Antibiotic resistance.

[thepool]

This is a serious issue which is causing concern around the world.

As is well known some countries permit the free sale of antibiotics and many people self medicate often on the advice of a "pharmacist", friends or because of something that has been read on an internet forum.

These powerful drugs are rapidly losing effectiveness because of misuse. Self medication with antibiotics is inappropriate and in countries like Thailand if a Doctor suggests an antibiotic is taken then the Doctor should be challenged (politely) as to the need.

May I urge that the two links ( below) are opened and read.

One relates to a document from Public Health England taddressed to every hospital in England and the other is the American CDC's publcation which addresses this serious issue.

http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317140862615

http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf

[h90]

I always do self medicate them...what is wrong with it?

And surely less often as the doctors would. In Thailand they just use Antibiotics all the time no matter if needed.....Go to the doc get antibiotics.

That doesn't even address the legal and illegal use in meat production.

(hint....beside the health in some cases less food for the same weight gain is necessary).

[Mudcrab]

I always do self medicate them...what is wrong with it?

And surely less often as the doctors would. In Thailand they just use Antibiotics all the time no matter if needed.....Go to the doc get antibiotics.

That doesn't even address the legal and illegal use in meat production.

(hint....beside the health in some cases less food for the same weight gain is necessary).

The problem can be (and is) that people take the antibiotics until the symptoms disappear.

However the bacteria may not have been totally eradicated and some may develop an immunity to the particular drug.

A doctor usually prescribes a course of medicine that often continues after the symptoms have disappeared but continue to work on any remaining bugs.

Many prescribed medicines will have words similar to "take one or two tablets two times a day until finished" for that very reason.

Of course there is also the claimed issue of antibiotics being fed to animals in the production/growth process that find their way into the human, and allegedly have the same effect. That is the bacteria become resistant to whatever antibiotic the animals have been fed.

[Dap]

I always do self medicate them...what is wrong with it?

And surely less often as the doctors would. In Thailand they just use Antibiotics all the time no matter if needed.....Go to the doc get antibiotics.

That doesn't even address the legal and illegal use in meat production.

(hint....beside the health in some cases less food for the same weight gain is necessary).

Nothing wrong with it if you are properly trained to know precisely how many days

and at what (med) strength the particular antibiotic requires for what particular ailment ...

and you complete the regimen. Then, no problem at all

[Dap]

Well placed tp. Every adult needs to have an understanding of this

incredible abuse and it's very serious consequences.

Thank You for your post.

[arjunadawn]

A very timely and useful post. I know medicine and while less developed parts of the world contribute to the problem of AB resistance they are hardly the sole cause; thus, restricting AB access would likely increase mortality without substantial impact. Restricting access might be a temporary fix knee jerk reaction from western interests, but it would only increase costs and suffering in less developed parts of the world, with the trajectory of resistance lessening slightly, but still increasing. Making doctors further gatekeepers of basic human tools for survival is foolish and shortsighted. The mechanism is not in place throughout the world to enable this.

The war against the changing membrane structure of various bacteria (membranes and their synthesis means are the primary means to limit or kill bacteria- stasis or lysis) has been fought all along since Lister and others. Bacteria have an evolutionary ability to adapt protective measures even when seemingly separated by oceans- truly amazing. AB use in places like the US contribute far more than places where holistic healing tools are still used, regardless of the widespread accessibility of AB. In the US, for example, doctors are frequently pressured by patients to prescribe, when its not know if bacteria or virus (AB have zero efficacy against virus). The pressures from patients, the associated followup payments from insurance being potentially less than first visits, and other factors have doctors "Shotgun" medicine- "go ugly early."

If the clinical findings are equivocal for bacteria or virus it is often felt to lessen patient complaints and discomfort and just Rx AB; after all, what harm?" I do not find the 3rd world is the biggest contributor of resistant strains and in fact most are coming out of nosocomial environments- hospitals.

Couple these observations with poor incentives on the part of government to R&D antibiotics and there are relatively few Pharma companies doing any significant R&D. In fact, there have been few breakthrough ideas lately; most are further generation developments of existing classes- and classes detail the mechanism by which certain families of AB inhibit or destroy cell wall synthesis. Without constant R&D it was always a losing battle.

In west a culture determines sensitivity to bacteria, or not. Doctors, however, will also Rx at same time as test, if they even order test, and then call patient and say stop taking Rx, its a virus, or allow the continued 7-10 day standard AB regimen to continue because "it could do no harm."

An additional thought for those interested, and perhaps can influence some public debate back home: We sterilize everything we send up into space, and isolate everything that returns- why? Because we don't want to contaminate space, and also our real understanding that Bacteria, known or unknown organisms, viruses and others pose an unacceptable risk to human life. Organisms for which the collective immune system has no previous exposure (See B Cell), or little, or recent, would rage like wild fire throughout our species (See MesoAmerica and Small Pox).

Thus scientists recent de thawing of ancient giant viruses should pose a terrifying threat to all mankind. Viruses are alive--- but not! Dead! but not. They exist as inert chemical matter without DNA, waiting to inject and infect and cause to reproduce itself in a vulnerable host. Resurrecting viruses that have been off the Immune world for eons is literally insane and Frankenstien-ish. Thank you for allowing my thoughts.

Edited March 7, 2014 by arjunadawn

[h90]

I always do self medicate them...what is wrong with it?

And surely less often as the doctors would. In Thailand they just use Antibiotics all the time no matter if needed.....Go to the doc get antibiotics.

That doesn't even address the legal and illegal use in meat production.

(hint....beside the health in some cases less food for the same weight gain is necessary).

The problem can be (and is) that people take the antibiotics until the symptoms disappear.

However the bacteria may not have been totally eradicated and some may develop an immunity to the particular drug.

A doctor usually prescribes a course of medicine that often continues after the symptoms have disappeared but continue to work on any remaining bugs.

Many prescribed medicines will have words similar to "take one or two tablets two times a day until finished" for that very reason.

Of course there is also the claimed issue of antibiotics being fed to animals in the production/growth process that find their way into the human, and allegedly have the same effect. That is the bacteria become resistant to whatever antibiotic the animals have been fed.

Yes, aeh, sorry I thought everyone knows of this, but of course you are right, it isn't common known.....

I don't want to say that it is a minor issue, but I have seen on my staff, eating antibiotics every second day....(getting better, stop, getting worse stop, and at all it might not been bacteria at all). Or one of our freelancer he ate strong antibiotics for 1 year, 2 weeks, 1 week off, 2 weeks again, just when he had money he ate them....(infection in the frontal sinus).

My wife had the habit to eat these sour throat antibiotics without being sick...just because they taste good.

And sure there are even worse stories....

(I recall the ranting from a dairy manager, that 20-30 % of the cows in Europe have infection in the udder so they put in antibiotics, and try to mix the milk together with the other.....than the dairys Yoghurt dies....seems to happen frequently).

So the misuse might be way worse than we believe......Usage with pigs and beef is another topic...

[ArfurMaggot]

Fight fire with fire. If you are worried about resistance in bacteria, stop taking any drugs. Just say, "No"!

[technologybytes]

I don't know anything about resistance, but I do know that Antibiotics should be avoided unless absolutely necessary.

Antibiotics kill bacteria, but they are not fussy enough to know good from bad bacteria. We all have good bacteria in our bodies doing some important things, overuse of Antibiotics cause problems in this respect.

Also, strange side effects can be felt when using Antibiotics. I had a bad tooth and the dentist prescribed a long course of amoxycillen prior to root canal treatment, I thought I had no reaction to antibiotics but later I started to get really scary anxiety attacks, something I had never had before or since.. it was really scary and now I'd be very reluctant to use the same medicine again unless there really was no choice.

[Suradit69]

I always do self medicate them...what is wrong with it?

And surely less often as the doctors would. In Thailand they just use Antibiotics all the time no matter if needed.....Go to the doc get antibiotics.

That doesn't even address the legal and illegal use in meat production.

(hint....beside the health in some cases less food for the same weight gain is necessary).

"In Thailand they just use Antibiotics all the time no matter if needed. ..."

As as been documented many times before, this is a world-wide problem, not a Thai problem. As I (and others) pointed out in one of many similar threads (post #6) : http://www.thaivisa.com/forum/topic/704083-antibiotics-and-doctors-in-thailand-vs-usa/?hl=%20antibiotic

Even on Thai Visa, and other "news" sources, this topic has been done to death with little effect.

Doctors everywhere are handing out antibiotics for cold symptoms that are most likely caused by viruses that are unaffected by antibiotics, for sore throats and everything else. People go to the hospital or to a doctor and want to go away either meds or having been given an injection and doctors just want to get patients in and out as fast as possible.

Pharmaceutical companies pump doctors to dispense their drugs and give them "tea money" especially in the US and Europe, and as someone pointed out above they are widely (mis)used in livestock.

​And a similar problem has developed with the overuse of anti-malarial drugs taken as prophylactics, which often robs people of natural immunity as well as reducing the effectiveness of the drugs in treatment.

The major drug pushers are the western pharmaceutical companies.

Edited March 7, 2014 by Suradit69

[attrayant]

I was baited by the Thaivisa newsletter to get here because the link says "Is there a real danger of a resistance to antibiotics?" I'm relieved to see that's not how the OP is titled. I guess whoever puts the newsletter together thinks the issue is debatable.

I have a relative who pops a single pill whenever it looks like it's going to rain because, he says, "I always get sick when it rains". Just ONE pill! He's probably a walking MRSA incubator.

[nithisa78]

Well placed tp. Every adult needs to have an understanding of this

incredible abuse and it's very serious consequences.

Thank You for your post.

Thank you. There are potential of very serious consequences.

[mrfaroukh]

yes it is very dangerous if you have allergy to it. Once I almost died not due to allergy but just because before getting the injection I did not had breakfast. I was lucky they had anti allergy medicine there or else.......................

[thailandbeachisland]

First thing to do: stop eating meat full of antibiotics...

[hawker9000]

I can see the personal dangers and global impact of the antibiotics present in the meat we cultivate & eat. And I can appreciate the harm that antibiotics can do to the human body's flora (e.g., in the gut), and by virtue of their possible side-effects, like tb mentioned. And I can understand the danger in just popping ABs not part of any real course of treatment. But if out of ignorance or an abundance or caution I complete a full normal AB treatment unnecessarily (i.e., the actual pathogen was not present), how does that have any impact on global resistance? How does my having taken that antibiotic - for a full 7-10d course - myself without the bug being present increase that or any other actual bug's resistance to that antibiotic somewhere else?

[Dap]

I can see the personal dangers and global impact of the antibiotics present in the meat we cultivate & eat. And I can appreciate the harm that antibiotics can do to the human body's flora (e.g., in the gut), and by virtue of their possible side-effects, like tb mentioned. And I can understand the danger in just popping ABs not part of any real course of treatment. But if out of ignorance or an abundance or caution I complete a full normal AB treatment unnecessarily (i.e., the actual pathogen was not present), how does that have any impact on global resistance? How does my having taken that antibiotic - for a full 7-10d course - myself without the bug being present increase that or any other actual bug's resistance to that antibiotic somewhere else?

"myself without the bug being present increase that or any other actual bug's resistance to that antibiotic somewhere else?"

It doesn't.

[thepool]

I today received a PM the content of which appears, on face value, to be alarming .

It is alleged that

A young person died in hospital as the result of a hospital acquired infection and it is further alleged that------

"This strain is causing carnage in many Hospitals in the Bangkok and Eastern seaboard area"

It gets worse !

This hospital (I was not given the details) was said to not have the required antibiotics for treating this infection because the Thai FDA refuse to authorise these antibiotics for use in Thailand.

Maybe others know about this "carnage" and the unavailability of appropriate antibiotics ?

[Sheryl]

Please do not spread rumors.

A very comprehensive range of antibiotics is available in Thailand.

[thepool]

<script type='text/javascript'>window.mod_pagespeed_start = Number(new Date());</script>

Please do not spread rumors.

A very comprehensive range of antibiotics is available in Thailand.

I am very well aware of the fact !

I personally have no wish to "spread rumor"

I was merely (without divulging the identity of the individual who sent me a PM) reporting faithfully what was alleged.

I personally doubt what was said but the claim, if true, was of concern.

edit

As a moderator I suspect you may have access to PM,s, if so you are welcome to enter my box and read the information yourself.

Edited March 8, 2014 by thepool

[attrayant]

I was merely [...] reporting faithfully what was alleged.

That's pretty much the definition of spreading rumors.

Before hitting that 'forward' button on that apocryphal story you received, I recommend doing a little research to see if there might be any truth to it. If the story exists nowhere else aside from your inbox, that's probably where it should stay.

[thepool]

<script type='text/javascript'>window.mod_pagespeed_start = Number(new Date());</script>

I was merely [...] reporting faithfully what was alleged.

That's pretty much the definition of spreading rumors.

Before hitting that 'forward' button on that apocryphal story you received, I recommend doing a little research to see if there might be any truth to it. If the story exists nowhere else aside from your inbox, that's probably where it should stay.

On reflection you most likely are right

[attrayant]

This is a great article about the post-antibiotic world:

Imagining the Post-Antibiotics Future

After 85 years, antibiotics are growing impotent. So what will medicine, agriculture and everyday life look like if we lose these drugs entirely?

Here's a hint: scary.

Edited March 8, 2014 by attrayant

[thepool]

<script type='text/javascript'>window.mod_pagespeed_start = Number(new Date());</script>

This is a great article about the post-antibiotic world:

Imagining the Post-Antibiotics Future

After 85 years, antibiotics are growing impotent. So what will medicine, agriculture and everyday life look like if we lose these drugs entirely?

Here's a hint: scary.

Thanks. A dramatic and "tabloid type" presentation .

However the essential facts are there !

[hawker9000]

When the situation becomes dire enough, and the demand great enough, (and government regulation/bureaucracy is forced by a sadder but wiser public outcry to retreat enough) the pharmaceutical industry will once again have the incentive necessary to fire up its R&D capability. Make no mistake; it'll take time; there'll be a lag; lots of people will probably die. But eventually, I believe, the pendulum can swing back.

[JimHuaHin]

In a word, 'yes', there is an over use of antibiotics.

The more sinister dimension of this issue is the over use of antiobiotics in feed animals, especially chicken and cattle. These antiobiotics generally stay in the meat of animals, and subsequently consumed by humans, and thereby lowering the effectiveness of any antiobiotics consumer by humans.

On a personal note, I suffer from frequent sinus infections, and over recent years I have had to take stronger antiobiotics to get rid of the infection, all because of I developed a tolerance to the general first line antiobiotics used to treat the infections.

The lessons - avoid any meats that come from animals that have been force fed antiobiotics and use antiobiotics only when necessary.

All too frequently, some doctors proscribe antiobiotics for conditions for which antibiotics are virtually useless, but which raise the individual's tolerance of antiobitics.

[hawker9000]

How does a person develop a "resistance" to antibiotics? The antibiotic kills - or is intended to - some specific bacterial pathogen. It's the bacteria that's either susceptible or resistant to the antibiotic, no? So when you say you've had to change your antibiotic, doesn't that mean you've actually managed to acquire a different, more resistant strain of the disease?

If farmers were to maintain a separate feed supply for use within, say, 2 weeks of slaughter, would that eliminate the problem of antibiotics in the meat we eat, giving the livestock a chance to metabolize anything in their system?

[wilcopops]

Antibiotics don't work on YOU, they attack the bacteria causing the problems. If you have a "resistant" strain then you have a problem. Massive use of antibiotics gives bacteria a chance to "naturally" evolve and become resistant....so the cause is overuse, the solution is not that simple but certainly is you over-rely on antibiotics, then you are contributing to the likelihood of further resistant strains occurring.

[thepool]

<script type='text/javascript'>window.mod_pagespeed_start = Number(new Date());</script>

In a word, 'yes', there is an over use of antibiotics.

The more sinister dimension of this issue is the over use of antiobiotics in feed animals, especially chicken and cattle. These antiobiotics generally stay in the meat of animals, and subsequently consumed by humans, and thereby lowering the effectiveness of any antiobiotics consumer by humans.

On a personal note, I suffer from frequent sinus infections, and over recent years I have had to take stronger antiobiotics to get rid of the infection, all because of I developed a tolerance to the general first line antiobiotics used to treat the infections.

The lessons - avoid any meats that come from animals that have been force fed antiobiotics and use antiobiotics only when necessary.

All too frequently, some doctors proscribe antiobiotics for conditions for which antibiotics are virtually useless, but which raise the individual's tolerance of antiobitics.

Just as a matter of fact there is no such thing as " strong" antibiotics there are only appropriate antibiotics.

Sinus "infections" are rarely helped by taking oral antibiotics.

http://www.nhs.uk/Conditions/Sinusitis/Pages/Introduction.aspx

Persistent "sinus" problems are best helped by good ENT advise

[hawker9000]

Antibiotics don't work on YOU, they attack the bacteria causing the problems. If you have a "resistant" strain then you have a problem. Massive use of antibiotics gives bacteria a chance to "naturally" evolve and become resistant....so the cause is overuse, the solution is not that simple but certainly is you over-rely on antibiotics, then you are contributing to the likelihood of further resistant strains occurring.

So back to my original question then. How does one individual's overuse of antibiotics contribute to that individual's acquiring one of these antibiotic-resistant infections later on (except for merely being a member of the human species collectively helping to bring about the evolution of these new AB-resistant bacterial strains)?

So, we can phrase the question this way: Is personal overuse of antibiotics unhealthy and likely to lead to more serious problems down the road for that individual, OR is it instead a "social sin"? If I'm a selfish bastard, and don't care about the rest of the human race, am I harming myself by taking antibiotics without knowing for sure what I have or that they'll do me any good (e.g., 'have the flu)?

[wilcopops]

Antibiotics don't work on YOU, they attack the bacteria causing the problems. If you have a "resistant" strain then you have a problem. Massive use of antibiotics gives bacteria a chance to "naturally" evolve and become resistant....so the cause is overuse, the solution is not that simple but certainly is you over-rely on antibiotics, then you are contributing to the likelihood of further resistant strains occurring.

So back to my original question then. How does one individual's overuse of antibiotics contribute to that individual's acquiring one of these antibiotic-resistant infections later on (except for merely being a member of the human species collectively helping to bring about the evolution of these new AB-resistant bacterial strains)?

So, we can phrase the question this way: Is personal overuse of antibiotics unhealthy and likely to lead to more serious problems down the road for that individual, OR is it instead a "social sin"? If I'm a selfish bastard, and don't care about the rest of the human race, am I harming myself by taking antibiotics without knowing for sure what I have or that they'll do me any good (e.g., 'have the flu)?

So long as you don't have a family. As someone who harbours restart bacteria you can carry them around for others to "enjoy"

there are more cells of bacteria etc on your body than actually those that comprise your body......if you persist in using in appropriate antibiotics (e.g. broad spectrum antibiotics) again and again you can become colonised with resistant bacteria.

they can then cause problems for you and all those nearby.

Edited March 14, 2014 by wilcopops