available drugs cannot meet patient needs. According to a recent study in The Lancet, antibiotic-resistant superbugs were responsible for more deaths globally in 2019 than either HIV or malaria, and the problem is only getting worse.

Spurring antibiotic development must be a priority for policymakers, researchers, and industry leaders in their efforts to be better prepared for future pandemics. Congress can take meaningful action to accelerate antibiotic innovation by passing the PASTEUR Act, a bipartisan bill designed to reinvigorate antibiotic development and foster appropriate use of these lifesaving drugs. By changing the way in which the U.S. government pays for antibiotics, the PASTEUR Act would encourage development of urgently needed new drugs—specifically those that can address unmet patient needs.

Moving forward, health care leaders, researchers, and others must focus on the fundamental importance of antibiotics, both in the day-to-day practice of modern medicine and for combating future pandemics. That starts by addressing the broken market for antibiotics and ensuring that these essential drugs are on the shelf when they are desperately needed.

David Hyun directs The Pew Charitable Trusts’ antibiotic resistance project.