Dr. Fred Bortzbooks

Review of Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them

by Brad Spellberg M.D.

(Prometheus Books, 264 pages, $26.00, September, 2009)

Reviewed by Dr. Fred Bortz

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Dear President Obama, Senators, and Representatives:

I write this book review in a form of a letter to you at the suggestion of author and infectious disease specialist Brad Spellberg, M.D., whose Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them lays out a critical societal problem that begins with medicine and ends with politics.

No, Spellberg did not personally request this unorthodox approach to reviewing. The book itself led me to address our national leadership as well as the readers of this website.

You are probably aware of the growing problem of antibiotic-resistant bacteria. But like most Americans, you probably think that only hospitalized and immuno-compromised individuals are at risk. You probably also think that the problem can be solved by better sanitary practices.

But both of those are overstatements. As Spellberg writes, "Hospital-acquired infections are the natural by-product of concentrating sick patients in hospitals, and exposing those sick patients to all of the invasive procedures modern physicians use."

Furthermore, "it has become routine for healthy people going about their normal daily lives to acquire and develop severe complications from--or even die from--antibiotic resistant infections."

But surely we have a solution, you must be thinking. The modern pharmaceutical and biotechnology industries are developing new antibiotics faster than microbes can evolve resistance to them.

That is the most serious public misconception of all. Even though those industries may be capable of developing new antibiotics, they are not doing so.

For the past 25 years, antibiotic development has been declining, Spellberg writes. "Unfortunately, this crisis in new antibiotic availability is occurring at exactly the same time that the world is experiencing an explosion in the frequency of multi-drug resistant diseases."

There are many reasons for this phenomenon ranging from the economics of the drug business, research and development funding, patent law, regulatory requirements, media coverage, and public attitudes. As political leaders know all too well, it is often easier to find fault and point fingers than it is to solve a problem.

But Spellberg and his colleagues on the Infectious Disease Society of America's Antimicrobial Availability Task Force operate on the assumption that this is "a complex, interwoven societal problem that is no one's fault." [emphasis in original]

A problem like that requires government involvement, and the best way of prompting such involvement is by a grass-roots effort. Thus Spellberg urges his readers to contact Congress and other national leaders.

In response, I suggest that as long as you are already preoccupied with reforming health care, please ask your staffers to read this book and help begin an urgently needed public debate on how to address the Rising Plague of antibiotic-resistant bacteria.

Fred Bortz,
author of science books for young readers