A: The goal of medicine is to get infected patients on the right antibiotics (or right antiviral agents) as fast as possible both to cure the infection and prevent the spread of disease to other patients. Controlling the spread of infection, especially in hospitals, is a major goal of rapid diagnostic testing. In clinical trials of new antibiotics, the goal is to get the patient with an infection of interest enrolled quickly and to not enroll patients that do not have infections. Using rapid diagnostics can make a clinical trial of a new antibiotic much for efficient and far less expensive by identifying the target patient population quickly.

A: The more that bacterial species are exposed to antibiotics, the more likely they are to develop resistance, whether that exposure is from use in humans, in animals, in fish, or on fruits and vegetables. That is why there is a concerted effort worldwide to use the right antibiotic, at the right dose, for the right period of time, and only in people who actually have infections. The second objective is to use antibiotics in animals, fish, and agriculture to fight infection rather than for growth promotion when no infection is present. The more we use antibiotics, the faster we will lose them. Thus, we need to use them wisely.

A: CDC has stressed the need for enhanced surveillance for resistant bacteria both locally and globally, rapid detection of infections in patients to guide therapy, faster outbreak response to prevent spread of disease, improved antibiotic prescribing, increased susceptibility testing to choose antibiotics wisely, nationwide implementation of CDC’s hospital antibiotic stewardship program, and global partnerships to optimize antibiotic use.

A: In general, we fear the emergence of new diseases that can spread rapidly through populations, like SARS and MERS, as well as the re-emergence of older diseases, like Ebola and Zika viruses, but we tend to forget that one third of the world’s population is infected with tuberculosis, which continues to cause outbreaks, even in the United States. Our surveillance system for infectious events, such as antibiotic resistant bacteria, is very limited in the United States. My hope is that the governments will heed the warnings voiced at the recent meeting of the United Nations General Assembly and spend more on enhancing the capabilities of both local and national public health laboratories to do better surveillance using real-time technologies, rather than reporting what happened two weeks, two months, or two years ago, so that responses can be swift and efficient to limit the spread of disease.

A: Superbugs are multiply antibiotic-resistant bacteria for which treatment options are very limited or non-existent because they have developed so many different ways to avoid being killed by antibiotics. They represent the beginning of the post antibiotic era where infections are no longer treatable. To avoid the development and spread of superbugs, we need to use antibiotics judiciously, pursue strong infection control policies in healthcare institutions, and prohibit the use of antibiotics in animals purely for growth promotion.