By now, we've all heard about the growing threat of antibiotic-resistant bacteria. 'We know not to ask our doctors to prescribe an antibiotic unnecessarily, and we've been told that frequent handwashing cuts down on the transmission of bacterial infections.

With such strong warnings, you might assume that antibiotic resistance is going away. But the reality is that it isn't.

Increasingly, bacteria that are responsible for sinusitis, ear and urinary tract infections and many types of pneumonia are resistant to one or more antibiotics. This means that many infections that were once easily cured try taking an antibiotic for a few days can now linger much longer-and even become life-threatening.

How antibiotic-resistance develops: Bacteria can become resistant to antibiotics by mutating to become insensitive to the drug. The surviving resistant organisms then multiply and create new strains of bacteria that don't respond to antibiotics that were previously effective. The potential for resistance is enhanced when patients do not finish a full course of an antibiotic-or when antibiotics are overused or misused in general. Latest developments...

Lax Handwashing

What's new: Many people still aren't washing their hands. Although91% of American adults claim to wash their hands after using the restroom, only 83% actually do so, according to the American Society for Microbiology.

What this means for you: Because many viruses and bacteria are spread from hands to the mucus membranes of the mouth, nose or eyes, dirty hands are a prime means of transmitting infection.

Self-defense: In addition to washing your hands after using the restroom and before eating or preparing food, it's also important to wash after handling garbage...playing with a pet...changing a diaper...blowing your nose, sneezing or coughing...and inserting or removing contact lenses.

What to do: Use soap and warm, running water, and rub your hands together for at least 10 seconds. Don't forget the wrists and backs of your hands. Dry with a clean cloth or paper towel. Pocket-sized bottles of hand-sanitizing gels and disposable towelettes that contain alcohol are convenient ways to wash when water is not available.

More Drug-Resistant Strains

What's new: The number of drug-resistant and multidrug-resistant strains of bacteria is up sharply from just a few years ago. Approximately 70% of the bacteria that cause infections in hospitals are now resistant to at least one common antibiotic.

What this means for you: If you are hospitalized, you are now at an increased risk of contracting an infection that can be difficult to treat and that may even result in death. Recent studies show that 5% to 10% of hospital patients in the United States get an infection during their stay, and nearly 100,000 die annually as a result. This compares with approximately 13,000 deaths from hospital-acquired infections in 1992.

Self-defense: Keep hospital stays as short as possible. Visitors and hospital staff should wash their hands before and after contact with you. With some infectious diseases, such as tuberculosis, visitors and staff may need to wear a mask, gown and gloves to prevent the spread of the infection.

Antibiotic Ban For Poultry

What's new: In July 2005, the US Food and Drug Administration (FDA) announced a ban on the use of the animal antibiotic enrofloxacin (Baytril) in poultry. Enrofloxacin is a fluoroquinolone antibiotic in the same class as ciprofloxacin (Cipro). The ban followed the finding that fluoroquinolone-resistant bacteria that infected poultry were becoming increasingly less responsive to Cipro in human infections caused by the same bacteria. This was the first time the FDA had banned an antibiotic used in animal health because of the potential harm posed to people by the emergence of drug-resistant bacteria.

What this means for you: Greater attention is being given to antibiotic use in agriculture, animals and people. Europe has instituted a ban on the use of all growth-promoting antibiotics. In the US, antibiotics are still given to poultry to increase growth. The FDA is currently reviewing the issue, and many experts believe the US should also ban growth-promoting antibiotics.

Self-defense: To find poultry that is totally free of antibiotics, check with your local butcher or at a natural-food store.

Cipro Resistance

What's new: Ciprofloxacin, one of the first line antibiotics that is used to treat anthrax (a leading bioterror weapon), is becoming increasingly ineffective against other infections.

What this means for you: For now, other antibiotics can fill the gap for ear, sinus and urinary tract infections. Experts do not believe that Cipro's effectiveness against anthrax has been compromised-but this could change in the future if the antibiotic is overused.

Self-defense: Some of the experts believe that doctors are too quick to prescribe Cipro when another antibiotic would be sufficient. If your doctor prescribes Cipro, ask if another antibiotic could be used.

New Staph Infections

What's new: A drug-resistant strain of staphylococcus bacterium-community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)-formerly found only in hospitals, is now increasingly being detected within communities.

What this means for you: This particular staph bacterium appears to be more virulent than others and spreads from person-to-person, particularly through skin-to-skin contact sports, such as football and wrestling.

Self-defense: To prevent infection, wash well with soap and water immediately after any contact sports, being especially careful to clean any cuts. Never share towels or washcloths in a gym.

Latest Antibiotics

What's new: Tigecycline(Tygacil), the first in a new class of antibiotics called glycylcyclines, was introduced in June 2005. It was approved by the FDA as a first-line treatment for hospital based skin and soft tissue infections caused by bacteria that are resistant to other antibiotics. A new class of antibiotics called diarylquinolones, which treats drug-resistant tuberculosis, is now in clinical trials.

What this means for you: Despite these new drugs, antibiotic research is getting short shrift. That's because many major pharmaceutical companies have found that it is more profitable to fund research and development for new drugs that treat chronic illnesses, such as diabetes, arthritis and high cholesterol.

Self defense: Write to your representatives in Congress and tell them that you support efforts to boost incentives (via tax credits and other means) for pharmaceutical companies to develop new antibiotics.

To write to your congressional representatives online, go to www.firstgov.gov. This Web site also gives mailing addresses and phone numbers for your congressional representatives

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