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View Diary: The looming antibiotic crisis can't be solved by the free market (248 comments)

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  •  It's not obvious to me why rampant sales (4+ / 0-)
    Recommended by:
    entrelac, Steve Masover, Paul1a, JerryNA

    of "antibacterial" soaps are even legal, since they increase the likelihood of antibiotic resistance developing. That ought to be something the US government has an interest in as a public health issue, and so could regulate. What on Earth department would handle it I don't know.

    We all understand that freedom isn't free. What Romney and Ryan don't understand is that neither is opportunity. We have to invest in it.
    Julian Castro, DNC 4 Sept 2012

    by pixxer on Wed Mar 13, 2013 at 06:23:06 AM PDT

    [ Parent ]

    •  Anti bacterial agents are not antibiotics (13+ / 0-)

      The use of anti bacterial soaps and other surface disinfectants should not be conflated with the use of antibiotics.  they are very different chemistry with very different biological actions.  Biological resistance to the disinfecting agents used in some soaps may well occur (indeed it is highly likely to so do) however that does not indicate any increase in the likely resistance to antibiotics.  in reality the mechanical action of washing has a greater log reduction than the anti-bacterial agent in the soap, the exception being alcohol based hand gels used in hospitals.

      Disinfectant chemistry is relatively simple with most molecules focused on disruption of the cellular membrane operation.  the antibiotic chemistry we use involves complex organic molecules that are typically derived through biological processes in fungi or plants, there multiple modes of action some very focused some broader spectrum.  The biggest problem is that as the number and type of pasmids present in the environment to be collected and incorporated by organisms is increasing and has provided resistance characteristics to species that would not otherwise exhibit those attributes.

      there is only one reality, republicans just forget at times

      by Bloke on Wed Mar 13, 2013 at 06:58:11 AM PDT

      [ Parent ]

      •  I'll admit to just parroting public health (0+ / 0-)

        organizations on the soap thing, without looking up the chemistry myself. But public health organizations have indeed decried the widespread use of "antibacterials" in soaps etc. I always assumed that the action in hand gels must be to disrupt the lipid bilayer, which would be pretty hard to develop resistance to. You're saying that the "antibacterial" soaps are also just working on the membrane? [OK, I can look this up, really :) ] Thanks.

        We all understand that freedom isn't free. What Romney and Ryan don't understand is that neither is opportunity. We have to invest in it.
        Julian Castro, DNC 4 Sept 2012

        by pixxer on Wed Mar 13, 2013 at 07:12:53 AM PDT

        [ Parent ]

      •  OK, I learned something about Triclosan (2+ / 0-)
        Recommended by:
        JerryNA, Sunspots

        and it is indeed something bacteria could easily become resistant to, given all it does is act to inhibit an enzyme involved in FA biosynthesis. Search obviously a quickie at this point, but here is something from a peer-reviewed journal (Clinical Infectious Diseases), anyway:

        Results. Soaps containing triclosan within the range of concentrations commonly used in the community setting (0.1%–0.45% wt/vol) were no more effective than plain soap at preventing infectious illness symptoms and reducing bacterial levels on the hands. Several laboratory studies demonstrated evidence of triclosan-adapted cross-resistance to antibiotics among different species of bacteria.

        Conclusions. The lack of an additional health benefit associated with the use of triclosan-containing consumer soaps over regular soap, coupled with laboratory data demonstrating a potential risk of selecting for drug resistance, warrants further evaluation by governmental regulators regarding antibacterial product claims and advertising. Further studies of this issue are encouraged.

        So, as you importantly point out, this does not have to do with resistance to the antibiotics we buy from the pharmacist. However, the potential for creating bacteria resistant to this compound that could indeed be of use in the future (and evidently is not so in hand soaps) should mean that the compound should be removed from the popular market.

        I also liked this popular article, though I read it pretty quickly. It's from the USC magazine "illumin."

        We all understand that freedom isn't free. What Romney and Ryan don't understand is that neither is opportunity. We have to invest in it.
        Julian Castro, DNC 4 Sept 2012

        by pixxer on Wed Mar 13, 2013 at 07:33:02 AM PDT

        [ Parent ]

        •  There are lots of surface disinfectants (1+ / 0-)
          Recommended by:
          pixxer

          Triclosan is not particularly effective, and many of the claims made are exaggerated.  I really do not worry about that aspect, I believe that the challenge associated with producing effective antibiotics is far greater than the challenge/cost associated with producing surface disinfectants.  
          Once we have a resistant organism eradication from the environment such as a hospital is relatively expensive but is possible, getting it out of the community is a bigger issue. eradicating those pathogens from people is a real challenge.  Many of us are colonized with MDROs but asymptomatic, a drop in immune status may change that relationship, as does the impact of certain antibiotics (check out the prime cause of Clostridium difficile associated disease)
          the whole subject is a lot more complex than simply banning a biocides in hand soaps.

          there is only one reality, republicans just forget at times

          by Bloke on Wed Mar 13, 2013 at 03:39:13 PM PDT

          [ Parent ]

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