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A Wake-Up Call On Antibiotic Resistance

A new report says deadly superbugs are everywhere—and warns of a coming “post-antibiotic era,” in which common infections kill.

With guest host Jessica Yellin.

This undated photo provided by the Center for Disease Control (CDC) shows plates of Methicillin-Resistant Staphylococcus Aureus (MRSA) in CDC’s healthcare-associated infections laboratory. (AP)

This undated photo provided by the Center for Disease Control (CDC) shows plates of Methicillin-Resistant Staphylococcus Aureus (MRSA) in CDC’s healthcare-associated infections laboratory. (AP)

It’s a frightening scenario. A deadly bacterial infection spreads across the globe and our antibiotics are powerless to fight it. Superbugs no longer the stuff of movies. A new report warns the rise of antibiotic-resistant bugs have become a Global Health Threat.  We could be facing a post-antibiotic future in which common infections and minor injuries kill again. Fighting this is challenging. The crisis has spread to your doctor’s office and many of America’s farms. This hour, On Point: the rise of superbugs and what we can do to roll back the threat.

Guests

Maryn McKenna, journalist, author and blogger. Writes the WIRED magazine blog, “Superbug.” Author of “Superbug: The Fatal Menace of MRSA.” (@marynmck)

Dr. Stuart Levy, professor of molecular biology and microbiology at Tufts University. Director of Tufts’ Center for Adaptation Genetics and Drugs Resistance. Author of “The Antibiotic Paradox: How Miracle Drugs are Destroying the Miracle.”

Dr. Michael Bell, deputy director of the Centers for Disease Control’s division of healthcare quality promotion.

From The Reading List

BBC: Antibiotic resistance now ‘global threat’, WHO warns — “The WHO says more new antibiotics need to be developed, while governments and individuals should take steps to slow the process of growing resistance. In its report, it said resistance to antibiotics for E.coli urinary tract infections had increased from ‘virtually zero’ in the 1980s to being ineffective in more than half of cases today.”

Reuters: ‘Superbugs’ that can overpower antibiotics are spreading: WHO — “In its first global report on antibiotic resistance, with data from 114 countries, the WHO said superbugs able to evade event the hardest-hitting antibiotics – a class of drugs called carbapenems – have now been found in all regions of the world.”

WIRED: Sneak Peek: What the White House is Thinking About Antibiotic Resistance — “The President’s Council of Advisors on Science and Technology (PCAST for short) is preparing a major report on the problem of antibiotic resistance. The report won’t be published for a few months, but today PCAST held one of its periodic meetings, and aired what it thinks the most important issues are going to be. For anyone who cares about our dwindling ability to fight infections, or the responsibilities of healthcare to curb antibiotic use, or the large role that agriculture plays in causing antibiotic resistance to emerge, its live webcast was a satisfying listen. “

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  • John Cedar

    I wonder if the third leading cause of death in the US (medical error) will jump to first, as these supper-bugs become more prevalent? While the medical community would emphasize and have us believe the genesis of these bugs starts with patience who don’t finish their meds…the largest problem is that hospitals are Club Med for these bugs. If you know someone who has an antibiotic resistant infection, chances are they contracted it at a medical facility.

    Whenever I visit a healthcare facility, I am astounded at the lack of hygienic principles that are in place to prevent cross contamination. If you were to put a different color of non drying paint on everyone and everything in one of these places at the beginning of a day, by the end of the day, everything and everyone would be one uniform brownish color.

    • Shag_Wevera

      Not just patients who don’t finish their antibiotic cycle, but MDs who overprescribe them.

    • Ray in VT

      According to 2011 CDC figures “Chronic lower respiratory diseases” is the 3rd leading cause of death http://www.cdc.gov/nchs/fastats/lcod.htm, although a more recent study by the American Academy of Neurology suggests that Alzheimer’s may be the third highest leading cause of death http://www.washingtonpost.com/local/new-study-ranks-alzheimers-as-third-leading-cause-of-death-after-heart-disease-and-cancer/2014/03/05/8097a452-a48a-11e3-8466-d34c451760b9_story.html.

      • John Cedar
        • Ray in VT

          It isn’t really what “the doctors say”. It is based upon another study, which a number of authors say was credibly conducted. Given the knowns and the unknowns of reporting and such I think that it is hard to come up with a hard number.

        • hennorama

          John Cedar — you raised a good point about medical errors in hospitals, but characterizing them as “the third leading cause of death in the US” as if it was a fact rather than an estimate is a bit of a reach.

          FTA in the link (emphasis added):

          “Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death.”

          Still, it’s a good point that medical errors as a group need more attention.

          • brettearle

            I wonder how they can serve up estimates that can be up to 440,000, rather than more than that?

            Also, Hospital Error may obtain, anyway–and it gets hidden–if the patient recovers.

            There, the bad practice is never clearly monitored or reflected upon in retrospect.

            Because it is Hidden.

          • hennorama

            brettearle — TYFYR.

            The NPR piece discussed a finding from a meta-ish study, the results of which were generally accepted by others in the medical field. As to the magnitude of the range of the estimate, and why it isn’t higher, there are multiple possibe reasons, including that errors not resulting in patient death might be un- and under- reported.

            The practice of medicine is both science and art, and involves fallible humans. This means that, as they say in baseball, “hits happen.”

            When trying to improve the performance of a system involving such complexity, standardization of terminology and event reporting is extremely important. Given that even basic diagnosis is fraught with complexity and potential differences in both observation and interpretation, this makes the analysis of outcomes rather difficult. In other words, attributing a result to any one (or more) events is quite difficult. Was the initial diagnosis accurate? Were the appropriate tests administered? Was the timing optimal? Was the medical resident on duty for 30 straight hours? Etc, etc.

            This complexity does not mean that nothing should be done about medical errors, of course, but only that reducing them is no easy task.

            Thanks again for your response.

          • brettearle

            Hidden, and hard-to-quantify, factors are indeed troubling.

            In my earlier response, I raise the issue of hidden mistakes–due to recovery.

    • brettearle

      For quite some time, MDs were not reminded, via hospital policy, to wash their hands–thoroughly and frequently.

      I’m wondering whether such emphasis is somewhat lost on support staff–because Hospitals are not focusing on anyone who might come into contact, with anyone else, in a hospital.

      Indeed, there ought to be more PSAs out there, about this matter, to the Public.

      • TFRX

        I can tell you, via personal experience, that that is not. At least in suburban / urban New England.

        And those alcohol-only foaming hand sanitizer dispensers are everywhere. (They’re the “good old fashioned” ones, as opposed to the ones with triclosan or other antibiotics, which contribute to “superbug” status.)

        My time working in a hospital turned me into a germophobe. But it didn’t keep me from catching viral bronchitis from some gung-ho non-medical worker who had to “play hurt”.

        PS When it comes to hospital visitors, people who don’t go there much, there is plenty of signage. It makes the “employees must wash hands after using restroom” sign in every restaurant everywhere look lonely.

    • jimino

      Thank God for malpractice lawyers.

      In fact, if libertarians got their way, personal injury lawyers would be the biggest beneficiaries.

  • Matt MC

    I heard an earlier show on this, and one of the more interesting problems was that drug companies have no incentives to develop new antibiotics because if they did, hospitals would demand that they be shelved and preserved only when the standard antibiotics failed.

    • brettearle

      Do you recall what report this was and why Hospitals would be so foolish, as to wait until people are afflicted–before using more effective medications?

      Such Drugs would be more effective, by comparison, as a preventative measure.

      Doesn’t make sense.

      • Matt MC

        I don’t think it was about them being foolish. They would simply want to preserve the new antibiotics and not reduce their effectiveness through overuse. In other words, they would try the traditional antibiotic first, and if the “super bugs” persisted, they would save the new drugs as a last resort.

        • brettearle

          Got it.

        • brettearle

          But what about those who might have been spared who could have received the more powerful drugs to begin with?

          • Matt MC

            They wouldn’t wait for them to die. They would just try the original antibiotics first. They talked about it on this show: http://onpoint.wbur.org/2013/04/04/antibiotics-and-meat

          • brettearle

            And yet that practice of delay would be enough to discourage the manufacture of such powerful drugs?

            To me, that doesn’t add up.

          • Matt MC

            I believe Tom asked, “Why aren’t drug companies working on new antibiotics” and that was her answer. Apparently, she seemed to think that if they were not used much as standard antibiotics, which are also, of course, used in factory farms as well, that the companies would not sell enough of the pills to make the initial investment (whatever billions) worth it. I’m not sure if I agree, either, but that is what the lady said on that particular show.

          • brettearle

            Thanks for going to the lengths, that you did, to explain.

            Not everyone does that.

          • TFRX

            WHat would “new antibiotics” be like?

            I’m actually wondering if new antibiotics would be more selective rather than “more powerful”.

            I’m also thinking of the first generation of almost any drug–like sulfa antibiotics from before we were born, or anabolic steroids from before there were good test for them: Plenty of power, but massive side effects, etc.

          • brettearle

            Yeah, marketplace has got to be tested.

            And side effects, generally, can be underestimated–over time–can they not be?

            Isn’t there a point in time, where time itself, can warp statistics–and then we see side effects that weren’t earlier detected?

            Is VIOXX not a reasonable example of this?

          • TFRX

            (Apropos of nothing, except maybe that Cosmos was on last night, but “Isn’t there a point in time, where time itself, can warp statistics?” sounds either spacey or deeply profound on its own.)

          • brettearle

            Sets my Brain astirrin’.

            Thanks.

            You saw something in Manifest Content that I hadn’t `exactly’ meant.

            That can be the beauty of communication, No?

  • Yar

    We are losing in the war to evolve! Chemical farming, genetic modified crops, antibiotic arms race, it all comes down to wailing and gnashing of teeth. Over all but the last century, we have had a deep connection to the environment where our food grew. This allowed all organisms to evolve together, now that we severed the connection with place we have lost our ability to adapt, all the while increasing the rate of change in our environment.

  • Coastghost

    Are any protocols in place to deny antibiotic therapies to patients who demonstrate an inability or an unwillingness to follow strict dosage and dosage completion regimens?
    If failure to follow antibiotic treatment regimens contributes to the development of drug-resistant pathogens, why persist with offering antibiotic therapies that will not be followed?
    We don’t care for “denial of service” when it comes to medical treatment, but if a patient is risking his own health and that of others by not completing a prescribed treatment regimen, why persist necessarily with offering him such an option?

    • Don_B1

      What has been tried along those lines is definitely not prohibiting offering antibiotics but to requiring the patient to come to the medical facility to receive the medication.

      It would be highly unethical to not treat the patient.

      • brettearle

        Right.

        Imagine, if it ever got to that point!

      • Coastghost

        But how ethical is it for a patient to pose risks not only to his own health but to the health of society at large?
        Where does “patient responsibility” begin or end?

        • brettearle

          You’re not usually a Regulation kind of Guy, are you?

          How are you going to monitor such a program?

          • Coastghost

            I’m not trying to propose any scheme: but I’m guessing here that it would all come down to individual doctor and individual patient: it is incumbent upon doctors to explain clearly the rationale for an antibiotic treatment regimen, and it is the distinct responsibility of the patient to follow the protocol or risk denial of service specifically for treatment with antibiotics.
            This IS the 21st century: if our wonderful tech-fueled civilization can’t do a better job of communicating to all the risks posed by the indifferent appropriation of antibiotics, perhaps our civilization will soon be conquered by microbes.
            As E. O. Wilson could tell us in the next hour: this would be evolution at work.

        • jimino

          Why should a patient be any more concerned with your or anyone else’s well being than, say, a person making business decisions?

          • Coastghost

            I’m not sure I understand your question, but I suppose any patient indifferent to his own effective treatment (with antibiotics, per this discussion) will be equally indifferent to the well-being of you and yours truly alike.

      • keltcrusader

        I seem to remember seeing a show (60 minutes/Nightline?) a couple of years ago on Russia doing a program similar to this because of the problems they were having associated with resistant strains of TB.

    • brettearle

      How can such a policy be possibly monitored?

    • http://neilblanchard.blogspot.com/ Neil Blanchard

      This is a systemic problem; not an individual problem.

      • Coastghost

        The problem seems very much an aggregate of individual problems.

        • http://neilblanchard.blogspot.com/ Neil Blanchard

          The aggregate of individual behavior is likely to be more or less random – which means it would not sway the overall trend.

          The overuse of antibiotics in factory farming is systemic, and not random, and therefore is probably pushing this trend.

          • Coastghost

            Fair point fairly made, although I continue to suspect individuals will yet contribute to the trend, however marginally.

    • nj_v2

      Haha!

      Right-wingers are so wedded to their personal-responsibiity meme, they think any and all problems are a matter of personal situation and individual choice.

      • Coastghost

        And are you so enamored of groupthink to deny that people take their own personal choices seriously, and that these choices can easily be impinged upon (positively and negatively) by the sensible or senseless personal choices of others? Why do you begin to argue that only corporate or collective bodies represent “humanity in action”?

        • nj_v2

          You really should take a writing class. Your style is so ponderous and obfuscatory that it’s difficult to know what your point is.

          How many other people went “Huh?” after reading that?

          • Coastghost

            Never fear your dictionary.

    • hennorama

      Coastghost — this brings to mind those who refuse vaccinations.

      Using similar lines of thought, should they be left untreated if they acquire a disease that might have been prevented via vaccination? Should they be held liable if others they come in contact with are adversely affected? Should vaccinations simply be discontinued altogether, and the human “herd” be culled via infectious diseases?

      • keltcrusader

        I do not even want to imagine a world with rampant infectious diseases allowed to run their course – a truly frightening prospect.

        We are so removed from the benefits vaccinations and antibiotics have afforded mankind that people do not remember, a time not so long ago, where a simple infection or disease could easily kill you.

      • Coastghost

        We do well to recognize that people have the right to refuse treatment altogether: that said, the rest of us have every reason to insist that such people accept fully the consequences of their decision, which in respect thereof could well entail denying treatment or therapy, whether for infectious diseases or no.
        What protocols do we have in terms of public health for quarantine, and how far are we willing to insist upon them, to whatever extent quarantine could be efficacious?
        (Sometimes, questions provoke only further questions, so thank you for yours.)

  • brettearle

    I can’t prove this.

    But, as we speak, I believe that Probiotics are helping me to thwart a localized infection.

    Why aren’t we discussing Probiotics?

  • iccheap

    what about emerging medical strategies to augment natural defenses? Antibiotics have helped us immensely, but they certainly can wreak havoc on our natural homeostatic balance.

  • PJD

    I agree that maybe prescribing antibiotics is not always done the right way. However, I feel like we need to also start paying attention to how much antibiotics we are feeding to our chickens, pigs and livestock.

    • NrthOfTheBorder

      I wonder why there seems to be so little conversation/congressional interest on this part of the picture!

      • weblizard

        I’m guessing they have no wish to upset their industrial-farming donors…

        • NrthOfTheBorder

          Right you are! Our representatives are hamstrung by the need for donations – that even with an issue like this they are rendered impotent and unresponsive.

    • hennorama

      PJD — Prophylactic and metaphylactic use of antibiotics in animal husbandry is indeed an important issue. However, affecting a change in these widespread practices will be difficult, as these practices tend to lead to faster weight gains and increased profits. In addition, when examining large-scale production of animals for food, confining animals allows for both greater efficiency of production, and increased risk of infectious disease. Balancing these factors can be difficult, and the unfortunate result is that “give ‘em the drugs” is often the veterinarian’s advice.

      • http://neilblanchard.blogspot.com/ Neil Blanchard

        What is more important: agribusiness’ profit margin, or the health/well being/survival of humankind?

        • hennorama

          Neil Banchard — thank you for your response.

          The answer to that question varies based on the interests of those to whom it is posed.

          An additional factor is that the actual producers oftentimes have little to no control of the methods involved in raising these animals, as various strictures are imposed by the processors and branded purveyors of the final products that reach grocery stores.

          These strictures have significant advantages in terms of standardization and efficiency, which again means that affecting a change will be difficult.

          Thanks again for your response.

  • http://neilblanchard.blogspot.com/ Neil Blanchard

    The “new drugs is too costly” canard points to the fact that we need to develop drugs *without* any profit motive.

    • jytdog

      This is a terrible idea. I want my tax dollars spent on key services like paving roads, paying for firefighters and cops, building and maintaining infrastructure, education. Discovering and developing drugs is incredibly risky – huge attrition rates due to failure as you go from target to screening to developing lead compounds from screening hits (an especially difficult thing to do) and then finally testing compounds in humans first to see if they are safe (Phase I) then in small trials for efficacy (Phase II) and then big trials to examine safety and efficicacy (Phase III). We don’t know if a given drug candidate will be safe and effective enough until AFTER the Phase III clinical trials! Not a good use of tax dollars. This kind of risky activity is exactly what private investment is for.

      • http://neilblanchard.blogspot.com/ Neil Blanchard

        If we need antibiotics, but they are not profitable (enough?) for private drug companies to develop new ones – then what would you suggest?

        • jytdog

          Lots of folks who are smarter and closer to the issues than you and me have been thinking about this – just do a websearch for “antibiotic incentives” and you will see what the US and EU governments ,WHO, and nonprofits have already been doing, and you will find many proposals to help get new antibiotics developed. For example the FDA has already set up an accelerated pathway for antibiotic approvals, which lowers the risk of failure somewhat. And if you google “antibiotic startups” you will see there is plenty of entrepreneurial activity and $ going toward the problem too. We definitely also need changes in how current antibiotics are prescribed and better hygiene to prevent spread (many of the nastiest bugs are spread in hospitals).

  • Yar

    Look at the economic picture for Penicillin, the federal government took over control to make it more widely available. Can you imagine that model today?

  • Kathy

    Maybe we should sell ineffective antibiotics over the counter so people can take them for their colds and flu and stop going to the doctor and demanding a prescription for something that actually works.

  • Frank

    Development of new antibiotics must be done independently of the pharma companies and production of compounds done by the generic producers. Since there is no profit in new antibiotics, discovery and production needs a new paradigm. If big pharma invented the Polio vaccine today, we would be paying $500 a dose.

  • Melinda Hart

    The concept of antimicrobial stewardship should include methods to prevent the infection from occurring in the first place, thereby greatly reducing the use of antibiotics. Eliminating microorganisms like C.diff and MRSA from the environment before they harm patients is what can and should be done – right now. This is already happening – and hospitals across the U.S. are reporting fewer infections after using pulsed xenon UV room disinfection robots to quickly destroy the deadly pathogens lurking in healthcare facilities.

  • hopeful61

    Incredibly, many people still go to the doctor with the common cold, which is caused by a virus, expecting antibiotics – without letting the 7-14 days (the duration of the common cold) pass to see if they get better – and they are actually given a prescription for an antibiotic. Incredibly, many doctors are still prescribing antibiotics just to satisfy the patient. Patients should be educated that antibiotics do not work on viruses! As a registered nurse I’ve been worrying about this for years as it such a widespread practice.

    • hopeful61

      Another contributing issue is that with the healthcare system in this country being the mess that it is, doctors are only given 15 minutes with a patient. Doctors are expected to listen to the patient’s concerns, diagnose, treat and get them out (usually with a prescription) in 15 minutes. Some get them in and out much faster, of course. Quick fixes all around.

  • http://argonnechronicles.blogspot.com/ Dee

    I dislike this guy’s attitude about patients. Patients want some sort of relief. It does not have to be an antibiotic. Prescribe chicken soup, nasal spray, etc., etc., give them guidance! (And we’d probably wait longer before going to the doc if work and schools weren’t tapping their feet for us to get back to work and school.

    • hopeful61

      I agree. But common sense is that the common cold requires time, fluids, and rest. Over the counter remedies are, in my opinion, not helpful. You just have to wait it out. The workplace – well, the entire culture – contributes to this problem. People should be allowed to stay home while they are infectious and allowed to rest and recover. Often they do not do this due to not having enough sick time or being afraid they will somehow compromise their employment or get behind in their schoolwork. In this country, the culture really doesn’t really allow human beings to get sick. And now we are in this unfortunate situation.

  • Steven Broadway

    The largest and least known point of knowledge in the microbial world and how it relates to human existence is that we have co-evolved with many microbes. We rely on them for digestion and aiding in our own immunity. However, we tend to classify all these microbes as “germs” even though there are those that could have potentially or known positive effects when present on our bodies, living in a beneficial symbiosis with ourselves.

    We forget as well that we only evolve at a slow rate, minute in relation to that of bacteria. We are constantly subjecting bacteria and other microbes to selectors for natural selection. These selectors are antibiotics, high alcohol hand sanitizers and sprays that have a high efficacy for killing a wide range of microbes, even those that cause no obvious harm to our bodies. Doing this with such high frequency allows for the selection of stronger, more resistant bacteria over millions of generations of these microbes while our evolution in drug technology has a rate that cannot keep up.

    I recently graduated with my bachelor’s degree in Microbial Biology and I believe it is up to those in the field and the field of Public Health to develop policy that mitigates harmful infections by balancing low rates of highly efficient sanitation and the presence of symbiotic microbes.

  • brettearle

    Some people DO have the basic science.

  • brettearle

    He’s major proponent of asking question of MDs?

    We hear that all the time from Medical Professionals.

    And yet, MD appointments times can be so fleeting that they violate the Theory of Relativity.

    How many questions can you actually cram in?

  • weblizard

    I’m at work- did anyone bring up ageliferin, first discovered in sponges? It appeared to break down the resistant element and biofilm formation in bacteria?

  • Scott B

    There’s a surface protection film called “Sharklet” that’s based on sharks’ skin patterns that’s naturally anti-bacterial in that bacteria litreally can’t get a grip on it, and it doesn’t contribute to drug resistance. This material should be utilized in hospitals, and other public places where germs are easily found and transferred, much more than it is

    • brettearle

      Why is it not being used more, do you think?

  • concerned citizen

    I haven’t heard much discussion of overuse of antibiotics in veterinary and medical practice on animals and people who are clearly dying. My father went to the hospital with end-stage lung cancer about 20 years ago and he was prescribed ciprofloxacin while he was there. He did not have an infection, had no fever, and clearly would not survive long enough to finish the course of antibiotics. This can’t be a wise use of antibiotics. In another instance, my horse went to the veterinary hospital with what turned out to be an intestinal perforation. While there he was subjected to many abdominal taps and acquired a multi-drug resistant peritoneal infection. Instead of recommending euthanasia for a clearly hopeless case, the vets switched antibiotics several times, using increasingly exotic antibiotics that I had never heard of.This infection was not acquired at his home stable but was acquired in the isolation ward at the veterinary hospital. In the end I put him down, but in the meantime this was a recipe for creating a bacterium for which there is no treatment.

    On another topic, I have traveled to India several times and have witnessed people who can get an over the counter dose of antibiotics whenever they have a cold; they will take it for 2 or 3 days until the cold is over and then stop the course of antibiotics. I have never heard this issue discussed.

    • brettearle

      Sorry for the loss of your Father…and, too, your horse.

      In your father’s case, I’m wondering whether the MDs were trained, even programmed, to prolong life, at all costs…etc
      –unless there was a Living Will.

      In the case of veterinary medicine, wouldn’t the Vet Docs have followed your lead on euthanasia–or did you only realize, in retrospect, it was hopeless?

      And, too, did the Vets not want to blame themselves or be blamed–so they tried Heroics?

    • jared

      The World Health Organization seems aware of the situation in India.

      http://apps.who.int/medicinedocs/en/d/Js19569en/

      They address a lot of points, but not the problem of education concerning finishing the course of the medication that you point out. Is that worse in India compared to other places?

  • originalname37

    I hate to have to say this, but, despite the above description (and what Jessica Yellin keeps saying), Dr. Stuart Levy is the Director of Tufts’ Center for *Adaptation* Genetics, not “Adaption” Genetics. (“Adaption” is not a word)

    • jared

      Why don’t we employ Occam’s Razor and make it one!
      Over a 10 year period, we could save 8 million syllables.

  • NrthOfTheBorder

    This development is a prime example of the failure of capitalist system on many accounts. To further rely on it will only make things worse – that is until the problem gets so bad, people will pay anything for an new antibiotic if it means relief or cure.

    This is where to government should either sponsor new antibiotic research or development – or twist the arm of the industry to do so – pronto.

    • tbphkm33

      Ultimately, the government pays for most pharmaceutical research. A majority of breakthroughs come from University labs – financed by public monies. Then turned over to private companies for a nominal fee, like $1. Who in turn either exploit the breakthrough or squash it for their own motives. Inherently an idiotic system, but something that is so often found to exist in the US style of crony capitalism.

  • NrthOfTheBorder

    Can anyone tell me where the US is on restricting (or banning) the use of antibiotics on livestock? (Apparently 80% of US consumption). Correct me if I’m wrong, but hasn’t the EU prohibited it for a decade or more?

    • hennorama

      NrthOfTheBorder — no ban exists in the U.S. Voluntary reduction is encouraged. In contrast, in 2006, the European Union banned the practice of feeding antibiotics to livestock to promote growth.

      See:
      http://www.globalization101.org/regulating-antibiotics-in-animals/

    • Chris

      The EU has. The FDA recently made overtures towards phasing out the use of antibiotics for growth promotion. Check out: http://www.pewhealth.org/reports-analysis/issue-briefs/new-fda-policies-on-antibiotics-use-in-food-animal-production-85899540059

      • NrthOfTheBorder

        “overtures” sounds weak and ineffective – which, in turn, means nothing will change.

    • jared

      “5. Why are you taking this collaborative (voluntary) approach?

      FDA believes that the collaborative approach is the fastest way to implement the changes outlined in Guidance #213. We have worked with stakeholders, including animal pharmaceutical companies, to encourage their cooperation on this important public health issue, and we are confident in their support.”

      http://www.fda.gov/animalveterinary/guidancecomplianceenforcement/guidanceforindustry/ucm216939.htm

    • ExcellentNews

      Nowhere. After his 2000 “election”, Bush effectively told federal agencies to get out of the way of business (including the FDA). Things have not changed today. The key regulatory posts at most federal agencies are still unstaffed because the Republicans in Congress have been blocking appointments since 2008.You don’t hear about this much, because the attack against our government is going on so many fronts that this is small potatoes…

  • https://www.facebook.com/kyle.rose Kyle Rose

    I suspect this problem will solve itself, as these increasingly exotic antibiotics come with so many side effects (fluoroquinolones like Cipro, for instance, cause lingering joint pain in a large percentage of patients and sudden tendon rupture in a small fraction) that no one will want to take them unless they actually need them.

    • NrthOfTheBorder

      Thanks for this perspective Kyle.

      We’ve gotten to the point where we can’t be in discomfort, even for a moment, so we imbibe any manner of things to make us feel better.

      Now, we’ll have to suffer through it — saving precious miracle drugs for when they’re really needed.

  • on_2nd_thought

    Yes it’s a crisis now. 30 years ago when those of us expressed concern about the likelihood of resistant bacteria developing we were considered alarmist conspiracy theorists. Now global society is poised to re-enter the Middle Ages medically. The same willful ignoring of the facts is happening with global warming, nuclear energy, fracking. It amazes me that humans continue to deny looming threats until it’s too late to avert disaster and only respond when there’s a crisis. Of course, in all these cases, there’s a profit motive for some to keep doing what we’re doing as long as possible.

    • brettearle

      Very good point.

      Although subtler and only indirectly analogous, remember the Tylenol scandal?:

      No OTC drug companies ever thought, seriously, of employing tamper-resistant package seals, before the fatal poisonings occurred.

    • andrewgarrett

      Why is nuclear included in your list? If we used more nuclear we’d save human lives – nuclear kills far fewer humans than fossil fuels – and we wouldn’t be warming the planet. Instead of storing our energy waste product in the atmosphere we’d be arguing, for centuries, perhaps, about what to do with it. That would be far better for humanity and the planet.

      • on_2nd_thought

        Fukishima, Chernobyl, Three Mile Island… We’re poisoning our planet.

      • ExcellentNews

        Most progressives who are opposed to nuclear have never seen a coal mine or visited a coal-fired power plant. Sadly.

    • NrthOfTheBorder

      The rest of us get dragged down by the greedy or thoughtless aspirations of a few. And why does this happen? Because we let them, that’s why.

      We seem to have gotten to a point where greedy, thoughtless aspirations have been institutionalized. We therefore have an intractable structural problem. And how do such structural problems get resolved? In revolution or war that’s how.

  • TyroneJ

    One issue related to this topic that I’d have liked to hear addressed is the issue of US market manipulation of antibiotics.

    Prior to about 2 years ago, for example, doxycycline was so inexpensive that Walmart would sell a 30-day supply of doxycycline,used for Lymes in humans and animals, for $4. In early 2013, the domestic suppliers started to have a shortage due to “manufacturing issues”, and that same prescription, by last summer, was $400-$600. The FDA could have alleviated the shortage by allowing imports, but they didn’t. (Google “doxycycline shortage” without quotes, and the CDC bulletins on this shortage will come up.) The “shortage” has been alleviated in the past few months, but the price of doxycycline in the US is still so high that it’s still not back on Walmarts inexpensive drug list.

    There have been a number of antibiotics & other drugs that have gone through this artificial “US shortage”, price spike, and then when the “US shortage” alleviated, the new price settles at several times what the pre-shortage price was. THAT’s something that needs to be addressed.

    • brettearle

      Are we also not confronting, here, the differences in test standardizations, abroad, by comparison to those recognized and employed by FDA?

    • tbphkm33

      Underscores the need for the US to have common sense regulatory overhaul. It is one thing if a car manufacturer decides to increase its prices from $25K to $400K per vehicle, that’s their problem. Yet another when someone like a medical supplier decides to artificially increase their profits by charging more. The US regulators should pay more attention to the common good of the public, not just side with their political paymasters.

    • notafeminista

      Interesting information – what’s the source for the “artificiality”?

    • ExcellentNews

      Well said. It’s the same way that the oil cartels manipulate the price of oil to maintain it around $100/barrel.

  • aafreen

    A small story to underscore the importance of public education.

    Growing up, my grandmother kept a small bottle of “fish penicillin” in the fridge. Her advice was to start taking some every time you felt ill. I only recall, maybe, one occasion that I followed her advice. But I doubt it is very rare.

    Don’t do that.

  • Robbie Gammack

    please discuss the issue regarding when every family member is on an antibiotic how the rest of family can get it into their system through the air through contact and have been tested to have antibiotic in their system as well thank you

  • brettearle

    No, no….you’re very wrong.

    Look it up.

    This WAS a major issue for Hospitals–with regard to their need and their willingness to LITERALLY remind MDs of this basic practice.

    Indeed, for a long time, this negligence was apparently of growing concern in Medical Facilities.

    Sometimes the most obvious things are the most critical, are they not?

    This isn’t a matter of having respect for MDs or people–about second nature habits.

    I’m sure there are actually times,when Detectives forget to bring, or carry, their firearms.

    Or one of the firemen have forgotten to equip themselves with small hatchets.

    Not washing hands was considered to be, potentially, such a serrious problem, that hospitals felt COMPELLED to do something about it.

  • nidur

    Very interesting broadcast. However I have heard similar warnings about the coming of Super-bugs since the 1970s, which would occur someday due to the overuse of antibiotics. So nothing much has changed, except that we are getting closer and closer to “someday.”

    • NrthOfTheBorder

      In today’s world nidur, one wonders what it takes to constitute a warning. We’re like a helpless giant who can’t decide when to get out of bed in the morning let alone decide on what’s important.

      It’d be one thing if we (our government for example) was talking about issues and charting a course forward. But the I get the impression issues like this don’t get out of the dim lights of agencies or sub-committees.

      It’s high time “We the People” make ourselves heard – and I’m talking about the sensible, middle-of-the-road folk who know better but have been silent for too long.

      • nidur

        I think it is the disinformation campaigns that are run on everything from this situation, to climate change. This has been described by several commentators. The tactics the special interests used to fight the idea that smoking is bad for you are being used on many other issues. So there is enough confusion, and doubt created in people’s minds, that nothing is done about many of our very serious problems.

  • Kevin Burber

    I agree that people really do not understand. However, there are ways to explain. I always try to create a little model for my kids that makes some sense of how their body works. I refer to getting a vaccine as “getting supercharged”. The doctor puts a little piece of the bug or maybe a dead bug inside your body so that your system will know what to do if a real bug comes along. It’s training your body to know how to kill it so it can’t make you sick. I explain ab resistance. Some ab’s will blast open the shell of the bacteria and his insides will be splattered everywhere. (boy – what can I say…it works!) HOWEVER, if he has a bunch of his buddies with him, one of them might get scared and jump off your body and onto someone else. He’s going to tell all of his new pals to put their armour up when they see the medicine and it won’t work anymore. Then that person will just get sicker and sicker and sicker.

    It doesn’t have to be 100%. People just need to have an incredibly simple model to that makes sense and puts the pieces (somewhat) together for them.

  • jared

    Since the horses are out of the barn on this, tell me why it is so hard to get a Zithromax script out of my doctor’s hand! Give up this new Prohibition!

  • L Martinez

    It is just like people asking for all kinds of medical procedures that are unnecessary, such as mammograms and PSA tests.

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  • nidur

    I didn’t express my opinion very well. When I first heard of this problem, back in the 1970s, I thought it was appalling that virtually no one in mainstream medicine was doing anything about it. Now the problem is upon us, and there is still no rush to change things. It reminds of how, as a society, we are handling many of our other problems Climate change comes to mind right away. I am not in the medical field, and I am not a scientist.

  • TJPhoto40

    It’s a very important topic, and the show presented some valuable information, though I think you passed over agribusiness misuse with too casual and simplistic a reference to how farms employ antibiotics. I was shocked at the comment by Jessica Yellin that she felt she had wasted her time at the doctor’s office if she came away without a prescription for an antibiotic for a common condition that everyone now should know is not likely related to bacteria at all. This reflects the incredible ignorance of the general population still unaware of this issue. Public health information can’t be that challenging. Why don’t doctor’s offices and clinics give out to all their patients a simple explanation of what’s a virus and what’s a bacteria, how they manifest in human illness and so on? This should be a standardized handout provided to every single patient as part of the education of the populace by those in the medical community.

    • Lawrence

      If people look at their own self defenses like the immune system that has evolved to combat most of the common complaints that pushy, patients demand antibiotics for, then maybe it may limit the demand for these drugs.

      America just wants to take a pill for everything.

  • andic_epipedon

    This show wasn’t very enlightening. I am a scientist and I get it. What I want to know is where are all the anti-viral medications? I almost died seven years ago from a virus and there was nothing I could take.

    • ExcellentNews

      Well, whatever kind of scientist you are, biology does not seem to have been part of the curriculum. The show is about antibiotic resistance, which by definition applies to bacterial pathogens only. You might not think of bacteria as a big deal today – thanks to antibiotics. Just 100 years ago, bacterial infection was THE prime cause of death everywhere. And an ugly and painful one.

      On viruses – by virtue of their “nature”, there are not many agents that really work against them. Even today, there is nothing truly effective and safe you can take to prevent or mitigate a viral infection.

      Which brings me to one of my favorite sayings when I discuss economics with friends. I always say that one of the few humans who ever deserved to be billionaire thanks to their work is Dr. Flemming (discoverer of antibiotics).

      • andic_epipedon

        Biology was part of my curriculum and I know it is more difficult to make anti-virals. I think what it comes down to is that anti-virals are not profitable unless it relates to terminal illnesses like AIDS and I think viruses are just as deadly as bacteria. What is your degree in or are you just a devil’s advocate?

        • ExcellentNews

          Ok, I should have been less snide with my answer. The lack of broad-spectrum anti-virals is not really a matter of profit.
          Most antibiotics are compounds that attack proteins making up bacterial cell walls. Because of their common evolutionary ancestry, most bacteria share the same proteins, this allowing a single compound to work against all bacterials groups sharing this protein. Because they bind to exterior compounds, their delivery is relatively easy and effective.

  • Lawrence

    Natural health care, making the body stronger so it can heal itself seems to be forgotten.

    Coffee, smoking, lack of exercise, horrible diets, no sleep, stress all contribute to a weakening immune system.

    Americans seem to avoid any self-control, or will power to stay healthy, then when things go wrong they want a pill to cure it.

    • ExcellentNews

      Natural health care ??? You need to study some biology. In nature, man dies or suffers horrendously from a host of pathogens or parasites. Or from his own immune system in maximum overdrive. There is nothing nice or wholesome in nature. The nice life is product of our technology and science.

      This being said, bad diet, lack of exercise…etc. do decrease the quality of life for most people. But unless you are morbidly obese or diabetic, they have little effect on the unfolding of an infection from E. Coli, MSRA or N1H1.

      • Lawrence

        Yes. I agree. But it makes no sense to ignore good health habits, get sick, create a weak immune system and wonder why one gets sick.

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