http://www.nytimes.com/...
I read this article, and had to laugh at some of the quotes.
Waxman calls it a 'market failure'.
One scientist bemoans that if don't inject all sorts of money into antibiotic research, "we’re back to dancing around a bubbling cauldron while rubbing two chicken bones together".
Our never ending quest to obliterate disease has backfired. Bacteria are winning.
"The world’s weakening arsenal against "superbugs" has prompted scientists to warn that everyday infections could again become a major cause of death just as they were before the advent of penicillin around 1940."
The idea that humans can compete against bacteria is a dangerous one, given the rapidity of selection possible with bacteria. In a world where antibiotics are handed out over the counter to humans to treat colds and flu, where pharmaceutical regulations are so poorly enforced, it's impossible to be sure of the purity and strength of what one is taking; in the real world, we are not talking about ideal conditions.
My background is not medicine, but I did take two semesters of microbiology, so I know a bit about the history of this, as well as the potential hazards.
We've had a run of 7 decades with antibacterial drugs, which is roughly 4 generations of humans. Bacteria generation times may be as short as 15 minutes or as long as several days. When drugs are used to suppress bacterial growth and they are not applied properly, the opportunity to select resistant strains becomes alarmingly evident.
As noted in the NYT article
"About 100,000 Americans a year are killed by infections acquired in hospitals, many resistant to multiple antibiotics. Methicillin-resistant staphylococcus aureus, or MRSA, the best known superbug, now kills more Americans each year than AIDS."
What is not discussed by media is the economic pressures to sell pharmaceuticals into markets where they are used inappropriately. The places where these 'superbugs' seem to be growing the most rapidly is in the 3rd world, now,
but originally, the first places antibiotic resistant strains were noted were in Europe and the US. Most European countries have taken strong action to change antibacterial use protocols. The US has been slower to adopt some of these measures, but is starting to improve. Not quickly, but at least starting to improve.
Meanwhile, new technology exists that can rapidly identify bacterial strains. This is the smart response - rapidly identify and target the offending microbe, using the correct regimen of drugs. But these techniques are rarely being used. Prophylactic post operative use of antibiotics is still par for the course.
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So, I read this article and wonder; what part of this looming disaster is caused by the greed of pharmaceutical companies which have handed out antibiotics like candy for many decades, even after being warned about the proliferation of resistance?
I observe too, that the New York Times article does not mention this aspect of the discussion. 100,000 people die from MRSA each year.
Yes, of COURSE antibiotics save lives.
Yes, of COURSE antibiotics are an important part of our modern world.
But use of these powerful drugs must be accompanied by responsible use.
What part of the 100,000 dead in the US each could have been prevented by tighter controls on the use of antibiotics, many decades ago when the studies pointed out the clear evidence that over use and inappropriate use of these 'wonder drugs' would cause.
Studies go back even before this one:
Isenberg HD, JI Berkman. The role of drug resistant and drug-selected bacteria in nosocomial disease. Ann NY Acad Sciences 1971; 182:52–8
This problem is going to worse, not better as new drugs are developed, because bacteria will simply evolve to resist the new regimen or process.
Politicians who make decisions about where public money is spent need to take notice of these issues. The market driven pharmaceutical industry is interested in profits first: reducing their sales of antibiotics, what informed science tells them conflicts with their desire to make shareholders happy.