Currently viewing the category: "antibiotics"

Further support for what I’ve been saying on this blog for years (and which has been obvious for decades)–a significant percentage of antibiotics prescriptions is unnecessary. According to a recent study, doling out antibiotics for sinus infections improved neither symptoms nor recovery time. And although patients may now have come to expect antibiotics to treat their inflamed, runny noses, doing so is actually leading to a rise in antibiotic-resistant strains of bacteria, a very dangerous scenario indeed.

The research conducted at Washington University in St. Louis, Missouri included 166 adults with moderate, severe or very severe symptoms such as sinuses and nasal discharge that lasted between 7-28 days. Some were given , others placebo, and the results showed that the antibiotics “did not result in a significant difference in symptoms compared to patients who received placebo.”

Said lead researcher Jay Piccirillo: “Patients don’t get better faster or have fewer symptoms when they get antibiotics. Our results show that antibiotics aren’t necessary for a basic sinus infection–most people get better on their own.”

Wait, let’s hear that again…”most people get better on their own.” And again…”most people get better on their own.” One more time, “most people get better on their own.” How many times do you have to hear it, people?

I have to keep saying it because I am blown away by the number of people still running to their doctor for the cold they just can’t shake. A full 20% of all antibiotics prescriptions are for sinus infections (inflammation and thick yellow or green mucus discharge)–the common approach taken by the very large majority of today’s western medical doctors. With 37 million Americans diagnosed with sinusitis each year, well…that’s a heck of a lot of antibiotics. And how many people actually finish their dose? Well, I don’t know the answer to that, but let’s just say more than a few people mention to me that they “had some antibiotics lying around.” WTF?!

The authors of this latest study have it right, so I’ll just finish with their words:

“We feel antibiotics are overused in the primary-care setting. There is a movement afoot, led by the Centers for Disease Control and Prevention, to try to improve the judicious use of antibiotics. We hope this study provides scientific evidence that doctors can use with patients to explain that an antibiotic is not likely to help an acute sinus infection.”

Werd to that.

Listen up, peeps–your voice does matter, and it can make a difference.  I know many folks speaking out against the liberal use of antibiotics in animal feeds, and the governing bodies are listening.  In late May, consumer groups lodged complaints with the Food and Drug Administration denouncing the widespread use of antibiotics in animal feed and urged the agency to do more to halt the practice.  And just recently the World Health Organization (WHO) has recommended restricting and even eliminating the use of antibiotics to boost animal growth.  Bravo!

Limiting the use of antibiotics in animal husbandry is suggested to reduce the risk of developing and transmitting resistant microbes to humans.  Antibiotic resistant bacteria, like Methicillin-resistant Staph aureus (MRSA), are believed to be transmissible to humans via farm animals, particularly pigs.  The mode of transmission can include meat consumption, being in close contact with the animals, or through the environment (groundwater contamination).

The European Union has already banned most antibiotics in animal feeds (with the exception of two in poultry feeds) since 2006, and Scandinavian studies have shown that restrictions have led to a decrease in resistant animal bacterial populations.

MRSA is not the only drug-resistant bacteria on the rise in animal products, either.  Bacteria resistant to fluoroquinolones and the most recent generations of cephalosporins have become more common.  Both these classes of drugs are considered essential to human health as a last line of defense to combat the most stubborn infections.  Resistance to third and fourth generation cephalosporins in Salmonella Heidelberg infections in humans has been increasing over the last several years.

According to Beth Karp, senior veterinary epidemiologist with the US Centers for Disease Control and Prevention, “Between 2008 and 2010 resistance increased from 8 percent to 24 percent. In retail chickens isolates, resistance in Salmonella Heidelberg increase from 17 percent in 2008 to 31 percent in 2009.”
The strain is resistant to nearly all antibiotics.
We are well beyond a wake-up call here.  Antibiotic resistant bacteria is no joke, as we have seen what it can do during mass outbreaks like in 2007-2008.  More and more meat products are contaminated with these super-bugs, and with further neglect, it’ll only be a matter of time before we see another one (fluoroquinilone-resistant campylobacter is common in the U.S. in poultry products).
Again I say bravo to the WHO for taking a stand, as well as the USFDA for listening to consumers and passing on their recommendations to the meat growers industry.  As for meat manufacturers, I hope you are listening.  I get wanting to provide product that’s beefier and all-around more aesthetically pleasing, but your current practices are a powder-keg waiting to explode.  Hopefully you’ll discontinue the practice of pumping-up livestock with antibiotics, hormones or anything else that you might be adding.  Just the meat, please–the people have spoken.

Look!  Up in the thighs!  It’s a bug!  It’s the clap!  It’s Super-Gonorrhea!

Aw sh@#!…look out unsafe sexers, gonorrhea is back with a vengeance.  The sexually transmitted disease is developing resistance to the drugs we treat it with here in the U.S., researchers warn.

In 2009, nearly 25% of strains tested nationwide were resistant to the following antibiotics: penicillin, tetracycline, fluoroquinolones, or a combination thereof.  In 2010, Neisseria gonorrhea started developing resistance to the cephalosporins, the last class of drugs being recommended to fight the bacterium.  Microorganisms that develop drug resistance are called superbugs, like the methicillin-resistant Staph aureus (MRSA) that has plagued the U.S. over the last several years.  Do I really need to explain the dangers of superbugs?

People contracting gonorrhea often show no symptoms, but untreated clap can lead to infertility and chronic pelvic pain in women, and in men epididymitis, a painful condition of the ducts attached to the testicles that may also cause infertility.  If it spreads to the blood or joints…could be bye-bye.

The Centers of Disease Control and Prevention (CDC) report that 700,000 gonorrheal infections occur in the U.S. every year.  Antibiotic resistance in gonorrhea has been happening since the 1970s; but as this newest resistance to cephalosporins is occurring, it becomes serious cause for alarm.  Researchers are seeing the emergence of cephalosporin-resistant gonorrhea in South East Asia.  Typically, resistant strains from that part of the world migrate over to the U.S., and then spread from West to East.

OK, one more time: NO GLOVE, NO LOVE!  C’mon people, buy some dang rubbers…and use them!  SheeshWhat the heck is so hard about that?

(In whiniest voice musterable) But I don’t like the way it feels.

You like the feel of epididymitis, knuckle-head?  Then take one for the team, why don’t you…and help stop the spread of Super-Gonorrhea.

Last post I discussed a new and deadly form of superbug: extremely drug-resistant (XXDR) TB. Two more drug-resistant microorganisms that will likely become a health threat in upcoming years have also surfaced–they are drug-resistant malaria and drug-resistant HIV.

Like XXDR TB, these two new superbugs are a result of over- and misused drug responses. In the case of DR-malaria, the drug in question is artesunate–a derivative of artemisinin, the world’s last weapon against malaria. On the Thai-Cambodian border, DR-malaria is popping up, experts believe, as a result of over-the-counter purchases and self-administering of artesunate.

Although artesunate has some use in fighting malaria, it is not meant to be a stand -alone drug. This weakened drug response makes it easy for the malaria bug to withstand and develop resistance. Artesunate has been banned in Cambodia; despite this, it continues to be sold to locals in small, unlicensed shops for self-treatment of malaria.

DR-HIV is starting an upsurge in South Africa. Because of short drug supplies, many people do not take the full course of antiretroviral treatment, and drug-resistance results. For the unfortunates that fail on one antiretroviral regimen, other drugs can be tried; but for each successive one the risk of mass drug-resistance increases–not a good prospect in the fight on HIV in sub-Saharan Africa, where 2/3 of the world’s 33 million HIV cases exist.

As I pointed out in my last post, the evolution of drug-resistant microorganisms is a truly frightening notion on the surface. But all is not futile. I talked about maintaining one’s own health as the best possible defense against microorganisms–superbugs or not. This includes adopting all health-enhancing behaviors, as well as abandoning those health-depleting behaviors we have become all to accustomed to. One in particular is proving to be an incredible long-term solution to slowing down the growth of drug-resistant microorganisms, and it is being practiced with great success in Norway.

The Norwegian public health system has adopted a program to combat drug-resistant bugs, and it’s basis is to cut back on the use of antibiotics. Bravo Norway! They have recognized there that the majority of antibiotics are prescribed for benign symptoms, like minor coughs or fevers.

“We don’t throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better,” says one Norwegian doctor. “Penicillin is not a cough medicine,” says one marketing message on a package of Norwegian tissue paper. Hallelujah!

I’m pleased to see a country making a mass effort to contain a menacing global problem. The World Health Organization (WHO) says antibiotic resistance is one of the leading public health threats on the planet. I couldn’t agree more–time to take proactive measures. And Norway is doing just that. We could do the same here in the U.S. but it will take a concerted effort by physicians; something I think will be much harder to count on. Only time will tell which direction it all goes. But with the looming dangers of DR-TB, DR-malaria and DR-HIV we better start doing something. As I keep preaching, all we can do is take the best care of ourselves possible by practicing health-enhancing behaviors. It will be the strong that survive if a superbug onslaught is allowed to fester.

Hooray for nutritional products for kids! I’m thrilled by any product developed for a child’s nutritional consumption. The latest–probiotic straws–to replenish healthy gut bacteria for children that might have had a bout of diarrhea or have been through a round of antibiotics or such, are now available through the Nestle’ corporation.

I am a firm believer in the power of commerce–that is, allowing the markets (peoples’ buying habits) to determine product availability. That’s why I vehemently oppose mandating regulation or restrictions on the food industry. The food industry only produces what people (the market) want(s). So Coca-Cola and Pepsi now both sell bottled water. Why? Simple–it’s a huge market. Duh! Businesses only care about making money. There’s nothing immoral about it (with regard to the food industry)–amoral, for sure; but immoral?..no way.

So although it may be surprising initially to hear that the Nestle’ corp–makers of Quick, Butterfinger, Chunky, Coffee Mate and a slew of other junk food products–is behind the latest health product for kids, it makes complete sense to me. Health and nutrition is a large and growing market; and naturally, parents will want products that also ensure their children’s health and well-being. Can you both be a junk food and health food manufacturer? Sure, why not?

OK, back to the product. Nestle’s Health and Clinical Nutrition (HCN) products has aligned itself with BioGaia, makers of the Probiotic Straw which contains a daily dose of L. reuteri, a “universal” gut organism, meaning it is found throughout the animal kingdom. L. reuteri is already being used in products in 42 countries, including formula products in Europe and Asia.

Probiotics help replenish healthy and useful gut bacteria, which are necessary to ward off opportunistic organisms that could overtake a deficient environment. Probiotics can be taken by children of any age. Vaginal births and breastfeeding lead to greater flora production in children, but probiotic supplements can help enormously. Probiotics can help boost the immune system, and a preliminary Chinese study showed that probiotic supplementation may aid in preventing colds.

Thumbs up to Nestle’s. Yeah, you can manufacture both health and junk together. The market determines what should be available. Some want Hot Pockets, others probiotics. No problem–Nestle’s got ’em.

Something must be wrong with me–I love to see people squirm. Not just anybody, mind you, but mostly people who have lied, cheated, or acted hypocritically in one way or another. And I especially love to see it in people, or groups, that act arrogantly. C’mon, you know you love it too. We all get a sense of satisfaction when the chickens come home to roost, and these people have to squirm and lie some more to rationalize themselves. Pure comedy.

Take, for instance, the latest study to be published in the medical journal, The Lancet, which has reported that doctors routinely overprescribe antibiotics for viral infections. You don’t say? Really? Wow. Seems like that same idea was reported right here in this blog back in October. According to the study, 80% of sinusitis (inflammation of the sinuses) cases in the U.S. are prescribed antibiotics despite the fact that the majority are due to the common cold virus. And just like I said in my October post: Antibiotics don’t do diddly against viruses–they’re meant exclusively to fight bacterial infections.

OK, here’s the good part: The study’s authors then attempt to explain the inordinate amount of antibiotics prescriptions by stating that when the patient has had the symptoms for a long time, doctors assume it’s due to a bacterial infection….(Pause…silence)

Ah, ha, ha, ha, ha, ha….what a joke. Do any of you buy that baloney? Let me tell you the real deal (and this information comes straight from a medical doctor who taught me in chiropractic college): Doctors prescribes medications at nearly every doctor’s visit regardless of the situation because, and I quote, “the patient expects it”. That’s the truth in a nutshell: Doctors prescribe antibiotics full well knowing they’re useless against viral infections, precisely because the patient expects something, not because it’s the right thing to do, but because they know the patient wants it and will go somewhere else to get it. In other words, there ain’t much of a market for non-prescribing M.D.s, period.

The only reason this study has come out at all is because of the explosion of antibiotic resistant bacteria that have penetrated our world, otherwise, trust me, the practice would continue. Antibiotic resistant bacteria is a growing and severely dangerous phenomenon. There is no longer time to play around, so now the medical community is asking how. But, unfortunately, you’ll never get to the truth by hiding it, or in the case of these authors’ conclusions, by asking the wrong questions.

I’m going to end this by being as fair as I can to my medical brothers and sisters–it’s not totally their fault. Overprescribing antibiotics really is a consequence of what the public wants, and demands–like most things–and people really do yearn for a magic bullet. But what makes the medical clinician at least equally responsible is that they know better. It may be true that a medical business which doesn’t prescribe medicines will soon have to close its doors; however, it may be time to start pushing a more health-responsible agenda, which would be to teach patients that their bodies have everything necessary to fight the common cold virus, and that antibiotics are unnecessary, and useless, in these cases. Still–I just love to see them squirm.

The 20th century could definitely be called the Pharmaceutical Age; it was teeming with breakthroughs–vaccines, life-saving surgical procedures…Viagra! Advancement seemed to have no bounds. Heart disease? Take this. High blood pressure? Take that. Sniffle? Have an antibiotic. There’s a pill for every ill.

Then came the 21st century and pharmaceutical innovation leapt into new territory. Normal physiology acting up?–have a statin. How about an H2 blocker? Or tranquilizer? We do physiology better than the human body does. Yes, progress.

Then, of course, came performance enhancing drugs–steroids for athletes, steroids for cattle, Ritalin for medical students. Woohoo! Top of the world, Ma!

According to IMS Health, U.S. prescriptions have risen 12% to 3.7 billion over the last five years. 3.7 billion? With prescription drug use skyrocketing, is it any wonder that an AP investigation this week found a vast array of pharmaceutical drugs contaminating the drinking water of 24 major metropolitan areas? It isn’t to me. Check it out: 41 million Americans are drinking water laced with antibiotics, anti-convulsants, mood stabilizers and sex hormones, as well as a load of over-the-counter pain medications like acetaminophen and ibuprofen. And here’s the best part of it all: The drugs are remnants of non-metabolized pharmaceuticals passed through the urine of our over-medicated countrymen. Pretty gross, eh?

Now to be fair, the concentrations of said drugs are minuscule; however, many experts admit that we do not fully know the health implications of the widespread contamination yet. And to make matters worse, evidence shows that chlorine, a commonly added chemical used to treat water, can react with many pharmaceuticals making them more toxic.

Here’s what stands out the most for me regarding this frightening story. We have become a society so obsessed with quick fixes, especially pharmaceutical drug treatments that I can’t imagine any other scenario than this one happening. Duh! Medications aren’t fully absorbed by the body (thank goodness!) and so they’ve got to go somewhere. We’re taking pharmaceutical drugs by the boatloads–their concentrations in our water supply only reflect our consumption habits. That should speak loudly about what we’re doing to ourselves. Truth is, if you’re a medication junkie, this story probably doesn’t phase you–that would seem rather contradictory. But if you’re not, and you actually care about what goes into your body, then this story has got to creep you out a little; it sure did me.

Anyway, on the lighter side: The report did list some drug concentrations of various city water supplies, and I couldn’t help but see the comedy in it all. Check it out and chuckle:

  • New York, the city that never sleeps–tranquilizers
  • Philly, home of the cheesesteak–cholesterol drugs
  • L.A., where narcissism & cocaine share the spotlight–anti anxiety drugs
  • San Francisco, no explanation necessary–sex hormones

I guess our drinking water says a lot about our culture.

As medical technology advances, modern society is increasingly faced with tough ethical questions–questions regarding right to life and quality of life issues. Take for example a new study which suggests that antibiotics are overused in people dying of dementia diseases and should be considered more carefully in light of the growing problem of drug-resistant superbugs. In other words, should people at the end stage of disease be given life-saving treatments despite the fact that time is not on their side? Or should medical practitioners consider the larger implications to the public health as a whole?

According to study co-author Dr. Susan Mitchell, a senior scientist with the Harvard-affiliated Hebrew Senior Life Institute for Aging Research in Boston, “Advanced dementia is a terminal illness; if we substituted ‘end-stage cancer’ for ‘advanced dementia,’ I don’t think people would have any problem understanding this.” What she is referring to is withholding antibiotics from people in the end-stages of Alzheimer’s disease, a fatal brain disease. Although many dementia patients die from infections like pneumonia, the underlying cause of illness and deterioration is damage to brain cells.

In the study, over two hundred people with advanced stage dementia residing in nursing homes in the Boston area were followed over an eighteen month period or until they died. Almost half the subjects died during the study. All subjects failed to recognize loved ones, had stopped speaking, were unable to walk or feed themselves, and were incontinent. Researchers looked at the patient’s medical records and found that 42% received antibiotics–many intravenously–within two weeks of their death. And here’s the kicker: The closer the patients were to dying, the more likely they were to receive antibiotics.

The problem with the practice of administering antibiotics to people near death is that we are in the midst of a superbug (antibiotic resistant strains of bacteria) epidemic; and the indiscriminate use of anti-bacterial medicines is more than a little to blame. Liberal prescribing of antibiotics is common in nursing homes, in children with ear infections, in adults with coughs and sore throats, and in many other ailments which, for the most part, will resolve on their own over time, or for which antibiotics are useless, like viral infections. But the fact is that, in nursing homes, the standard of care is for doctors to see the residents only one time per month or once every two months. According to Dr. Daniel Brauner, a geriatrician and ethicist at the University of Chicago Medical Center who was not involved in the study, “I’m sure a lot of these antibiotics were prescribed over the telephone.” I’m sure of that, too.

So the question remains: Should medical treatments be administered to people who are at the end stage of terminal illness? I’m certain there is no real answer. If the person is your loved one–your wife, husband, mother, father, and so forth–I’m quite convinced the answer will be YES! We all want the extra time with our closest family members. But in the bigger picture, perhaps a dignified death with the help “the old man’s friend”, as pneumonia was once called, is in order. As bioethicist Bruce Jennings, consultant at the Hastings Center, a research institute on medical ethics, says, “You might rescue the patient from life-threatening pneumonia and they live a few days, weeks or even months longer, but the extra time you have bought them by that rescue is not beneficial.”

Everybody knows about harmful bacteria, like E. coli, Staph aureus, Neisseria gonorrhoea and others, and how they wreak havoc on our health. But not all bacteria are bad–good bacteria reside in our gut and other places, and not only keep harmful bacteria from settling in and colonizing, but can also ward-off illness.

According to a new study out of Australia, long-distance runners taking probiotics (a supplemental mixture of “good” bacterial colonies) showed a boost in immune system function and had less respiratory illness than runners taking a placebo. These results show one potential major benefit of supplementing with probiotics.

Probiotics are bacterial and yeast mixtures with such recognizable names as Lactobacillus acidophilus and Bifidobacterium. Most people take them following a round of antibiotics to help replenish the numbers of helpful bacteria in the digestive system. The many benefits attributable to probiotics are:

Taking probiotics, then, is a great way to enhance the health, especially of the digestive system. But as you can see, supplementing with these essential microorganisms has even wider-reaching effects than that. I take them regularly myself, and find them a useful supplement to eating yogurt, another great source of Lactobacillus and Bifidus cultures. So don’t fear all bugs; some microbes are necessary for life–our life. Now that’s symbiosis!

Heed the warning, readers: Sexually transmitted diseases (STDs) are on the rise, and some pretty nasty ones are out there to get you. You already know from an earlier post that syphilis is back with a vengeance, but you can add to that rectal gonorrhea and new HIV infections for the unwise. Rounding out the mix is the antibiotic resistant strain of Staphylococcus aureus, which researchers think is being transmitted among gay men during sex.

A new study appearing in the Annals of Internal Medicine reports that methicillin-resistant Staph aureus (MRSA) is showing up outside of hospitals in San Francisco, Boston, New York and Los Angeles. It states that gay men are 13 times more likely to get infected than heterosexual men. Researchers believe that the infection is being spread through sexual activity, and that illicit drug use and increased risky sexual behavior is fueling the transmission. Because Staph aureus can, and in some people does, colonize around the anus, those having sex which might break the skin are at a greater risk of infection.

I don’t have to tell you how dangerous MRSA is. It’s resistant to penicillins, a common class of antibiotics, and is therefore difficult to treat, often requiring intravenous antibiotic drug therapy…which ain’t cheap. If the infection gets bad enough it can lead to death–approximately 19,000 people were killed by MRSA (mostly in hospitals) in 2005.

So what’s the advice? C’mon people: Use protection without exception! Safe sex is still in. It better be, because the alternative just isn’t worth it. And not to sound like a Moral Majorist here, but…keep the number of sexual partners to a reasonably modest amount, sheesh. Hey, I’m not knocking a good orgy; heavens no. But the days of wine and roses are over–they ended in the 70s. Free love costs beaucoup bucks now. So be smart. No glove, no love. Simple as that.

Eeeewww. It’s like a creepy movie. Staphylococcus invasion from outer space. Lock up your kids. Lock up your pets. Lock up your livestock. Yecccch!

More staph infections popping up all over the country. One kid dead in Virginia. Eight in New Jersey infected with a Methicillin-resistant strain. See what happens when antibiotics are over-prescribed?

Oh, don’t even try to push the blame on somebody else, Medicos. No, no, no. It was you who gave antibiotics for every single ailment no matter how minor. You gave them to patients that you had diagnosed as having viral infections, despite the fact that antibiotics only work on bacteria.

“But the patient expects to be given something.”

Yeah, and now we have an antibiotic resistant epidemic on our hands. I’m so excited to see the BS fly when public health officials try to explain this one.

Wait! This just in: Five more high school kids infected with Methicillin-resistant Staph aureus (MRSA). Whew!–they’re spraying the showers and locker rooms. Hmmm…What took so long? Really, really frightening stuff. Just check out this Google page to have your head spin. The number of infections around the country are staggering.

Here is the take home lesson: Antibiotics should be taken only periodically–that is, only when absolutely necessary. When antibiotics are taken for every little cold or flu, bacteria respond by mutating and developing resistance. Every year, I talk to a good dozen people who say, “I wasn’t feeling well, so I just went to my doctor and got antibiotics.” WTF! You really can’t ride out that cold?

So I always respond, “Oh yeah, which bacterial infection are you treating?” Here are the two most common answers in order of frequency:

  1. “Uh, I don’t know.”
  2. “It’s a viral infection.”

“Great, feeling better?”
“Oh yeah. Definitely.”
Yeah. BS. Listen, antibiotics do nothing against viral infections (probably 90% of colds and flu) and now they don’t do nuttin’ against Staph aureus. I sure hope we learn our lesson on this one. But somehow, I doubt it.

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