Why So Down On Antibiotics?

[moldy]

It's not unusual to come across the question "How do I cure this without taking antibiotics ?", and hear general warnings concerning this or that general antibiotic once one is recommended.

I don't understand this: earlier in my life I took 2 even 3 month courses for acne, and have frequently used them for many minor ailments without resistance or side effects.

Sure I understand other people may have different experiences, but we are talking fractions of a per cent, life can't be lived as if exceptions are the rule or we'd do nothing (with all respects to those who have had bad experiences). And a good doctor would counsel before hand anyway; hopefully.

I think my life would be much worse than without them, viral conditions frequently turn bacterial ,and infections tend not to just go away in the tropics too. So maybe that doctor is not so crazy or lazy when he dishes out the obligatory bag of amoxy candy.

Anybody agree?

[sweetchariot]

It's all about resistance. We (as in the population of the world), have been taking these antibiotics for so many years that the bacteria sussed on to it. Then they came up with MRSA and a few others that are immune to anything we can chuck at them.

You have an infection - OK have some pills. You have a cold - bugger off and drink some hot lemon.

We've given away too many of our secrets to these nasty little little bugs, who by the way have lived here for several million years more than we have.

[Maestro]

The way I understand it, a bacterium develops resistance to an antibiotic substance when the blood level of the antibiotic is insufficient to kill the bacterium. This can happen when the dose of antibiotic is too low, when the antibiotic is taken at intervals that are too long, or when the antibiotic is taken for too short a time.

The OP did not cite any references for being "down on antibiotics". A danger exists, for example, when animals whose meat is intended for our food are treated with antibiotics shortly before being slaughtered. Eating that meat we will then take a low dose of the antibiotic that was given to the animal and if we happen to have an infection at this time the bacteria in our body will develop resistance to this particular antibiotic. If these bacteria are part of a contagious disease, we can then pass them on to other people and they will not respond to treatment with that particular antibiotic. If this happens often enough, the antibiotic becomes widely ineffective for for treatment of these bacteria in humans and newer antibiotics have to be researched and developed. Soon, these will again be added to animal feeds and the entire cycle continues.

It is basically the exposure of bacteria to insufficient blood levels of antibiotics that leads to incurable or difficult-to-cure diseases like MRSA (methicillin-resistant staphylococcus aureus), c.diff (clostridium difficile), etc. It is not necessarily because of antibiotics in meat, that was just an example. It can also be, and often is, because patients fail to take antibiotics as prescribed, and sometimes because of poor hygiene in hospitals or elsewhere.

--

Maestro

Edited May 19, 2008 by Maestro

[sweetchariot]

I am not sure if I'm allowed to call a mod in this manner, but what has just been described above is one if the worst urban myths I have ever heard.

Millions of tests have proved conclusively that antibiotics cannot travel from live animal - cooked meat - human. It is scientifically impossible.

As for your low blood dose theory, that carries a little weight. Most guys working in this field will tell you how amazed they are at the mutations - almost daily. They are very clever buggers, and although we take them for granted, and often see them as a nuisance, there would be no life on earth without bacterium.

Millions of years of survival has to tell you something.

[Ijustwannateach]

On a personal note, more to the point of the OP, I had an antibiotic-resistant strain of some kind of throat bug (which seems to be going around here, so be careful) which resulted in my needing a tonsillectomy, so I'm pretty sure that over-use of antibiotics (and their non-prescription availability) is pretty serious. They've been pretty complacent about it- either that or at their wit's end- but either way very few *new* antibiotics have been developed in recent years/decades.

There have also been a few of our members online here who have personally been victims of antibiotic-resistant tuberculosis, which is something I'd really rather not have, but which is according to official sources at epidemic levels in the region.

Regarding antibiotics used by farms and the food industry: it may not be a simple matter of the antibiotic itself transferring, SC, but of the resistance- check out the following paper, which details the transfer of *genes* from the meat of animals who had developed the resistance from farm antibiotics:

Multiple Antibiotic Resistance Gene Transfer from Animal to Human Enterococci in the Digestive Tract of Gnotobiotic Mice

Or this paper which shows some evidence that antibiotic runoff in farm use could give resistance to bacteria in the soil, which could then transfer to the bacteria on produce and thence to humans:

Antimicrobial Resistance of Enterococcus Species Isolated from Produce

So it appears there is some scientific basis to be worried about the widespread use of antibiotics indiscriminately on farms, though the mechanism through which it offers resistance to bacteria in humans is a bit more complicated and indirect than one might think.

...and, incidentally, you're allowed to disagree and engage with mods on the substance of any topic which does not itself violate the rules; though I would avoid namecalling...

[PeaceBlondie]

Twice in the past twelve years, I became the victim of nasty bacterial infections, none of it related to sexual practices. An infection in my digestive tract gave me full-scale diarrhea for weeks. An infection in a wound nearly cost me my upper arm. In both cases, I consulted the best doctors (Texas and Thailand) who were baffled. The digestive bacteria disappeared when the emergency room doctor happened to prescribe a more effective antibiotic. The arm infection was only cured by invasive surgery, removing encapsulated globs of goop by hand. Even a desperate email to a friend who has a Ph.D. in bacteriology was useless.

Apparently there are hundreds or thousands of types of bacteria, and only a few tests for specific bacteria. I recall the story of a dentist in Texas who died from a flesh-eating bacteria he picked up from a rusty nail on a fishing trip.

I am no expert, but experience shows me that even experts in infectious diseases are not as smart as the bacteria.

[geriatrickid]

Maestro, well said.

Peace Blondie has a gem too;

I am no expert, but experience shows me that even experts in infectious diseases are not as smart as the bacteria.

Just goes to show that the old folks can teach the young'uns a thing or two.

(Old as in being on the evolutionary scale. Bacteria have been around since the beginning of earth and we humans are mere babes. Apologies to the creationists )

[moldy]

Maestro, well said.

Peace Blondie has a gem too;

I am no expert, but experience shows me that even experts in infectious diseases are not as smart as the bacteria.

Just goes to show that the old folks can teach the young'uns a thing or two.

(Old as in being on the evolutionary scale. Bacteria have been around since the beginning of earth and we humans are mere babes. Apologies to the creationists )

Sure, read all the postings from all the usual heavyweight posters, great reading too. An education.

Despite the problems should we diss antibiotics though?

And those that avoid using them- are they being smart?

I'd rather be cured!!

[Ijustwannateach]

If you're sure that what you have is susceptible to treatment by antibiotics, not just an "insurance measure" or a random "Monte Carlo" method of attacking an unknown ailment (both common approaches by doctors here), why, then, go right ahead. Otherise it's a "tragedy of the commons." You can gain some limited (but perhaps even no) benefit now by abusing a vast public resource in a way that makes it unavailable to others in the future.

[moldy]

If you're sure that what you have is susceptible to treatment by antibiotics, not just an "insurance measure" or a random "Monte Carlo" method of attacking an unknown ailment (both common approaches by doctors here), why, then, go right ahead. Otherise it's a "tragedy of the commons." You can gain some limited (but perhaps even no) benefit now by abusing a vast public resource in a way that makes it unavailable to others in the future.

It's assumed of course that one would take an approp. drug, and under medical supervision for a definite ailment, although in my view prophylixic (sorry sure bad word or wrong sp.) is also valid, eg, if someone is particularly prone to bronchitis and has suffered a heavy cold which has resulted in a determined cough, then surely a course of antibiotics is valid. Obviously my opinion only and without actual med. qualification. But arguably a matter of strategy and planning really.

Isn't it non compliance, weak and overly short prescription that lead to problems ?. In which case the drugs are surely not the problem at all.

Arguments against are can be based merely on fashion and politics. Apologies again I'm rather busy and can't go off and get the link, but I believe a recent study reported antibiotics being ineffective for sinusitis. A little digging showed the poor quality of the report, in fact they hadn't even established bacterial infection and had onlu used one type of antibiotic anyway. At best the assumption should have been amoxycillin largely ineffective against supposed bacterial infection.

We need to guard against getting caught up in militance and hype.

[Crushdepth]

Despite the problems should we diss antibiotics though?

And those that avoid using them- are they being smart?

I'd rather be cured!!

No we shouldn't diss antibiotics. However, we *should* diss doctors that hand them out like lollies. Most antibiotics have specific action and randomly dishing them out is often innapropriate (eg for a simple cold, which is a viral illness not treatable by antibiotics). But hey, TIT and doctors make more money out of medicine sales than they do from consultations.

[moldy]

The way I understand it, a bacterium develops resistance to an antibiotic substance when the blood level of the antibiotic is insufficient to kill the bacterium. This can happen when the dose of antibiotic is too low, when the antibiotic is taken at intervals that are too long, or when the antibiotic is taken for too short a time.

The OP did not cite any references for being "down on antibiotics". A danger exists, for example, when animals whose meat is intended for our food are treated with antibiotics shortly before being slaughtered. Eating that meat we will then take a low dose of the antibiotic that was given to the animal and if we happen to have an infection at this time the bacteria in our body will develop resistance to this particular antibiotic. If these bacteria are part of a contagious disease, we can then pass them on to other people and they will not respond to treatment with that particular antibiotic. If this happens often enough, the antibiotic becomes widely ineffective for for treatment of these bacteria in humans and newer antibiotics have to be researched and developed. Soon, these will again be added to animal feeds and the entire cycle continues.

It is basically the exposure of bacteria to insufficient blood levels of antibiotics that leads to incurable or difficult-to-cure diseases like MRSA (methicillin-resistant staphylococcus aureus), c.diff (clostridium difficile), etc. It is not necessarily because of antibiotics in meat, that was just an example. It can also be, and often is, because patients fail to take antibiotics as prescribed, and sometimes because of poor hygiene in hospitals or elsewhere.

--

Maestro

I didn't cite a reference for being down on antibiotics . It's an opening line in a discussion.