Antibiotic resistance: The last resort

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Health officials are watching in horror as bacteria become resistant to powerful carbapenem antibiotics — one of the last drugs on the shelf.


As a rule, high-ranking public-health officials try to avoid apocalyptic descriptors. So it was worrying to hear Thomas Frieden and Sally Davies warn of a coming health “nightmare” and a “catastrophic threat” within a few days of each other in March.

The agency heads were talking about the soaring increase in a little-known class of antibiotic-resistant bacteria: carbapenem-resistant Enterobacteriaceae (CREs). Davies, the United Kingdom's chief medical officer, described CREs as a risk as serious as terrorism (see Nature 495, 141; 2013). “We have a very serious problem, and we need to sound an alarm,” said Frieden, director of the US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

Their dire phrasing was warranted. CREs cause bladder, lung and blood infections that can spiral into life-threatening septic shock. They evade the action of almost all antibiotics — including the carbapenems, which are considered drugs of last resort — and they kill up to half of all patients who contract them. In the United States, these bacteria have been found in 4% of all hospitals and 18% of those that offer long-term critical care. And an analysis carried out in the United Kingdom predicts that if antibiotics become ineffective, everyday operations such as hip replacements could end in death for as many as one in six.

Written By: Maryn McKenna
continue to source article at nature.com

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  1. Last several times I went to a doctor they have stated that probably viral so we’ll avoid the anti-biotics. This is a hopeful sign but still far to much squandering of our anti-biotics and far to little money spend on comming up with more in these tight economic times. I really worry we’re too stupid for our own good sometimes.

    • In reply to #5 by Cairsley:

      Those pharmaceutical companies need to get back to work on antibiotics, or do they need to be nationalized first?

      The point is there are only so many variations you can try and so far its been impossible to find one that can’t be out evolved by the microbes eventually, and given how rapidly they breed eventually isn’t all that long.

      This is a good example of a problem like climate change where we’ve known about it for a long time and known what needed to be done, or at least things that should be done to contain the problem — stop over prescribing antibiotics — but due to laziness we just haven’t done it. If anything my guess is the main blame with the pharmaceuticals is that they have no monetary incentive to discourage over prescription of their antibiotics. Well, unless you take the long term view which believe me I’ve worked in the corporate world and almost no one does that, its all based on short term plans and goals usually one year out but almost never more than five.

      • In reply to #7 by Red Dog:

        This is a good example of a problem like climate change where we’ve known about it for a long time and known what needed to be done, or at least things that should be done to contain the problem — stop over prescribing antibiotics — but due to laziness we just haven’t done it.

        This is correct. I can recall lectures in the 1960′s in an agricultural college, pointing out the dangers of the misuse of antibiotics in intensive animal rearing! The same abuses continue (legally or illegally) in some parts of the world, even today.

      • In reply to #7 by Red Dog:

        “… unless you take the long term view which believe me I’ve worked in the corporate world and almost no one does that, its all based on short term plans and goals usually one year out but almost never more than five.”

        Thanks, Red Dog. Good to hear from someone who knows how things work inside the large corporations. Perhaps pharmaceutical companies will now start taking a longer-term approach to find ways to treat CREs. In the short term they might have to accept a reduction in profits, but in the long term that may not be so, if a longer-term approach to the research and development of antibiotics gives rise to a solution to the problem that CREs pose.

  2. People are demanding antibiotics so that they can return to work or life quickly. They demand it for their children so that they can return to school and alleviate a daycare problem. I am aware of several people (co-workers) who caught the office virus that was going around. I told them that antibiotics would not work on a virus, yet they return from their doctors with prescriptions in hand. …and these are separate people, separate occasions. I’ve learned that people will tell the doctor symptoms of a bacterial infection in order to get a prescription. Then they come back to work with full symptoms and say “I’m OK I’m on antibiotics.” A few days later when their health is naturally improving, they credit the antibiotics. Meanwhile, they spread their virus to other co-workers. I have to wonder why doctors fall for this or are they concerned about losing a patient’s business. (?)

  3. The real issue might be in the realm of pro-biotics rather than anti-biotics.

    One thing that bacterial pathogens can’t handle is competition from other bacteria. Pathological bacteria prefer to deal with similarly pathological global pharmaceutical conglomerates, they’re a similarly lower form of life and more easily corruptable. Pro-biotics is more of a level playing field. More like real capitalism.

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