SHOW: SUNDAY MORNING (9:00 AM ET)
April 2, 2000, Sunday
HEADLINE: PRESCRIPTION FOR PERIL; OVERUSE OF ANTIBIOTICS CAN RESULT IN TREATMENT- RESISTANT BACTERIA
ANCHORS: CHARLES OSGOOD
REPORTERS: RITA BRAVER
BODY: PRESCRIPTION FOR PERIL

CHARLES OSGOOD, host:

It's scary to think that a reliance on disease-fighting drugs could be a Prescription for Peril, but consider this: A new report says drug-resistant cases of tuberculosis are up 50 percent in Denmark and Germany over just the past three years. It turns out that some of the drugs that were medical breakthroughs are backfiring on us. Rita Braver will be reporting our cover story.

(Footage of Lisa Bousel)

RITA BRAVER reporting:

(Voiceover) Last summer Lisa Bousel's life changed.

Ms. LISA BOUSEL (MRSA Sufferer): Oh, it's horrible. It's horrible. I'm consumed with pain, and I just want to get rid of the pain.

(Footage of hospital entrance; crowds of people walking in city)

BRAVER: (Voiceover) This third-grade teacher went into a Philadelphia hospital for sinus surgery, but she became a statistic, one of 70,000 people who each year are infected by Methicillin-Resistant Staphylococcus aureus, commonly called MRSA.

Ms. BOUSEL: The next thing I know there's a whole language that's thrown at me that I don't--I don't know those words. I think I was in so much shock. It was awful, and it was scary, I mean, it was very scary.

(Footage of boxes of drugs; bottles of Vancomycin)

BRAVER: (Voiceover) MRSA is a staph infection that cannot be cured the way it's supposed to be, with the antibiotic Methicillin. So doctors put Lisa Bousel on the drug Vancomycin, considered the big gun of antibiotics.

But at this point it looks like Vancomycin didn't really clear up that infection either, did it?

Ms. BOUSEL: No, it didn't. I was still testing positive after four weeks.

(Footage of bacteria under a microscope; drug laboratory; crowds walking in city)

BRAVER: (Voiceover) And Lisa has just one of the many types of antibiotic-resistant infections that are now worrying doctors, infections that cause tens of thousands of deaths each year.

(Footage of crowds walking in city)

Dr. WILLIAM SHAFFNER (Vanderbilt University Hospital): (Voiceover) It's very much a race against the clock.

(Footage of Shaffner)

BRAVER: (Voiceover) Dr. William Shaffner, of Vanderbilt University Hospital, in Nashville.

Dr. SHAFFNER: Because those of us in infectious diseases and public health are now at the point of being genuinely concerned about the spread of resistant infections, so this is something we really must do something about.

(Footage of bottles of antibiotics)

BRAVER: (Voiceover) Antibiotics were supposed to be wonder drugs in the fight against bacterial infection.

Unidentified Reporter: (From vintage newsreel) The live casualties at Normandy received the most expert medical care science can provide. Two modern treatments, penicillin and blood transfusion, have cheated death in thousands of cases.

(Excerpt from vintage newsreel; bottles of antibiotics)

BRAVER: (Voiceover) Penicillin was the first major advance, saving thousands of Word War II soldiers with infected war wounds. And over the years, drug makers came up with one antibiotic after the next, to treat everything from ear infections, to pneumonia, to meningitis, to a host of other illnesses.

(Footage of hospital pharmacy)

BRAVER: Back in the 1960s, the US surgeon general was actually predicting that we would soon be able close the book on infectious diseases that could be treated with antibiotics. But neither he nor anyone else in medicine could foresee the survival skills of the bacteria that cause those infections.

(Footage of bacteria under a microscope)

Dr. SHAFFNER: These bacteria--you see this haze--these bacteria were recovered from the patient. This antibiotic doesn't allow the bacteria to grow close.

BRAVER: So that's a good antibiotic?

Dr. SHAFFNER: That's a good antibiotic; that antibiotic works. But look, all of these other antibiotics, which in earlier years used to work against this sem--selfsame bacteria, don't work anymore. In other words, this bacteria is resistant to all of these antibiotics. This does not make an infectious diseases physician happy.

(Footage of information boards at Infectious Diseases Society meeting)

BRAVER: (Voiceover) In fact, there are a lot of unhappy doctors at the annual meeting of the Infectious Diseases Society in Philadelphia.

Dr. SHAFFNER: This is not a single clone...

(Footage of Shaffner, Dr. Glenn Morris)

BRAVER: (Voiceover) Dr. Schaffner shared his concerns with other specialists, including Dr. Glenn Morris of the University of Maryland School of Medicine in Baltimore.

Dr. SHAFFNER: And then...

Dr. GLENN MORRIS (University of Maryland School of Medicine): What we're doing is going above and below the threshold of protection.

Dr. SHAFFNER: Right. Exactly.

Dr. MORRIS: Yeah.

Dr. SHAFFNER: See, that's my idea, too.

(Footage of Morris, Shaffner; pills being counted)

BRAVER: (Voiceover) They both believe there's one major reason so many antibiotics are becoming obsolete: overuse.

Dr. MORRIS: We've been using these antibiotics now for 50 years. We've been overusing these antibiotics, and so what's happened is the bacteria are evolving.

(Footage of CDC sign; CDC building exterior; prescriptions being filled; packages of antibiotics; patients waiting in clinic)

BRAVER: (Voiceover) The Centers for Disease Control estimates that a whopping 50 million to 60 million unnecessary prescriptions for antibiotics are written each year. The problem is that antibiotics work only against infections caused by bacteria. Antibiotics cannot cure the common cold or even the flu, both of which are caused by viruses. But that doesn't keep patients from demanding them.

You know, everybody gets sick and they want to go to the doctor with a sniffle.

Dr. MORRIS: That's right.

BRAVER: And they want the doctor to give them something to put them out of their misery.

Dr. MORRIS: And that's one of our problems, is that we are finding that the heavy use of antibiotics in the community and in hospitals is resulting in the emergence of these resistant organisms. For ins...

BRAVER: So we're our own worst enemy.

Dr. MORRIS: We're our own worst enemy in this.

(Footage of people walking down sidewalk; hospital entrance; person washing hands; Tabitha Gerard lying in bed)

BRAVER: (Voiceover) Antibiotic resistant infections can be spread from one person to another. Hospitals are well-known breeding grounds, especially if medical personnel fail to wash their hands. But no one can be sure exactly how each infection is transmitted.

What kind of pain did you have with it? Was it bad?

Ms. TABITHA GERARD (Infection Sufferer): It's so un--it's hard to explain. It's just something that make you want to fall onto the floor.

BRAVER: And it was just the infection causing all that pain? Yeah.

Ms. GERARD: The pain--and the infection is--it's a killer pain.

(Footage of hospital personnel; Gerard)

BRAVER: (Voiceover) After Tabitha Gerard had gall bladder surgery, she developed a resistant infection. She was sent to Vanderbilt for treatment, and after three weeks doctors there finally found a combination of drugs that cured her. She was one of the lucky ones.

If this infection hadn't been treated, what would happen?

Dr. SHAFFNER: It would have been even more serious.

BRAVER: Is this--could this be a fatal kind of thing...

Dr. SHAFFNER: It's...

BRAVER: ...if it's not treated?

Dr. SHAFFNER: ...it could have happened.

(Footage of medical laboratory; herd of cattle)

BRAVER: (Voiceover) There's another reason why many doctors believe that antibiotic-resistant bacteria are appearing more often: widespread use of antibiotics in agriculture.

Dr. SHAFFNER: There are many of us in infectious diseases and public health, myself included, who are really quite convinced, we think that the data are clear that the extensive use of antibiotics in animal husbandry leads to a--resistance in bacteria, and those resistant bacteria will find their way into humans.

(Footage of crowds walking in city)

BRAVER: (Voiceover) No matter what the reason, the reality is that more and more of us--often without even knowing it--are walking around with dangerous bacteria, which though dormant for now, could prove harmful in the future.

Dr. MORRIS: We're seeing an in--increasing numbers of--of--of bacteria which show antibiotic resistance that are just being car--carried by normal, healthy people. They're walking around, they're fine. That resistant organism in their intestinal tract is not going to cause them any trouble whatsoever.

BRAVER: Unless?

Dr. MORRIS: Unless they happen to need a bone marrow transplant 10 years from now for breast cancer, and then suddenly we knock out their immune system. And then, that highly resistant enterococci can get into their blood, and may turn out to be a fatal infection.

(Footage of medical laboratory)

BRAVER: (Voiceover) So researchers, like Dr. Morris, are scrambling to develop still more antibiotics and other, different treatments to block bacterial infections.

Dr. MORRIS: For example, we've been looking at bacteriophage, which are viruses that kill bacteria. There are a lot of different therapies that were used back before antibiotics that suddenly we're beginning to look at.

BRAVER: (Voiceover) The good news is that at this point, doctors say they are not greatly worried about a major bacterial infection spreading quickly through the population. But don't start feeling too confident.

Dr. MORRIS: It's not so much, you know, "The Andromeda Strain" which is going to wipe out the country. It's more that we're turning the clock back to an earlier age, when infectious diseases were of concern...

(Footage of view into operating room)

Dr. MORRIS: (Voiceover) ...when surgeries were limited by the problems of post-operative infection, where you did not give somebody cancer chemotherapy which completely knocked out their immune system, because if they got infected you couldn't do anything about it.

BRAVER: And we could really be back there again?

Dr. MORRIS: There is the potential that we could be back there again. Unidentified Man: I think that's got it.

(Footage of Bousel)

BRAVER: (Voiceover) Lisa Bousel, the third-grade teacher from Philadelphia, has found some relief from her pain in the ancient art of acupuncture, but her anxiety is undiminished.

Ms. BOUSEL: I don't know what's going to happen. I don't know what's going to happen to me.

(Visual of SUNDAY MORNING sun logo)

OSGOOD: (Voiceover) Ahead on SUNDAY MORNING, baseball's oldest rookie.