Infectious diseases are the leading case of death worldwide, and the third leading cause of death in the United States, following heart disease and strokes. Because many bacteria have learned to evade some or all of the 100 or so antibiotics developed in the last 60 years to fight them, deaths from infectious diseases like tuberculosis are once again on the rise. So concerned are leaders of the World Health Organization, American College of Physicians, the American Medical Association, and the U.S. Centers for Disease Control and Prevention that they recently named antibiotic resistance as one of the top public health concerns of this decade.
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Inappropriate use of antibiotics contributes to the development of resistant bacteria or other pathogens. Our understanding is that antibiotics tend to be used more in the U.S. than in most other industrialized countries. The AIDS community needs to be on top of this issue and exercise leadership, for two reasons. First, AIDS patients use more antibiotics than most, so physicians and the community need to be especially attentive about correct use. And second, we need to be informed to avoid any possible discounting of the lives of persons with HIV when treatment or policy decisions are made.