Day 123 - Rx For a Healthier Planet

Fighting Antibiotic Resistance

Ethan's sick. The poor kiddo has strep throat, and the doctor prescribed an antibiotic to help fight the infection. As you may know, antibiotic resistance has become a major cause of concern in the medical community. New "superbugs" are evolving rapidly and science is finding it difficult to keep up. Here's some information I found at the Food And Drug Administration's site*:

When penicillin became widely available during the second world war, it was a medical miracle, rapidly vanquishing the biggest wartime killer--infected wounds. Discovered initially by a French medical student, Ernest Duchesne, in 1896, and then rediscovered by Scottish physician Alexander Fleming in 1928, the product of the soil mold Penicillium crippled many types of disease-causing bacteria. But just four years after drug companies began mass-producing penicillin in 1943, microbes began appearing that could resist it.

The first bug to battle penicillin was Staphylococcus aureus. This bacterium is often a harmless passenger in the human body, but it can cause illness, such as pneumonia or toxic shock syndrome, when it overgrows or produces a toxin. In 1967, another type of penicillin-resistant pneumonia, caused by Streptococcus pneumoniae and called pneumococcus, surfaced in a remote village in Papua New Guinea. At about the same time, American military personnel in southeast Asia were acquiring penicillin-resistant gonorrhea from prostitutes. By 1976, when the soldiers had come home, they brought the new strain of gonorrhea with them, and physicians had to find new drugs to treat it. In 1983, a hospital-acquired intestinal infection caused by the bacterium Enterococcus faecium joined the list of bugs that outwit penicillin.

Antibiotic resistance spreads fast. Between 1979 and 1987, for example, only 0.02 percent of pneumococcus strains infecting a large number of patients surveyed by the national Centers for Disease Control and Prevention were penicillin-resistant. CDC's survey included 13 hospitals in 12 states. Today, 6.6 percent of pneumococcus strains are resistant, according to a report in the June 15, 1994, Journal of the American Medical Association by Robert F. Breiman, M.D., and colleagues at CDC. The agency also reports that in 1992, 13,300 hospital patients died of bacterial infections that were resistant to antibiotic treatment.

Why has this happened?

"There was complacency in the 1980s. The perception was that we had licked the bacterial infection problem. Drug companies weren't working on new agents. They were concentrating on other areas, such as viral infections," says Michael Blum, M.D., medical officer in the Food and Drug Administration's division of anti-infective drug products. "In the meantime, resistance increased to a number of commonly used antibiotics, possibly related to overuse of antibiotics. In the 1990s, we've come to a point for certain infections that we don't have agents available."

Antibiotic resistance results from gene action. Bacteria acquire genes conferring resistance in any of three ways: Spontaneous DNA mutation, overuse of antibiotics and misuse of antibiotics.

While you and I can't do anything about spontaneous DNA mutations, we can avoid overuse and misuse of antibiotics. Here's how I'm going to avoid them:

• I won't eat meat that came from antibiotic-injected animals (the label will usually say antibiotic and hormone-free)
• I will wash my hands often, so I don't get sick in the first place, but I will skip the antibiotic soap. Most experts feel that thorough scrubbing with plain old regular soap is just as effective anyhow.
• I will only take prescribed antibiotics for bacterial infections.
• I will only take prescribed antibiotics when necessary (I could have Ethan wait 2-3 weeks and he would eventually get over the strep. My problem is that I have babies coming to visit next week and can't risk passing the infection to them.).
• I will finish my prescribed course! Do NOT stop taking your antibiotics halfway through your prescribed treatment, just because you feel better. You need to be sure you KILLED all those bacteria, instead of just doping them up!
  

Savings:

I'm not saving polar bears or spotted owls, just those damn humans again who always seem to get themselves into a pickle.

Difficulty Level: 2 out of 5

Hmmmm, hard to resist the lure of a good drug -- especially if it offers the promise of nearly immediate relief of a sore throat. However, if you can just remember that how your take your medicine affects all of us, that's a start.

*It was a very interesting article and it's got a lot more information than I quoted here. If you'd like to read the whole thing, you can access it here.