Wednesday, December 14, 2016

Antibiotics overuse

Has the US forgotten Alexander Fleming warned against antibiotics overuse in 1945 in his nobel prize lecture see last page of https://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-lecture.pdf

"The time may come when penicillin can be bought by anyone in the
shops. Then there is the danger that the ignorant man may easily underdose
himself and by exposing his microbes to non-lethal quantities of the drug
make them resistant. Here is a hypothetical illustration. Mr. X. has a sore
throat. He buys some penicillin and gives himself, not enough to kill the
streptococci but enough to educate them to resist penicillin. He then infects
his wife. Mrs. X gets pneumonia and is treated with penicillin. As the strep-
tococci are now resistant to penicillin the treatment fails. Mrs. X dies. Who
is primarily responsible for Mrs. X’s death? Why Mr. X whose negligent
use of penicillin changed the nature of the microbe. Moral: If you use peni-
cillin, use enough."

In the USA doctors over prescribe antibiotics, compared the norm in the northern Europe. Food and over the counter cleaners and creams also have antibiotics, none of which I know is the norm in Europe. (Particularly northern Europe).
I find it disturbing that NPR had this misleading story...
http://www.npr.org/sections/goatsandsoda/2016/12/10/504691357/million-year-old-hero-bug-emerges-from-cave

Around the same time as still more scientifically serious article https://www.newscientist.com/article/mg23231044-000-antibiotic-resistance-will-hit-a-terrible-tipping-point-in-2017/
By Debora Mackenzie
"A major menace looms over us. In 2017, many more people could begin dying from common bacterial infections. As resistance to antibiotics booms, diseases from gonorrhoea to urinary tract infections are becoming untreatable – a situation that looks set to get worse as the world reaches a new tipping point next year.

“We are about to reach the point where more antibiotics will be consumed by farm animals worldwide than by humans,” says Mark Woolhouse, at the University of Edinburgh, UK.

This will mean more resistant bacteria, which could be a big threat. The livestock industry has long played down any risk to human health caused by using antibiotics in farming, but the danger is now accepted, according to the UN Food and Agriculture Organization (FAO).

Colistin, a drug that is used more often in animals than people, is one example. It is now the only antibiotic left that works against some human infections, yet colistin resistance has developed, and spread worldwide in 2015. The European Medicines Agency says bacteria resistant to colistin probably arose in livestock, and that some EU countries could easily cut their use of this antibiotic 25-fold.

The UN General Assembly has called for countries to encourage the best use of antibiotics. But it hasn’t yet called for specific measures, such as banning their use to assist livestock growth – rather than fight infections – which can promote resistance.

At least agencies like the FAO are calling for change, says Woolhouse, as is China, where growing demand for meat has lead to soaring livestock production and resistance. But progress will require finding other ways to keep animals healthy, especially in poor countries where production is growing fastest and there are few alternatives."