Plague Makers

Starting in the 1960s, doctors began switching patients with resistant staph to methecillin. This change worked for a time, but of course the staph bacteria just evolved to methecillin like it did to penicillin. Apparently the doctors don’t understand evolutionary biology.

And just as with penicillin, by 1992, approximately 40% of these penicillin-resistant staph infections were resistant to methecillin as well (New England Journal of Medicine, 28 Apr 94.)

Thus by 1993, only one drug remained that could kill staph: Vancomycin. Of course, as of 2009, that is no longer true as many strains of staph that are resistant to vancomycin, penicillin and methecillin. So what will they use instead of vancomycin? Nothing. They’ve run out of miracle cures.

Resistant streptococcus infections have made headlines in the past few years when the patients dies a gruesome death from the “flesh-eating disease”

Today 30% of strep pneumoniae strains are resistant to penicillin, which once was nearly 100% effective. 30% of gonorrhea cases are resistant to both penicillin and tetracycline, while just ten years ago they were almost 100% effective. Now the CDC no longer recommends these two drugs for gonorrhea.

According to Fred Tenover, PhD of the Centers for Disease Control:

“We even have some strains [of streptococcus] now, although not all, that are resistant essentially to all of our clinically useful antibiotics.”

The Era of Superbugs

Every year 70,000 Americans die from bacterial infections they caught in the hospital, and which no antibiotic could cure. Of the 40 million patients hospitalized every year, 2 million acquire infections after they get to the hospital. (New England Journal of Medicine, Apr 94)

That’s a 1 in 20 chance. As many as 60% of those 2 million infections involve antibiotic-resistant bacteria.

In some ICUs, there can be as high as a 70% chance of nosocomial infection! (Nosocomial means acquired in hospital.)

Tuberculosis

At the turn of the 20^th century, tuberculosis was the leading cause of death in the U.S.

The newly discovered antibiotics worked wonderfully to control it, for a time. However, there is no more control, as MDR TB is becoming increasingly common. MDR TB stands for Multiple Drug-Resistant TB. MDR TB means resistant to one or more of the five drugs used to treat TB. Isoniazid and rifampin are the two main TB drugs. By 1991, 42% of new TB patients in New York City were resistant to one of these two drugs, and 60% of relapses were resistant to them both. So in other words, they gave one drug, got temporary remission, and then relapsed with a strain resistant to both!

And worse still, many strains of TB are resistant to all five drugs and predictably the problem is getting worse by the year. According to the World Health Organization, such cases are generally fatal. The WHO predicts that in the next decade, world deaths from TB will increase from 3 million to 30 million!

So motivated by fear are some doctors they have gone on record that they personally would not venture into certain inner city areas of New York City because of the danger of TB infection.

TB is a mycobacterium, this means they can survive in tissues for years, in a dormant state, waiting for an opportunity like a depressed immune system to become active again.

What are doctors doing about this situation of antibiotic resistance? Because of their control of information, most people today are unaware of the extent of drug resistance.

So even if you encounter a doctor who is cautious enough to tell you that you or your child doesn’t need an antibiotic at the first sign of a sniffle, patients will often go to another doctor to get antibiotics.

Thus, most physicians will just write the script as a convenience to their patients—remember they need repeat business to pay their bills and if their patients decide they are not a good source of prescriptions, they could lose their patients. Some studies have shown 10 out of 10 doctors will prescribe an antibiotic for minor colds, without taking a culture. By age nine the average child in the US has already had 17 courses of antibiotics. This is really one major part of the problem. But why?

The problem is called attenuation. It means that not enough of the bacteria are killed.

The three main reasons why this happens are:

1. Many people stop taking the antibiotic as soon as they feel better. They do this to save money. They do it because they don’t understand their contribution to the problem of drug resistance by doing so.
2. Even if people take the full course, no process is 100% efficient so some bugs manage to survive even a full course because of a mutation they posses.
3. If you have cold or flu symptoms, it could be from any of hundreds of viruses. So why give antibiotics, which only kill bacteria? In case you develop a “secondary” bacterial infection as a “complication” of the viral infection.

Leave Those Kids Alone

It starts at birth, children in most jurisdictions are required to have erythromycin ointment put in their eyes immediately after birth. This is because their mothers may have a venereal disease that could cause the child to go blind if it never saw a doctor again. The laws requiring this were passed in the 19^th century, before antibiotics (they initially required silver nitrate). Plus if the mother tests positive for any of a number of bacteria like GBH, the mother will be put on IV antibiotics while in labor.

Ear infections are another cause for antibiotic use. At the slightest sign of redness around the ear, or the slightest sniffle, any “good” mother will take her baby to see a doctor for a prescription of antibiotics.

Yet according to the NEJM (28 Jan 99) at least 41% of ear infections are caused by a virus. But they get antibiotics anyway. The drug of choice is amoxicillin, even though doctors have known since 1991 that kids who take amoxicillin for ear infection have a 2-6 times greater chance of recurring infection than kids who don’t. (JAMA, 18 Dec 1991)

Every time a child takes antibiotics unnecessarily, at least three things happen:

1. They gets better
2. Their immune system gets weaker, making recurrent infections more likely
3. The same type of antibiotics won’t work the next time, because the bugs that survived will still be present.

Most of the time, the child would have recovered anyway, without drugs, just like they did for all those centuries before antibiotics and like they increasingly do now if they have a drug resistant infection.

Kids are supposed to be sick sometimes, just like trees are supposed to be in storms. It’s how they build a strong immune system. Our kids are the most overdrugged, overprotected, artificially nourished kids and as a result are among the sickest, most allergic, most asthmatic, and most overweight children in the world.

It starts with the infant’s immune system being unnecessarily weakened by inappropriate antibiotics from over-protective parents and from doctors rightfully fearful of litigation and from drug companies hungry for a profit.

Back to the environment

The human body has about 10 trillion cells and 100 trillion bacteria, most in the gut. Antibiotics are relatively un-selective in the bacteria they kill. So when you take a full course of antibiotics, you severely weaken your immune system since the gut is such a large part of the immune system.

There are about 300 species of beneficial bacteria, or probiotics, in the gut which are necessary for many life functions, including complete digestion, absorption of vitamins and nutrients, and countering potentially pathological bacteria.

It can take months for the body to rebuild its normal bacteria.

The pervasiveness of antibiotics throughout the world from pills, food, and the animals we eat has promoted the survival of resistant bacteria. Scientists have found antibiotic-resistant bacteria in the bodies of African tribesmen who live in total isolation from civilization, with no access to drugs.

In the 60 years since their introduction, virtually everyone has developed some degree of immunity to antibiotics. The mutant, drug resistant strains are now normal. The more we take antibiotics, the more we destroy the older non-resistant strains. All that’s left is the mutant strains.

The National Institutes of Health, the Centers for Disease Control, and the World Health Organization agree on one idea: antibiotic resistance will be the number one health challenge of the 21st century. Infections with no cure will be the area in which we will see the greatest increase in the death rate.

One hidden source of antibiotics is food. There are no reliable numbers, but it’s estimated that up to 75% of the antibiotics produced in this country, which totals 50 million pounds per annum, according to federal statistics, are given to animals like poultry and cattle. 80% of animal antibiotics are given to promote growth, not health. Antibiotics are also used extensively on fruit trees and other plants, and even in fish hatcheries. Food processing does not destroy the antibiotics. When we take them in with the food, many of these animal antibiotics are still strong enough to have an effect on our body’s bacteria. This further complicates the problem of resistance. Today people may be resistant to antibiotics they never even got from the doctor.

The animal antibiotics are getting stronger all the time. According to the Journal of the South American Veterinary Association, 1996, a recent antibiotic called salinomycin was given to a herd of cattle. The drug killed 10% of the cattle from heart failure!

Even the FDA has known about the spillover of antibiotics from animals to humans for a long time. As far back as 1976, FDA Commissioner Donald Kennedy was publicly campaigning to ban antibiotics from animal feed. (New Eng J Med, 9 Sep 1976) Lobbying from the drug companies won out, and high dosages in livestock continue to the present time.

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