Superbugs - A Reality Check

[Calliope]

How close are we to a nightmarish return to pre-antibiotic era?

I know it is a subject most people don't want to think about, but after watching the excellent Jenny Brockie on Insight tonight, I realised that this is something that in time could adversely affect us all.

One of the worst aspects is that while millions are spent on trying to heal people with drug resistant illnesses, not much is spent on research into new antibiotics.

I would recommend that that you take the time to watch a repeat of this episode. It is pretty scary.

http://news.sbs.com.au/insight/episode/index/id/386/Superbugs#livechat

http://www.abc.net.au/science/slab/antibiotics/superbugs.htm

 

[Julia]

One of the worst aspects is that while millions are spent on trying to heal people with drug resistant illnesses, not much is spent on research into new antibiotics.

For new drugs to be developed, if it's going to happen in the private arena it has to be profitable for drug companies. They are not charities.
As long as governments fail to provide sufficient research dollars to scientists to work on this very real problem, we will be at continuing and escalated risk of everything suggested in the currently expressed concerns about the potential of reverting to the pre-antibiotic era.

Meanwhile, thousands of people who get a virus this winter and start sniffling, will demand antibiotics from their GP's, failing to understand that antibiotics have no effect on viruses. Overworked, fed up GP's will supply the prescriptions because it's the easy way to get the patient out of the room. And so the problem is perpetuated.

 

[moXJO]

My father got MRSA a year and a half ago in his leg. Was a nightmare to deal with. The antibiotics just would not work and ended up trying every remedy we could find. Took months to fight. Looks to be gone for now thank God

 

[Julia]

My father got MRSA a year and a half ago in his leg. Was a nightmare to deal with. The antibiotics just would not work and ended up trying every remedy we could find. Took months to fight. Looks to be gone for now thank God

I'm so glad to hear that, moXJO. My late mother had a foot infection, ulcer between the toes, which just would not clear up and became gangrenous, spreading up the leg. Her choice was amputation of the lower leg or allow the infection to become systemic causing death. She chose the latter.
A choice we would all hope never to have to make.

 

[Calliope]

The Suoerbug program can now be watched on;

http://news.sbs.com.au/insight/episode/index/id/386/Superbugs#watchonline

Those who have been posting to trivial health threads on this forum may get a reality check.

To put it in Sdajii's words;

Gee there's some crap posted online!

 

[derty]

Yeah this is really scary stuff. it is one of the elephants in the room. There is some headway being made with nanotech solutions at the moment though these will still be quite a way off implementation.

There are some really nasty bugs coming out of India at the moment due to the factories that produce the generic versions dumping all their wast into the rivers. As a result you have the latest effective antibiotics being thrown out there to fast track the resistance cycle.

 

[pointr]

A few thoughts: 1) drug companies dont want to invest in a drug that a patient might take once every couple of years, as compared to a statin or antidepressant they may take every day for the rest of their life. So there needs to be some incentive provided.
2) Dr's may be slightly to blame, but non compliant ignorant patients share the blame, eg Been on antibiotics for a few days, the majority of the infection beaten, feel better stop taking tablets, only bacteria left to breed are the ones likely to be resistant.
3) While these are superbugs in the term of super destructive to patients , they are not super in biological terms, ie it can be a genetic deficiency that gives them the resisitance
eg the inability to transport certain material through their cell wall, if the material is an antibiotic these bugs with a genetic problem are resistant to the anti biotic. They only thrive in the 'clean' hospital environment where if in the outside world of microbugs they would soon die.
A penny for my thoughts but I'm told these are inflationary times

 

[Knobby22]

A few thoughts: 1) drug companies dont want to invest in a drug that a patient might take once every couple of years, as compared to a statin or antidepressant they may take every day for the rest of their life. So there needs to be some incentive provided.
2) Dr's may be slightly to blame, but non compliant ignorant patients share the blame, eg Been on antibiotics for a few days, the majority of the infection beaten, feel better stop taking tablets, only bacteria left to breed are the ones likely to be resistant.
3) While these are superbugs in the term of super destructive to patients , they are not super in biological terms, ie it can be a genetic deficiency that gives them the resisitance
eg the inability to transport certain material through their cell wall, if the material is an antibiotic these bugs with a genetic problem are resistant to the anti biotic. They only thrive in the 'clean' hospital environment where if in the outside world of microbugs they would soon die.
A penny for my thoughts but I'm told these are inflationary times

Good comments. Drug companies are working on new alternatives but we really need a breakthrough in a completely new form of antibiotic. We only a small number of types at the moment, the rest are variants.

 

[Calliope]

Professor Matthew Cooper made the valid point in the program that it would have cost over half a million dollars to treat one of the other participants who had multi-resistant TB, and yet research programs are poorly funded.

See more on Budget spending on medical research in; http://theconversation.edu.au/artic...s-been-saved-now-we-need-to-spend-wisely-1608

Let’s look at how health research funds are currently spent. Last year, almost half of the NHMRC research budget – $700m of taxpayer money – was spent on basic science, with a further one third on clinical medicine.

A small amount, 14%, went to public/population health, and only 5% to health services research, which covers both research into service delivery and health systems research.

Yet, it is from health services and health systems research that the evidence for sensible health reforms will be produced.

 

[boofhead]

Did they mention Norway's change on antibiotic use during Insight? Norway has set to systematically reduce the use of antibiotics as MRSA has started to get to be so significant. They have found the cheaper, more general antibiotics are starting to to be more effective. They have also noticed a positive for the finances of the health system.

Agree with the above about people not taking full course of antibiotics being an issue.

How many people are given antibiotics for a viral infection? At best it is a treatment for potential secondary infection.

 

[medicowallet]

How many people are given antibiotics for a viral infection? At best it is a treatment for potential secondary infection.

Antibiotics are rarely prescribed inappropriately by a vast majority of GPs.

 

[sptrawler]

From what I have read the problem is due to the over presciption of antibiotics, causing the "bugs"to become resistant. This is exacerbated by patients not completing the full course of antbiotics as prescibed, therefore not completely killing the infection.
I did read a few years back that a synthetic antibiotic had been developed in France, however it wasn't going to be released generally but kept as a final backup if all else failed.

 

[sails]

Antibiotics are rarely prescribed inappropriately by a vast majority of GPs.

It still does happen. Couple of weeks ago I heard that 2yr old granddaughter had been given antibiotics without clear symptoms of bacterial infection. Sure enough, the antibiotics didn't touch the fevers, etc and then another antibiotic type was prescribed for a possible ear infection due to redness in the ear.

My son would have preferred the first antibiotics not to be given, however, due to an ex with anxiety issues, he wasn't game to go against doctor's orders...

So, unfortunately, it is still happening. Hopefully an isolated case, but is it possible doctors don't want to be sued for not giving it either?

 

[medicowallet]

It still does happen. Couple of weeks ago I heard that 2yr old granddaughter had been given antibiotics without clear symptoms of bacterial infection. Sure enough, the antibiotics didn't touch the fevers, etc and then another antibiotic type was prescribed for a possible ear infection due to redness in the ear.

My son would have preferred the first antibiotics not to be given, however, due to an ex with anxiety issues, he wasn't game to go against doctor's orders...

So, unfortunately, it is still happening. Hopefully an isolated case, but is it possible doctors don't want to be sued for not giving it either?

This is not evidence of poor prescribing.

Who made the statement that there was no clear bacterial infection? Your son?
Does the child have risk factors? asthmatic? previous hospitalisation?
Are there any particularly nasty pathogens in the vicinity at the moment with similar presentation?

Was your son even present in the doctor's surgery?

Are you aware of how antibiotics work or how long they would potentially take to have an effect on a fever which might be present?

Obviously the doctor might have prescribed the antibiotic without due diligence, but if you are assuming that the doctor prescribes to limit liability, you can also infer that they do a thorough clinical exam to do the same.

I am not saying that it wasn't a virus, nor could I have any real idea of what the doctor did. I am just pointing out that potentially 3rd hand information in situations like you describe often is tainted.