Antibiotics are losing their power against deadly infections. Can we fix the problem?
S E E D E D C O N T E N T
It's been almost a century since the discovery of penicillin kicked off the era of antibiotics. Over the decades, the germ-killing drugs have saved millions of lives by making it possible to eradicate tuberculosis, pneumonia and other bacterial infections that had been scourges for millennia.
But a complex phenomenon known as antibiotic resistance is now sapping the drugs' curative power. Research has shown that taking an antibiotic can cause infectious bacteria in the body to develop resistance to antibiotics; these drug-resistant germs can trigger subsequent infections that are hard to treat successfully — and spread such drug-resistant infections to others.
Experts say the problem is compounded by improper use of antibiotics by doctors, hospitals and patients, as well as by farmers and others in the agricultural sector (the drugs are commonly administered to livestock, as well as to humans).
Antibiotic resistance now poses an urgent threat in the United States and around the world. Certain skin infections, sexually transmitted diseases, urinary tract infections and other ailments that once could easily have been eradicated with common antibiotics are now resistant to multiple drugs. Some "superbug" infections are resistant to all antibiotics — meaning that effective, and potentially life-saving treatment, is no longer possible.
"We're in a tough situation because of the increasing likelihood that each time you or I develop an infection that is resistant, we will have very limited [treatment] options or no options at all," says Lauri Hicks, director of the office of antibiotic stewardship at the Centers for Disease Control and Prevention in Atlanta. "Not only are we more likely to end up in the hospital, we're more likely to have a lengthy illness. Even if we survive the illness, then we're more likely to have long-term consequences."
What can be done to curb the problem? What can doctors, hospitals and patients do? How about government officials and the agricultural sector? And what's the appropriate role for pharmaceutical manufacturers working to develop new germ-killing drugs?
Hicks and three other experts on antibiotic resistance will explore these and other questions in a panel discussion to be held in Boston on Friday. The one-hour discussion, sponsored by the Harvard T.H. Chan School of Public Health, will be live-streamed on this page beginning at 12 p.m. ET.
The other panelists are Marc Lipsitch, a professor of epidemiology and the director of the Center for Communicable Disease Dynamics at the Chan School in Boston; Helen Boucher, a professor of medicine at the Tufts University School of Medicine in Boston and the director of the Tufts Center for Integrated Management of Antimicrobial Resistance; and Kevin Outterson, a professor of law at Boston University and executive director of Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator.
The panel will be moderated by David Freeman, editorial director of NBC News MACH. Freeman has moderated a series of panels at the Chan School, including ones on self-driving cars and gene editing .
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Apparently we losing our birthright by abuse of our own medicines.
My oldest daughter, Anna, was prone to getting ear infections since her 1 month check up. When she was 5 months old, I told the Pediatrician to prescribe something other than amox, he looked at me like I was a stupid young mom who didn't know what the hell I was talking about. He reluctantly agreed and gave me some white grainy stuff that worked(HA! I wasn't so stupid for a 22 yr old mom!). She hasn't had an ear infection since she was 18 months old, and I give credit to the prevnar vax she got when she was an infant (It was suppose to help with ear infections too). Anna can still take Amox if needed but her dose has to be high because they over prescribed it instead of trying something else that I advocated for when she was little. I agree antibiotics are way over prescribed, the body has a natural way of fighting infections, Rx should only be given if its been a few days and the body isn't able to shake it.
My daughter was prone to ear infections, too, and she ended up on Vancomycin which we were told was antibiotic "gold" and if this didn't stop the ear infections, she would need tubes.
She ended getting tubes in her ear canals when she was only 16 months old.
GaJenn and Trout,
When I was a kid, I had terrible ear infections. The doc gave me good old penicillin (well I am old) and when that stopped working they took out my tonsils and androids when I was 7 and I rarely have a problem anymore. Seems they were harboring the bacteria. Nowadays, they would only take out the tonsils as a last ditch effort, since we have so many antibiotics, but what will happen when they stop working?
I also had a lot of ear infections. I had tubes in my ears and my adenoids out, but still have my tonsils. My son also had lots of ear infections, and had tubes in his ears - no tonsillectomy or adenoidectomy.
We both have allergies to pollens, so we were always congested, which makes a wonderful home for bacteria.
Another reason they're slow to take out tonsils nowadays is that it has been linked to GI issues - the tonsils are one of the first lines of defense against bacteria entering the GI tract.
I had a lot of what they called tonsillitis when I was a kid. But I still have my tonsils and have been told by many doctors that they are YUGE!
Both of my kids still have their tonsils, too
My brother had his tonsils out after many bouts with tonsillitis. My sister and I kept ours, and I first had tonsillitis as a teenager. They don't like to take them out after puberty, as the recovery is much worse, so I still have mine, too.
My brother was always a skinny, sickly kid, until his tonsils came out. He immediately started filling out, had better color, etc., and I think it was because he could finally eat without pain. It's hard to get a kid with a sore throat to eat.
My daughter had the same situation. We moved to Whidbey Island, Washington when I was in the Navy and my daughter was two years old. We were there for two years and she ran a constant series of ear infections due to the cool climate and high humidity. She was constantly on antibiotics, usually a Gantricin and Erythromycin combination for pseudomonas infections and the medicine just could not get rid of it. She had developed a resistance to them. She had PE tubes put in with no help. They finally put her on Gentamycin drops. At that time, Gentamycin was fairly new and was mostly used for the eyes. Not a whole lot was known about known about pediatric use for ear infections. We were told there was a possible risk of hearing loss. Got a humanitarian transfer to Yuma, AZ where it was warm and dry. Gentamycin worked and ear problems stopped and fortunately no hearing loss.
I hope it goes well, MUVA. Stock up on ice cream.
We were living in West Texas when she was born and lived there until she was about 4. West Texas is hot and dry, but cold in the winter.
She doesn't have any hearing loss tho there were times I thought she was hard of hearing. Turns out she was just hard headed
I remember my mom always being frustrated with me when I was little. Then she had a thought, and walked up behind me while I was playing and clapped her hands. I never knew she was there. She thought I hadn't been listening, but I had lost some hearing from all the infections. Temporary hearing loss, fortunately.
But after that, she demanded that our family doctor refer me to an ENT specialist rather than put me on yet another antibiotic/antihistamine combo. The tubes went in shortly after that. I didn't have another ear infection until I was 28.
I'm glad your mom gave you that hearing test.
My late wife referred to it as selective hearing loss...
Me, too. She said she felt really bad for yelling at me all the time. She really thought I was ignoring her. I had learned to read lips so well that nobody really suspected I couldn't hear. To this day, I feel like I can't understand somebody as well if I can't watch them talk, even though I have minimal hearing loss (probably job-related).
I got strep a lot as a kid as well, I had tubes twice and my adenoids out. My ENT never wanted to take my tonsils out either so I still have mine as well. My right tonsil is HUGE! I always have to tell my PCP that it's normal and it's always been like that LOL
I had hearing loss as a kid, I still do at times LOL. My tonsillitis or strep always included my ears(they are all connected LOL) which is why they put tubes in. The tubes helped stop the tonsillitis but eventually came back so I had them again with my adenoids removed. That seemed to do the trick! I still have my tonsils but the right one is huge!
When I was four, I got appendicitis. The hospital gave me way too much and decentisized my system. When I got a shot in MI a few months later, it triggered a massive reaction. I am now deathly allergic to PCN.
Oh wow! I'm sorry to hear that! I'm not allergic, but I'm sensitive to Keflex, it makes my face all flush and itchy. I am able to take the other antibiotics in the penicillin family though
Be thankful that you can't take Keflex. It can trigger Stephen Johnson Syndrome.
That can be triggered by many meds. Antibiotics in general, and I believe ibuprofen is often a trigger, but it can happen with almost anything. Scary stuff.
Wow! Thanks for that info!
I took care of 3 SJS patients when assigned to the burn center in the Army. Skin literally falls off. It does grow back though. We had to wrap them in gauze soaked in silver nitrate. They looked like mummy's. Then we had to cover the floor and bed frames in plastic as SN stains every think it comes in contact with. It did the trick but was just plain nasty.
Once you have had a patient with SJS (see 1.1.23) it is a nursing memory you never forget.
When you say silver nitrate, are you referring to Silvadene cream? Messy stuff to work with but very effective for burns.
It can on occasion be fatal. And I've only seen it in pathology texts, but from the pics, I'm sure that memory hangs with you.
Paula,
I think it's important to let people know that there are many drugs that can cause SJS, including many anit depressants. You need to be informed about the possible side effects of the drugs you are using.
No, SN is a liquid. Silvadene cream was actually invented by the doctors I served with on the burn unit. We used to call it Nozema plus. It was far more humane than sulfamyolin which was like applying a burn on top of a burn. We alternated every 12 hrs with sulfamyolin and silvadene.
I remember when I first became a Corpsman, Furacin ointment was the standard for burn treatment. When Silvadene came along, Furacin kind of disappeared from use as Silvadene was much more effective.
Medical research leads to cures. More support for medical research is needed, but please, not by increasing even more the cost of pharmaceuticals, notwithstanding the standard excuse that it is to fund the research and development of new drugs.
Our Publix(local grocery), and private pharmacies in my area do not charge for antibiotics or DM medications. Its hard to find places like that
Wow that is amazing. You are not kidding about that. I have a min. $10 co pay on them.
Add to that, Wal-Mart will not charge vets for medications. Just need a note from the prescribing doctor when you drop it off.
They even offer a one dose Zpac for free as well. And I just found out at work yesterday when our drug rep came in, they will even do 4oz of ninja cough for free. That stuff is amazing and will knock your cough right out!
Great name...Ninja Cough.
Ha! I think so too!
Me too!
That's true to a degree. Mostly, we treat the symptoms of a disease, not the disease itself.
Not all diseases are curable. Most are manageable. There are zero cures for neurological diseases and autoimmune diseases. Until gene therapy is perfected, probably only meds will minimize the damage and control these diseases.
Exactly, that's why we treat symptoms, not diseases. That's my point.
You are 100% correct about that.
I doubt that we are going to be able to turn the tide of anti-biotic resistant bacteria. Mother nature has seen fit for every organism on this planet to evolve given a change in their environment. If the change is slow enough, and the lifeform can adapt quickly enough it will, or at least it's offspring will.
Given that bacteria have a much faster growth rate than we do, their ability to adapt to their changing environment is also greatly accelerated. Insects with their fast reproductive rate are also well adapted to handle changes in their environment. He humans with our slower reproductive rates correspondingly have slow adaptive rates of change.
Will we find something to take the place of antibiotics; I would say surely. But then we will start the resistance vs effectiveness battle all over again. Survival on this rock is not guaranteed. You have to earn your right to survive.
Hence my quote from "War of the Worlds". For good or for bad, we no longer practice survival of the fittest, and that is why we also a war on allergies, autoimmune disease, etc. Antibiotics in a way, have made our species weaker but letting the weaker survive, so we have to count on both new drugs and gene therapy. Mother nature is cruel and we try to fight her cruelness. Hard to tell who will win.
Can we fix the problem? Frankly, I doubt it because we will just end up right back here again regardless of what meds we come up with to thwart bacterial infections. The problem is multifaceted:
1) We don't finish taking all of our antibiotics. We start to feel better, so we stop taking them thinking, "well, I am better now, no need to keep taking them." WRONG. The meds likely beat the infection down enough for you to feel better, but not kill it off completely. Your body takes over and finishes off the infection. The problem is that the bacteria you were trying to kill with the antibiotics is now resistant to the antibiotics you were taking. When you have 10's of millions of people doing this, the standard antibiotics lose their efficacy, and when you catch a bug from another human....well, we start all over again, making the bacteria nearly impossible to kill.
2) Surfaces. On rare occasions, you may see a brass knob in a public building. Back in the 40's and 50's, brass fixtures, knobs and handrails were usually made of brass. Bacteria has a hard time growing on brass. It was certainly not foolproof of course, but it did help keep bacterial infections down to a dull roar. Now? Well, brass is expensive, so society switched over to aluminum which has no ability to kill bacteria.
3) Overuse of hand sanitizers. Pretty much # 1 above, but with hand sanitizers. Hey, I use them too, but it's just another way that helps bacteria become resistant.
Side note. Bacteria and viruses are not the same thing. A virus can mutate and change, that's why some years the flu vaccine is effective and some years it isn't. It's also why there really is no cure for the common cold or AIDS, we can mitigate the damage, but there is no cure. So, if you are in a risk group and you get the flu, of course go to the doctor, but if you are relatively young and don't have specific risk, (asthma, COPD, etc), your best bet is rest and fluids. "Starve a fever, feed a cold"...
Disclaimer: I am not a doctor, if you are sick, go to the doctor and let them sort out what's wrong. If they give you antibiotics, for the love of God, take them until they are gone.
Oh yea. Viruses don't like heat, that's why you spike a fever, it's your bodies way of trying to kill the virus.
I was always of the opinion that the use of hand sanitizers was part of the problem antibiotic resistant bacteria which is why I never use them. Then, considering those sanitizers are really nothing more than alcohol, they tend to dry out your skin...which cracks...which lead to skin infections.
I used to be one of those who didn't use up all of my antibiotics. I've learned better. Now I take every single horse pill they give me
I agree with you trout. They actually did a study of farm children and found out that despite the level of bacteria they are exposed to, they have fewer allergies and less autoimmune diseases than children who live in urban and suburban areas.
The only time I use a hand sanitizer is on the subway or railroad when I am in NYC. There are just too many illnesses on those handrails for me.
The thing is, and you know this, those handrails are probably harboring more viruses and other goodies that hand sanitizers are absolutely powerless against. Coliform bacteria are not necessarily disease-causing, it's the type of coliform bacteria such as E coli, and then it has to be a pathogenic strain of E coli that causes an illness. And from what I've learned pathogenic E coli is actually very fragile. It has an optimal temperature, O2 level, and acidity level it can tolerate before it goes tango uniform.
That's why I roll my eyes at the hand sanitizers/towlettes at the grocery store. We even have a hand sanitizer dispenser where I work and you would think these ninnies would know better.
Everybody is so afraid of gerbies today. I played in the dirt and probably ate my share of dirt full of coliforms.
I use hand sanitizer or wash my hands with antibacterial soap between patients at work, but at home, I don't use antibacterial anything, except to scrub the bathroom and kitchen counters. I keep some sanitizer in the car for when I have to take trash to the dump, in case a bag leaks something yucky, but that's pretty much the only time I use it outside of work.
My son and I are rarely sick.
You are not alone, most people don't take all of them. Good on ya for taking all of yours. I have to start a course of ABO's today. Had some questionable moles on my back frozen yesterday so the doc ordered ABO's just to be on the safe side.
I hate having to use hand sanitizer. We have hospital grade disinfecting wipes that we have to use twice a day to clean our waiting room and our office phones and such. I always wear rubber gloves when I have to use that stuff!
We found one that has emollients and actually feels like lotion, which makes it a lot more pleasant. It's still alcohol-based, though, so if my hands are so dry they've cracked, I avoid it because it stings like the devil.
I'm sure health care workers prop up half of the hand lotion industry by themselves.
There are some without alcohol but they feel like you are putting soap on your hands, it's so slimy and it feels like it leaves a "film" on them. I hear it works but not as well. I keep baby lotion at my desk, I figure if it's good enough for babies.....
Also, people need to stop demanding antibiotics for colds and the flu. Those are viral diseases, and antibiotics don't do diddly squat. But I've known people (usually ignorant moms, TBH) who make a huge scene if they or their kids don't get the antibiotics they "need", because "I paid for this appointment, and you didn't even do anything!" and so on and so forth. So doctors give in and write a script just to soothe the savage beast in their waiting room.
Stop that, folks. You're going to get us all killed.
I totally agree with you Sandy. Get your flu shot. Even if it's not quite on for this year's variation, it will diminish how badly you get the flu.
Just got mine this morning. I'll take my son to get his after school.
Last time I had the flu was 1996. My brother gave it to me for Christmas. Can't say it was my favorite gift that year.
I've had my flu shot every year since then, and haven't had the flu.
LOL! I got my flu shot last week and the nurse asked me how I did with the flu shot last year. I told her I got the flu.
I did. And then I shared with everybody at Christmas
I got something for the flu last year from my doctor. It was a series of oral medication that worked pretty good.
Way to get on everybody's shit list
You probably had Tamiflu. It works well to make the flu milder and of shorter duration, but there are periodic shortages, so sometimes it's hard to get because it's reserved for the elderly or compromised patients.
It wasn't Tamiflu, tho. It was something else that has completely slipped my mind.
Yeah, we went to my daughter's house for Xmas and I was so miserable. She came down with it a few weeks later and then passed it on to her friend. I was like "you're welcome"
I never get the flu shot...I've only had the flu once and didn't even know it....I had a regular checkup doctors appt. and they are the ones who informed me that I had the flu. They did give a script (can't remember what for) to fight it. Then I had to make a new appt. for my regular check up.
^^^^^^^^ Bingo. I forgot to add that part and my edit time had expired. Thanks Sandy!
About once a year I get a severe case of bronchitis. It's almost always viral, but I go to the doctor to make sure that I don't have pneumonia. I pretty much argue with the doctor when he/she gives me antibiotics for a viral infection and then they look at me like "who has the medical degree here?"
Sound advice. I resist getting mine until mid November...ish. It's only good for ~3 months, (opinions vary), and the flu season in my neck of the woods runs from mid October to March ish. So I try to aim for the middle of the worst months.
Something many people don't know about the flu vaccine;
It's based on last years flu virus. So next years flu vaccine will be based on this years virus. They look at how the flu virus mutates year to year, then develop a vaccine for the next year based on their data. It literally is an, "educated guess". That's why sometimes it works well and other times...not so much.
Good call. Pneumonia kills people and we want you around.
Crikey... SMH. Just ask them how antiBIOTICS, help with a viral infection. Laugh at their BS answer, then suggest they take biology 205 and 206 again.
I swear the CDC has a dart board with all the strains on it and throw darts until one gets the majority of the hits
Flu shot is mandatory at my work. Thankfully they give it to us for free even though my insurance will cover it as well since it's preventative.
I lost my Dad a couple years ago to Pneumonia
I'm sorry, Jenn.
Thanks, Kath
Thank you, Sandy. It's been a couple years, but we were close, so it hit me pretty hard. I have him on my mantel so I still chat with him
THIS! so much THIS!!!!
I like that you have him on your mantel. Sorry for your loss. My dad passed away about 9 years ago and I still miss him a lot
Thanks Giggles
, I lost my Miller a few years before Daddy (they were buds), so I have my cat sitting on top of Dad too LOL
Sorry about your dad too. It doesn't matter how old we are, it's still hard
Thanks. It is hard
All very true Mr. F. We can only hope for newer drugs and hope that doctors and people start to wake up to the truth that we over use these drugs
Education is important. It's on the doctors to explain why it's important to take all of your antibiotics. But I totally agree, let's hope through education and better meds, we can dig ourselves out of the hole we are in.
Don't forget that eating meat also causes antibiotic resistance due to overuse by ranchers and feed lots.
The good news about that is that recently a lot of attention is being seen about "plant-based" meat. There are startups producing it and a couple fast food franchises are experimenting with serving it.
Been eating grass fed beef my whole life. Grew up on a ranch.
It's not just eating meat. Those antibiotics and the bacteria resistant to them end up in our waterways, and from there, they can get almost anywhere. The antibiotics pass through livestock's bodies the same as they do through ours - they really aren't broken down by our bodies. What goes in comes out pretty much unchanged.
Aren't most farms shying away from using antibiotics and hormones? When I buy meat, I make sure it says no hormones or antibiotics used. But hell, you never know if the labels are truthful or not.