'Post-Antibiotic' Era a Deadlier Threat Than AIDS: WHO


#1

(Newser) – Drug resistance today poses a bigger danger worldwide than did AIDS in the 1980s, the World Health Organization says in a dire-sounding report out today: “Without urgent, coordinated action, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” says a top official. Indeed, we could see a world where a child’s fall from a bike could mean a “fatal infection,” another WHO doctor tells the Telegraph.

newser.com/story/186145/post-antibiotic-era-a-deadlier-threat-than-aids-who.html

I imagine that this is partly due to overuse of antibiotics such as when a doctor prescribes antibiotics for what is likely a viral infection.


#2

Another cause is the overuse of antibiotics in the food industry. Cattle and chicken are routinely fed antibiotics. They end up in us and help build up antibiotic tolerant bacteria.


#3

Overuse of drugs may be part of the problem. But the fact is that a very small percentage of bacteria survive anyway. These are the bacteria which have a certain amount of inbuilt resistance to the drugs, and of course these are the ones that then multiply.

I remember reading a magazine article in a government library. It was an agriculture based department. It quoted an almost copybook case of a certain bacteria gaining resistance to a certain drug. At first almost all the bacteria were destroyed. But in ten years that particular drug was having no appreciable effect on that particular bacteria. The surviving population increased exponentially with every passing year.

It’s almost as though God (or the devil) foresaw our attempts to rid our world of the “curse”, and decided “You’re not getting out of it that easily.”


#4

This is one of the biggest uses. In essence, these places are possibly raising thousands of generations of resistant germs over the decades.


#5

It is a terrifying prospect that things like c. diff., and s. aureus will be beyond the reach of modern medicine. The threat of antiobiotic (really, antimicrobial, since it’s not just antibiotic agents that are losing their effectiveness thanks to pathogenic evolution) resistance is a very real specter. Many of the fatal hospital-based infections, such as those that inflict patients recovering from surgery, come from resistant strains such as MRSA. A “post-antibiotic” era really means that things like tuberculosis, strep and staph infections such as scarlet fever, will kill patients even in developed countries with access to good medicine.

I read (and reviewed) a book related to this recently, “The Missing Microbes”. The author’s contention extended past antibiotic resistance (which is certainly problematic) to the potential for antibiotics to cause our body’s naturally-occurring bacteria to shift in composition so that more modern diseases (such as celiac, diabetes, and obesity) emerge in higher proportions. I think he fell short of completing the connection, though he did make some important points. Among them, that 80% of antibiotics are used in fattening up livestock - not necessarily veterinarian use to treat infections, but rather just industry practice because we find that animals on penicillin grow fatter more quickly. And also that new antimicrobials are not likely to be developed because the economics of it works against their being developed.


#6

on the same topic this appeared in the NY Times yesterday, We Kill Germs at Our Peril:

We know that giving antibiotics to young chickens, cows and pigs means bigger, fatter animals brought to market. But we are doing pretty much the same thing to our own young, repeatedly dosing them up against all the infections of childhood (many of which do not require antibiotics to resolve). The results of an interconnected series of experiments in Dr. Blaser’s lab, with infant mice fed a variety of antibiotic regimens, lend strong support to the theory that exposure to antibiotics early in life has long-term effects on metabolism, and may contribute to our epidemic of childhood and adult obesity.


#7

I have to wonder about this. I realize there are those who claim antibiotics persist in the meat of food animals, but the feeders are stringently required to withdraw antibiotics and allow a period during which they can be flushed from the animal’s system before slaughter.

As to resistant bacteria, I wonder too whether giving children antibiotics for, say, earaches, is all that great a problem, particularly since parents will almost surely give the kid the whole course. But if you look at nursing homes, for instance, antibiotic use is absolutely massive, due to the difficulty of controlling infections in weakened residents. The first MRSA I ever heard of, perhaps twenty years ago, was in connection with nursing homes. Might be we just have to live with that.

Also, a lot of recent immigrants, both legal and illegal, purchase powerful antibiotics over the counter in their home countries, self-diagnose and use those antibiotics willy-nilly. Those drugs are pervasive in Hispanic communities in this country. I dare to say virtually every recent immigrant has a sizeable stash of them brought from the home country. It is hard to imagine a more effective way to generate bacteria-resistant strains.

I will agree that sometimes physicians will prescribe antibiotics without doing the labs. This should not be allowed except in the most obvious and extreme cases.

Since I very much question whether giving antibiotics to children or adults who actually do need them, is the source of resistant strains, there being such much more likely sources, I am dismayed by what could easily turn into underprescription of antibiotics to those who really do need them.

Think for a moment about this. Generally speaking, antibiotic resistant strains of, say, strep, are no more dangerous in the absence of an effective antibiotic than untreated nonresistant strains of the same bacteria. Both are equally dangerous. So, we are to encourage doctors to let a strep go for fear of causing a resistant strain of the very same thing that will have the very same effect?

Antibiotics’ basic action is interference with bacterial mitosis…cell replication. For the most part, one’s own body then gets the opportunity to kill off the germs by avoidance of massive infection that overwhelms the body’s defenses.

As one recovers from infections, one develops at least some degree of resistance. That’s the nature of the immune system. I have to ask whether one is better off recovering quickly and effectively from what could become a massive infection, even if some of the “bugs” escape through resistance (succumbing to the immune response instead), or to go through the course of what could be a damaging disease?

I grew up in what was then a relatively primitive part of the U.S. Because of old ways and because people could hardly afford medical treatment anyway, it was the local “way” to either recover from disease or infection on one’s own or succumb. People didn’t seek out remedies that could prevent death or damage to hearing, sight or organs. As a child, I recovered from Scarlet Fever all on my own, and I would not wish that experience on any child. As a child, my own father sustained heart valve damage from that disease. Fortunately, I didn’t. One hopes we don’t return to that out of excessive zeal to prevent antibiotic resistance.

I realize we could end up with few antibiotic defenses. But I do think we ought to concentrate on the likely sources of resistance-development rather than on, say, denying the child an antibiotic that might save his hearing, his eyesight or heart valve damage.


#8

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