Growing crisis of antibiotic resistance


#1

In 1977, then FDA Commissioner Donald Kennedy tried - and failed - to tackle the problem.

pbs.org/wgbh/pages/frontline/trouble-with-antibiotics/


#2

Here’s the problem. Everytime somebody here in my office has a sniffle, their doctor gives them a Z-pack ON THE PHONE! My doctor makes me come in for a culture. I’ve never ever gotten a Z-pack, and I haven’t been put on an antibiotic in years. Yet there are people here who routinely get them. If I ever get a real infection, I hope I haven’t developed resistant bacteria because of other people’s doctors’ insistence on failing to practice due diligence.


#3

Not really…only 30 percent of the tons of antibiotics used are prescribed for human use…the other 70 percent is put into animal feed and water to increase production.

Much of the antibiotics pass into manure, still viable, and is spread on crops. The dust from the crop fields is spread with wind, and after rain, is spread by runoff. Then people are exposed.

Whether you have been put on antibiotics by a doctor or not, you have been exposed, and especially if you live near an industrial animal farm, or even a relatively small agricultural area where animal manure based fertilizers are used.

Its the big corporate farms that are to blame, not your private physician.


#4

Are you saying the over prescription of antibiotics for non bacterial infections have no impact o the growing incidence of bacterial resistance?


#5

It probably does, but it’s not the only thing. Lots of physicians under-prescribe antibiotics or prescribe them without doing cultures. Both practices can lead to inadvertent antibiotic resistance. Mainly what antibiotics do is retard cell division until the body’s own immune system can “catch up” and kill the bacteria. It gains time. If inadequately prescribed or prescribed for the wrong thing, it can encourage resistant strain development.

Also, there are serious “incubating” sources. Nursing homes became full of MRSA, for example, before it became common in the outside population, because antibiotics are so frequently used there on patients with weak immune systems. Also, some of the resistant strains come from immigrants from countries where antibiotics can be bought “over the counter”. Stomach ache? Take CIPRO. Headache? Take CIPRO. Didn’t work? Take more.


#6

Sometimes the problems with prescription antibiotics is not simply that they were prescribed (though there might be legitimate concern that they are over-prescribed), but that people aren’t compliant with the instructions.

Prescribed antibiotics have to be taken in their full doses, and there’s a reason for that. What often happens however, is that people will take the antibiotics up to the point they start feeling better, and then stop taking them and discard the remaining pills. They think “oh, the medicine worked - I can stop taking it!”, but this helps lead to antibiotic resistance.

If someone is prescribed antibiotics for 30 days (or however long), he/she needs to take those pills for 30 days - not up until day 16, 22, 27, or whichever day he stops feeling symptoms of his infection.


#7

This is all correct, except for the emphasis on personal exposure. The biggest risk to me of widespread anti-biotics is the development of resistant bugs in the population, not in me. It is a community problem more than an individual problem, and as such it requires a community solution.


#8

No, not zero effect, but relative to your claims of the impact, I would say insignificant.


#9

I wonder about this just a little. I have used veterinary antibiotics on occasion. From the directions for use, it appears to me their antibiotic properties deteriorate pretty quickly and under often-encountered conditions. Possibly they can remain intact through circulation through the animal and into its feces, then remain intact out in the sunlight and rain, heat and cold, then picked up in the environment in sufficient amount to encourage superinfections in humans. But I can’t help questioning that.


#10

We are swimming in the hysteria of E. bola while causally brewing our own home grown super bugs.


#11

As I understand it, most of the evolution of anti-biotic resistant bacteria occurs in the ground water fed by the flushing of unused antibiotics as well as the runoff from commercial farms and ranches.

The bacteria in the ground water eventually affects bacteria at the surface as well and breeds the antibiotic strains into the upper ground level bacteria.


#12

Yes and they will be as bad as Ebola if we don’t get something working soon.

Wonder why we don’t try more of this approach:

en.wikipedia.org/wiki/Phage_therapy

Phage therapy or viral phage therapy is the therapeutic use of bacteriophages to treat pathogenic bacterial infections.[1] Although extensively used and developed mainly in former Soviet Union countries circa 1920, the treatment is not approved in countries other than Russia and Georgia. Phage therapy has many potential applications in human medicine as well as dentistry, veterinary science, and agriculture.[2] If the target host of a phage therapy treatment is not an animal the term “biocontrol” (as in phage-mediated biocontrol of bacteria) is usually employed, rather than “phage therapy”.

Bacteriophages are much more specific than antibiotics, so they can hypothetically be chosen to be indirectly harmless not only to the host organism (human, animal, or plant), but also to other beneficial bacteria, such as gut flora, reducing the chances of opportunistic infections.[3] They would have a high therapeutic index, that is, phage therapy would be expected to give rise to few side effects. Because phages replicate in vivo, a smaller effective dose can be used. On the other hand, this specificity is also a disadvantage: a phage will only kill a bacterium if it is a match to the specific strain. Consequently phage mixtures are often applied to improve the chances of success, or samples can be taken and an appropriate phage identified and grown.

Phages are currently being used therapeutically to treat bacterial infections that do not respond to conventional antibiotics, particularly in Russia[4] and Georgia.[5][6][7] They tend to be more successful than antibiotics where there is a biofilm covered by a polysaccharide layer, which antibiotics typically cannot penetrate.[8] In the West, no therapies are currently authorized for use on humans, although phages for killing food poisoning bacteria (Listeria) are now in use.[9]


#13

This is my concern as well. I can catch resistant bugs from people whose doctors don’t follow the prescribed protocol.


#14

I wonder why the antibiotic runoff doesn’t kill bacteria on the ground or in the water.

And water flows down, not up. Think about this for a moment. The antibiotics are in the manure on the surface. It rains and that water enters the ground water at fairly shallow levels and also flows into streams and rivers. Now, generally speaking, the ground water only returns to the surface in streams, downhill. It doesn’t return to the land surface higher up.

And once again, I have to wonder about the chemical integrity of antibiotics that go through an animal’s system, including its digestive tract, is expelled in feces, goes through heat, cold, biological action of various sorts, as well as hours and days of direct sunlight. Almost nothing can withstand that for very long without serious chemical breakdown.

I’m not saying I’m right, but when people attribute maintenance of antibiotic chemical integrity far beyond that which almost everything else has, this theory of generation of resistant antibiotics just doesn’t ring right with me.


#15

I think it does but there are a few strains that survive, multiply and replace those that died.

I am not sure but I don’t think the antibiotic chemical integrity is as important as the bacteria that survives it. Once it survives it is on its way.


#16

Not wanting to be seen as trolling an important topic but I would love to see how creationists (Polls tell me 40-50% of Americans fit this box) explain anti-biotic resistance. Maybe its just another get rich scheme for those pesky scientists!

Also those who worship free market, how does it solve this when there is no money to be made on these type of drugs yet the cost to be without them is almost immeasurable.


#17

Not being unfriendly here, but there are some bacteria in farm soil that can affect humans, but not many varieties at all. There are some cattle vector diseases that affect humans, but cattle don’t get much in the way of antibiotics except in the feed lots. I raise cattle, and I don’t give antibiotics to mine, ever, unless one has an infection. With cattle, that’s extraordinarily rare. Most of them never get any at all. Cattle are actually vaccinated for most cattle diseases.

Poultry and hogs are different. They get a lot more in the way of antibiotics. I don’t raise either one, but that is my impression.


#18

Microevolution.

Also those who worship free market, how does it solve this when there is no money to be made on these type of drugs yet the cost to be without them is almost immeasurable.

:cool:


#19

I’ve noticed this too. Doctors are rent seekers in the restriction of pharmaceuticals by prescription. Just look at the Texas hospital where they gave antibiotics to a guy with Ebola. This aspect should be as much a story as the rest of their incompetence.

My understanding is that people misunderstand what is happening. What happens is not that bacteria grow resistant to antibiotics but that strains that are resistant remain when exposed to antibiotics. The strains that are susceptible to the antibiotics die leaving us with a larger percentage of resistant bacteria. What has not happened is mutation when presented with an environmental stressor causing the bacteria to evolve.

The free market can’t solve a problem where the people want something but are unwilling to pay for it. There are lots of things people want but they aren’t willing to pay for.

The non free market’s solution is to just demand products be made regardless of the relative cost or desire. This doesn’t seem like a better solution as the average man still may not get what he wants. In fact he is much less likely to get what he wants since production is controlled by politicians. At least in the free market a person who really wants something that is expensive usually has the option to purchase it if he can acquire the money. In the non free market products are often banned and can not be manufactured in response to an individuals desire.


#20

Mine also from the* Frontline* article.


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