This is an archived article that was published on sltrib.com in 2016, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

The greatest emerging infectious disease threat we face today is not Ebola, Zika virus or the threat of influenza pandemics. It is the rising tide of antibiotic resistance.

Antibiotics are one of our greatest medical advances, but we are in danger of losing them. The CDC estimates that some 23,000 Americans die of antibiotic resistant infections each year. As an infectious disease physician, I have seen this first hand and helplessly watched patients die of infections with bacteria resistant to virtually all antibiotics.

Antibiotic use inevitably drives the emergence of resistance through selection of the fittest bacteria. The problem is that we overuse and misuse antibiotics ­— both for humans and in the animals we eat. The more antibiotics we use, the faster the bacteria become resistant. In the past we have been able to count on the development of new antibiotics to keep up with rise in resistance. No longer. Antibiotic development has slowed to a crawl. Antibiotics are expensive to develop and make relatively small profits for pharmaceutical companies relative to other drugs. Most pharmaceutical companies have abandoned their antibiotic development programs to invest in more profitable areas.

The good news is that we have recognized the problem and know what must be done. The National Action Plan to Combat Antimicrobial Resistance was developed in response to an executive order from President Obama and calls for several key actions. We must prevent infections, improve diagnosis of bacterial infections, greatly improve the way we use antibiotics and accelerate the development of new antibiotics, vaccines and diagnostic tests.

Encouraging and accelerating the development of antibiotics has been difficult. Fortunately, Sen. Orrin Hatch, a long time leader in addressing antibiotic issues, authored a critical piece of legislation, the Promise for Antibiotics and Therapeutics for Health (PATH) Act. It passed out of committee and awaits consideration by the U.S. Senate.

Under current regulation, large clinical trials aimed at common types of infection are required to approve a new antibiotic. But some of the most deadly and highly resistant pathogens infect a modest number of critically ill patients. It is for these infections that we need new drugs. The PATH Act would allow antibiotics to treat serious or life-threatening infections and address unmet medical needs to be studied in smaller clinical trials — the only feasible way for these antibiotics to be approved and ultimately save lives.

Under the PATH Act, these antibiotics would be approved only for the limited population of patients who need them. PATH antibiotics will be clearly labeled so that physicians know they are different from traditional antibiotics and must be used judiciously.

The PATH Act contains other provisions to promote appropriate antibiotic use and infection prevention. For example, it directs the U.S. Department of Health and Human Services to work with health care facilities and state and local health departments to implement formal antibiotic stewardship programs.

Improving antibiotic use means using antibiotics only when they are needed and choosing the right antibiotic for the right duration, both in the hospital and the community. It involves education and wise choices both by the public and doctors. The promotion of wise use is called antimicrobial stewardship, and a number of the leading investigators in this field are here in Utah.

Another problem is the use of antibiotics in agriculture to promote growth in animals. Some producers and restaurants have moved away from this and are offering meat raised without antibiotics, and more consumers are demanding this.

The PATH Act represents tremendous promise in addressing the crisis of antibiotic resistance. The United States Senate must maintain this momentum and pass the PATH Act.

Andrew T. Pavia, M.D., is the George and Esther Gross Presidential Professor and chief of the Division of Pediatric Infectious Diseases at the University of Utah and director of hospital epidemiology at Primary Children's Hospital.