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Klebsiella pneumoniae  (Source: ppdictionary.com)
One bacterium, called Klebsiella pneumoniae, has been particularly harmful with 15 to 50 percent of cases due to bloodstream infections resistant to carbapenem antibiotics

The European Center for Disease Prevention and Control (ECDC) has found that multi-drug resistant bacteria, or "superbugs," are spreading throughout Europe with resistance to even the strongest antibiotics.

One bacterium, called Klebsiella pneumoniae, has been particularly harmful. K. pneumoniae typically causes pneumonia, bloodstream and urinary tract infections.

K. pneumoniae has become resistant to antibiotics in Europe, leading to infection in many countries. In fact, K. pneumoniae is even resistant to the most powerful antibiotics called carbapenems.

According to the ECDC, 15 to 50 percent of K. pneumoniae due to bloodstream infections were resistant to carbapenems.

According to Marc Sprenger, ECDC's director, rates of resistance to "last-line" antibiotics such as carbapenems by K. pneumoniae had doubled to 15 percent in 2010 from 7 percent five years ago.

There are two main issues with fighting the superbug: the lack of commercial incentive to invest in last-line antibiotics, and the misuse of antibiotics.

There are very few new antibiotics in development. According to experts, only large drug firms like AstraZeneca are partaking in antibiotic research, and there's a lack of effort in creating new antibiotics that will only be used as a last line of defense.

Antibiotic misuse is a large problem with fighting bacteria. When antibiotics are overused, bacteria find other avenues of surpassing the antibiotics and invading the body. According to Sprenger, countries with the highest rates of multi-drug resistant infections also tend to be the ones with the highest antibiotic use. These countries include Cyprus, Greece, Bulgaria and Hungary.

But K. pneumonia isn't the only superbug to worry about. A different risk report focuses on a gene called New Delhi metallo-beta-lactamase (NDM-1), which can be found in K. pneumonia or E. coli. It makes bacteria resistant to nearly all drugs, and the ECDC reported 106 cases in 13 European countries by the end of March 2011. In late 2010, there were only 77 cases in the same 13 countries. In August 2010, there were patients in South Asia and Britain discovered with the NDM-1 gene.

Experts say doctors are largely to blame for the overuse of antibiotics leading to abuse and eventually resistance. They say patients demand them without needing them and hospitals readily give them out.

Source: International Business Times



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Silly Doctors
By ViroMan on 11/18/2011 11:10:24 AM , Rating: 4
... why you cure infections when the people can cure it themselves given time?
</silliness>

Ya this problem is probably due to people thinking they need antibacterial meds when they get the Common Cold. News flash! The Common Cold is a virus... antibacterial meds do nothing to it!




RE: Silly Doctors
By Dr of crap on 11/18/2011 12:42:45 PM , Rating: 1
I have yet to understand that statement -
"Patients demand it and doctors give out prescriptions."
Since when are the patients in charge?
If they don't need the drug don't give it out.
My family has yet to see a doctor that just gave out anti-biotics just because. When we DO get them it because we need them not to pacify us. Maybe if we DEMANDED them, we get them more??!!
Maybe a class action law suits against all doctors would fix that.


RE: Silly Doctors
By 3DoubleD on 11/18/2011 1:27:22 PM , Rating: 2
Demanding antibiotics from a doctor in North America is one thing, they'll likely just say no. But "demanding" treatments from doctors in other countries is different. Many places you only get treatment with bribes... and thus you can get any treatment you want with the right bribes. This is especially applicable to the worst offenders: Greece, Cyprus, Bulgaria, Hungary, ect.

Good luck with your legal action against doctors in those countries.


RE: Silly Doctors
By cfaalm on 11/18/2011 2:23:58 PM , Rating: 2
In the whole of North Africa: Egypt, Morocco, Tunisia etc (I don't know about the rest) it's also common practice to get antibiotics for stuff that wouldn't require them necessarily.


RE: Silly Doctors
By Solandri on 11/18/2011 3:37:28 PM , Rating: 5
It's like arguing on the Internet. You end up wasting a half hour explaining, trying to convince the patient that all he needs is some rest and fluids to let his body fight it.

Why do that when you can just prescribe him some "harmless" antibiotics in 30 seconds, and get him out of your hair so you can go see your next patient. For most people, a visit to the doctor is not "worth it" unless the doctor gives them some medicine to take home. So when the doctor tells them to just get some rest, they tend to fight it.


RE: Silly Doctors
By bjacobson on 11/18/2011 4:08:30 PM , Rating: 3
Hm, they should come up with a system of prescribing "antibiotics" [placebos] for such scenarios...


RE: Silly Doctors
By ViroMan on 11/18/2011 9:04:30 PM , Rating: 1
Why give them placebos when, you can give them vitamin c's? Tell them its going to get rid of their problem in a few days because really, it will.(but don't tell them its vitamin c)


RE: Silly Doctors
By mindless1 on 11/20/2011 5:12:41 PM , Rating: 1
That is naive and foolish. Antibiotics are one of the greatest inventions man has ever had. They saved millions, now billions of lives.

It is certainly true that they are overprescribed, but on the other hand the only way you would know if they were necessary with a patient is to withhold them and watch the patient get sicker.

Not sure where you draw your line about it but most people don't just hop over to the doctor's office for antibiotics unless their immune system was already losing the fight. It takes time for the body to create antibodies and how many days can a person just bed rest, setting aside their school, work, family responsiblities and potentially making others sick in the process?

I advocate bed rest and vitamin C... every day. Also taking a day off to save stength and recover is wise too, but there comes a point where everyone being sick so we don't use antibiotics has to be weighed against giving superbugs a larger foothold.

... and if people can just rest and get over it, they can do that against the superbugs too so I don't see the logic in it. Being immune to antibiotics doesn't make them any less of a foreign antibody in a host. Once we have germs that aren't recognized as an antibody, THEN worry because then the end for the species is near.


RE: Silly Doctors
By bigdawg1988 on 11/18/2011 4:11:53 PM , Rating: 2
Shoot, why don't they just give them sugar pills? Or are the doctors in with the pharmacies or something?


RE: Silly Doctors
By TSS on 11/19/2011 11:18:38 AM , Rating: 2
That doesn't adress the reason why people ask for medicine. And i can understand the no.1 reason for abuse of antibiotics: Kids.

What's more scary to a parent then losing their child? That can break down the best of them. My dad is a very wise and calm individual, but when i was 3 months old and i had a fever of 41,3C (42C is enough to kill an adult) even he didn't mind antibiotics at all. In that situation, of course medicine is approriate. But what it leaves behind is "oh my god my 3 month old baby nearly died, i'm NOT going to let it get this far next time".

Of course doctors share in the blame, for still giving out antibiotics. But parents can be very persuasive when they think the doctor is gambling with their childs life, no matter how small the odds might be. Since i'm an adult i've gotten sick much less often since my immune system is fully developped, and i go to the doctors office less often because i belive something really needs to be wrong before i need to go to the doctor. Even so, more often then not i've heard "wrong posture while sitting", "it'll go away", "nothing really to do about that" etc. And i'm willing to accept it since he's the doctor and probably knows what's best (don't worry if i'm really in pain i force him to check again too).

Thing is, would even i have that attitude with my own child? Absolutely not. My kid isn't going to die i'm damn well going to make sure of that. Me? i won't die, i can take a hit. I think that's the main culprit of overuse of antibiotics. Nor do i think that's something we can change since it's so deeply rooted in our being.

So all in all.... the best thing to do is just to keep developping antibiotics, for widespread *and* limited use. We are going to need to anyway, no matter how much you limit the use *eventually* bacteria will become resistant.


RE: Silly Doctors
By karkas on 11/19/2011 7:06:31 PM , Rating: 2
#1
I cant speak for other countries, but in America it is considered unethical/illegal to give placebo unless the patient is participating in a drug trial.

#2
Pharmacies don't stock sugar pills and a pharmacist isn't going to lie to the patient about what s/he is dispensing.


RE: Silly Doctors
By Reclaimer77 on 11/18/11, Rating: -1
RE: Silly Doctors
By retrospooty on 11/21/2011 7:41:40 AM , Rating: 1
You do realize that none of that has even started yet right? We are still dealing with a 100% private system.

Not that I agree with govt. run healthcare, I am just saying you cant blame this on something that doesnt even exist yet.


RE: Silly Doctors
By theArchMichael on 11/21/2011 12:03:47 PM , Rating: 1
Actually there are countries where they have much less regulated healthcare and pharmaceutical industries. A friend of mine from Mexico City buys antibiotics off the shelf at the grocery store WITH NO SUBSCRIPTION or without even signing anything. She did this for a cold/flu, and I did tell her it wasn't going to help if it was a viral infection. But of course, people who are scared or have lives to get back to just want to eliminate the possibility and tend to act selfishly.

She is super hot though... so I let it slide.


Freightening
By lightfoot on 11/18/2011 11:06:55 AM , Rating: 5
One of the most frightening things I've ever seen in my life was during my trip to China. Appearently in China, antibiotics are sold over the counter. In addition to this there seems to be a lack of education as to how antibiotics should be used. One person in particular would frequently pop anti-biotics like they were candy any time she got a runny nose. Worse yet she would stop taking them as soon as the symptoms went away.

I'm not saying that such behaviour doesn't occur in other parts of the world (including the United States) but at least in the U.S. we require people to have a short conversation with a trained medical professional prior to starting an antibiotic regime.




RE: Freightening
By dsx724 on 11/18/2011 11:29:40 AM , Rating: 2
Gross ignorance by the Ministry of Health in China. They really need to step up their game and restrict drug distribution. The problem is that manufacturing antibiotics is a lot cheaper than going to see a doctor especially since many use it as a cure-all.


RE: Freightening
By Yames on 11/18/2011 2:49:08 PM , Rating: 2
...and people are really worried about China taking over the world.


RE: Freightening
By bobsmith1492 on 11/18/2011 3:45:34 PM , Rating: 3
They'll take it over, sure, just with antibiotic-resistant diseases. Not the way they hope, I'm sure...


Food for thought
By sthayashi on 11/18/2011 12:13:00 PM , Rating: 2
I was informed by a med student friend that it is illegal for a doctor to prescribe a placebo. Which is ironic given that prescribing antibiotics for viral infections will have the same effect as a placebo. Said friend told me that quite a lot of doctors do just that.

This is one area where perhaps, just maybe, the government should step up and restrict antibiotic drugs a little further.




RE: Food for thought
By Kurz on 11/18/2011 12:54:49 PM , Rating: 4
Yep Antibiotics are probably the only thing I would regulate more heavily than any of our Illegal Drugs. Since antibiotics actually effect other people if used incorrectly.


RE: Food for thought
By bigdawg1988 on 11/18/2011 4:17:10 PM , Rating: 2
Maybe the law has changed since then, but it doesn't appear illegal according to Dr. Gupta...

http://articles.cnn.com/2008-11-27/health/placebo....

What if you just prescribed a vitamin or something other than an antibiotic? On the other hand, I see the potential for abuse there by the doctors and pharmacies.


RE: Food for thought
By superstition on 11/18/2011 4:53:37 PM , Rating: 2
Lots of doctors (especially dermatologists) prescribe placebos.

Many do it without information their patients.

"Half of Doctors Routinely Prescribe Placebos" - NYT 2008

For dermatologists, around 74% said they prescribe placebos.

"Half of all German doctors prescribe placebos" - Guardian 2011

I know first-hand about this because my doctors have prescribed placebos instead of making the effort to cure ailments, like my dermatologist who prescribed "as needed" antibiotics.

Others have tried to pass them off as being no big deal. They get paid. As long as I'm sick, they get paid again and again.

I have little faith in American medicine. I've been to too many patient mills and quacks.


RE: Food for thought
By Fritzr on 11/19/2011 10:02:34 AM , Rating: 2
For conditions that will self-cure or have no realistic medication, you WANT a doctor that will prescribe the MAGIC sugar pill. Placebos are proven to work as an active medication when the patient believes they are a treatment.

Prescribing antibiotics when a placebo is needed does nothing extra for the patient, but it does help make common diseases drug resistant.

Your attitude is a major part of the problem. Come the day you NEED an antibiotic you may find that the infection has already been immunized against antibiotics.


Mother nature fights back
By lowsidex2 on 11/18/2011 1:06:46 PM , Rating: 3
We can fight her all we want but she will win. Over population trumps all the other world problems combined. Or rather, over population is the cause of all the other world problems. We've put up a good fight but there will be a world wide event that will attempt to bring balance back to nature. HIV, SARS, N1H1... some day something will hit that we can't control.




RE: Mother nature fights back
By geddarkstorm on 11/18/2011 1:20:35 PM , Rating: 2
Thankfully it isn't all bleak. We are always several steps ahead with our drug developments. And despite this article, there are more types of antibiotics than carbapenems or beta-lactams (penicillin family). Additionally, most types of antibiotic resistance (for instance, resistance against streptomycin), actually weaken the bacteria when in a non-antibiotic environment (streptomycin resistant bacteria have a much lower production speed of proteins than non, making them grow slower and compete less). So, out in nature, resistance is very low in the population--it's just in hospitals and cities where antibiotics are being misused everywhere that the frequency of resistance is being greatly increased due to the constant selective pressure we are imposing, without giving a breather for the non resistant bacteria to come back and take over the population.

In short, if we stop using a type of antibiotic for awhile, bacteria become resensitized to it. Now, this isn't always or completely true (I'm looking at you tuberculosis), but it does come to our aid.

None the less, if we didn't misuse antibiotics, we wouldn't be selecting for these superbugs (at least not at this rate) in the first place. We really need, as a world, to address this issue before we do start falling behind...


RE: Mother nature fights back
By Ringold on 11/18/2011 5:27:42 PM , Rating: 2
quote:
We can fight her all we want but she will win.


Like nature won with polio! Oh, wait.

quote:
Over population trumps all the other world problems combined. Or rather, over population is the cause of all the other world problems.


How do you get from the root problem of the article, that people take antibiotics too freely and drug companies have little incentive to create new ones, to over population? If a smaller population still took too many antibiotics, the problem would be the same. I think you're stretching to try to drag out an old, disproved Malthusian theory.

quote:
some day something will hit that we can't control.


On the over populated point, the black death hit at a time of a much smaller population, so thats independent of population level. To the control point.. if its virulent enough and becomes quickly apparently, I don't see how the CDC and its global counterparts couldn't limit an outbreak to some number of countries or a continent. Not that millions couldn't die, but I don't know if a black death level event is as likely as it once was. All these extra humans over time that cause all the problems in your view have also been busily advancing technology and various social institutions over the centuries since then.


RE: Mother nature fights back
By derricker on 11/19/2011 7:21:39 PM , Rating: 2
quote:
Like nature won with polio! Oh, wait.


The 8 new cases of polio detected in pakistan this year would like to laugh at your stupid and sarcastic comment, the whole point is precisely that, no matter how much humanity "advances" (you were being sarcastic with that one too, eh?) it can't beat nature.

quote:
How do you get from the root problem of the article, that people take antibiotics too freely and drug companies have little incentive to create new ones, to over population? If a smaller population still took too many antibiotics, the problem would be the same. I think you're stretching to try to drag out an old, disproved Malthusian theory.


No, actually, there is a proven link with overpopulation and the rise of diseases.

quote:
Not that millions couldn't die, but I don't know if a black death level event is as likely as it once was. All these extra humans over time that cause all the problems in your view have also been busily advancing technology and various social institutions over the centuries since then.


If you take in account how an institution like the CDC or it's global counterparts handle a pandemic situation, the death of billions is almost guaranteed, after all, that's what all those technology advancements are best used for by the various social (and political) institutions.


feedlot antibiotics
By mmc4587 on 11/19/2011 10:22:21 AM , Rating: 2
The amount of feedlot antibiotics surpasses that of prescription antibiotics EVERY DAY!!!

We feed a cows 95% grain instead of hay, because it is cheaper. Because this makes them sick we medicate them 24/7. Because they are medicated 24/7 in cramped conditions resistant bacteria becomes epidemic (but since we slaughter them so quickly they rarely have a chance to become deathly ill).

Why doesn't anyone ever talk about this?
Because in America, you can get sued for saying such things...




RE: feedlot antibiotics
By derricker on 11/19/2011 8:15:39 PM , Rating: 2
they don't talk about that not only because of what you say, which is true btw, on top of that, it's easier to feel in control of the situation, no matter of big the mess being build up, as long as we think we are in control, with all our technology and and science.

society as a whole is now in hands of private interests, and the best thing is, nobody cares, as long as we get our next antibiotics shot.


By havoti97 on 11/18/2011 6:01:43 PM , Rating: 2
Your body's own immune system is the best defense. Without a good immune system, no amount of antibiotics will help you against bacteria invasion. Most of the times, these bacterial infections occur in already sick people with a ton of other comorbidities and weakened immune systems. It's nature "finish him off" move sort of. I don't hear about many young healthy 20 year olds dropping dead from drug resistance bacterial infections. This kind of thing happens more in ICUs in people with end stage diseases, more often than not, wrought onto themselves... poorly controlled diabetics to name one.




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