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Friday, 27 May 2011

Forget the data economy and look at pharmacy: antibiotics in particular. It might save your life, one day.

Antibiotics, discovered first in 1928 by Sir Alexander Fleming, were arguably among the greatest discoveries (inventions) of the 20th century and saved numerous lives during the 2nd World War and in the years thereafter.

Patients that were sentenced to death in former days, due to dangerous bacterial infections, aggressive illnesses like pneumonia or infected wounds, suddenly had a chance to survive their illnesses and live long and happily ever after.

If one group of drugs deserved the statement ‘wonder drug’, than must it have been the antibiotics. You could compare them with a sword, that could kill all bacterial enemies.

But due to exaggerated and needless usage of antibiotics this sword is getting more and more blunt. New generations of resistant bacteria are advancing: not only to the hospitals, but now also into the households of millions (and eventually billions) of people. And they will stop for almost nothing, unless very expensive, often toxic and therefore harmful antibiotics.

Where can you see the most needless usage of antibiotics?

You would expect that the most needless usage of antibiotics occurs among humans, but this isn't true. Although hospitals and inexperienced doctors in countries all over the world caused numerous cases of faulty usage or even abuse of antibiotics among patients, this is not at all the biggest problem.

The biggest problem is that antibiotics are used ubiquitously in:
  • cattle breeding of beef, poultry, turkeys and pigs
  • fish farms

It is calculated that the food industry accounts for almost 70% of all antibiotics usage.

A course overview, produced by Dr. Randy Regal of the University of Michigan in 2002 (!) reveals the following details:

Here is a list of several antibiotics that have played an extremely important role in resistance occurring through this modality.
  • Avoparcin in Europe.
  • Virginiamycin in the United States.
  • Ceftiofur, which is a third generation cephalosporin, in the United States.
  • Penicillins and tetracyclines in the United States.
  • Quinolones in the United States.
These are all antibiotics that are used in humans as well.
Here is a bit of an overview. The food industry use of antimicrobials in animals consists of about 40-50 percent of all antibiotics used in this country. Cleverly, the antibiotics are called "antimicrobial growth promoters," or AGPs. The reason why they are so desirable is that they increase growth and "feed efficiency" in animals by 2-4 percent. If you are a livestock farmer, 2-4 percent may be more than even your profit margin. To the farmer, there could be perceived negative ramifications to not using antimicrobial growth promoters.
Although this course is already quite old, it may be worth your while to have a look at it.

How topical the subject of antibiotics abuse is, is proved by news, published within the last few months:

Here are some pertinent snips of all four articles:

Bedbugs found carrying MRSA, dangerous drug-resistant bacteria
In Vancouver, scientists are analyzing the correlation between an outbreak of severe bacterial infections and a boom in bedbug infestations, according to a report initially released by The Associated Press.  The trends are thought to be related and are cause for growing concern in U.S. urban areas, where bedbug outbreaks have been on the rise. 
Hospital patients in British Columbia were afflicted by both attacks from bedbugs and infections from the dangerous MRSA bacteria (methicillin-resistant Staphylococcus aureus).  The number of coincidences led doctors to intuit a causal relationship. 
Examination of five of the Canadian bedbugs revealed that three of the parasites were carrying MRSA, and two were carrying VRE, or vancomycin-resistant Enterococcus faecium, another slightly less dangerous form of drug-resistant bacteria. 
Though a definitive correlation has yet to be established between the blood-sucking bugs and the bacterial infections, researchers are examining the possibility that bedbugs have actually been spreading the germs.  
The incidents occurred in poor neighborhoods where crowding is considered by investigators to be a contributing factor in the spread of both the infections and infestations. 
According to Dr. Marc Romney, co-author of the study released in Emerging Infectious Diseases, published by the U.S. Centers for Disease Control and Prevention, “it is not clear whether the bacteria originated with the bedbugs or the bugs picked them up from people who were already infected.”

Researchers find superbug gen in New Delhi water
A gene that can turn many types of bacteria into deadly superbugs was found in about a quarter of water samples taken from drinking supplies and puddles on the streets of New Delhi, according to a new study.
Experts say it's the latest proof that the new drug-resistance gene, known as NDM-1, named for New Delhi, is widely circulating in the environment — and could potentially spread to the rest of the world.
Bacteria armed with this gene can only be treated with a couple of highly toxic and expensive antibiotics. Since it was first identified in 2008, it has popped up in a number of countries, including the United States, Australia, Britain, Canada and Sweden.
Most of those infections were in people who had recently traveled to or had medical procedures in India, Pakistan or Bangladesh.
"This is not a problem that is looming in the future ... there are people dying today from infections that can't be treated," said David Heymann, chairman of Britain's Health Protection Agency. He was not linked to the research.

People that know me well, know that I’m the last person to promote fear-mongering. You should therefore not see this information in this light.
Deadly E. coli outbreak claims first victims
Three people in Germany have died from an outbreak of virulent enterohaemorrhagic E. coli (EHEC) bacteria, as potentially deadly diarrhoea continues to spread across the country. Many of those infected are fighting for their lives in intensive care units.
More than 350 cases or suspected cases have been registered, with several of those affected in critical condition. One patient is in a coma. EHEC can lead to kidney failure which can be fatal, as well as severe anaemia.

Two company canteens run by consultancy giant PriceWaterhouseCoopers in Frankfurt were closed on Friday after it was established that all 19 people infected with the EHEC bacteria had eaten there.

The EHEC bug occurs sporadically every year in Germany, but the current outbreak is unusual, according to public health body, the Robert Koch Institute (RKI).

Hotspots of infection include the northern state of Schleswig-Holstein, where the number of suspected cases rose between Monday and Tuesday from 90 to 200, as well as Lower Saxony, Hamburg, Hesse and Mecklenburg-Western Pomerania.

“The number of severe cases (more than 80 HUS cases) in a short time-frame is very unusual – and the age groups are atypical. Currently, adults, overwhelmingly women, are affected,” an RKI statement said.

It said that last year around 1,000 EHEC cases were reported in Germany, resulting in two deaths.
What exactly is this Ehec virus?

Four people died and over 600 were infected with a highly dangerous intestinal virus called Ehec within a week in Germany. The virus spreads quickly and scientists have no real idea where it comes from.
Ehec is part of the Ecoli bacteria group that causes bloody diarrhea in humans.
Germans have been told to stay away from raw vegetables, fruits and milk. While raw tomatoes and salads are on the list of the most likely sources the virus was actually found on cucumbers imported from Spain.
So what’s this mysterious virus?
Ehec is more dangerous than a normal gastric flu because its bacteria enter the intestines and start dissolving them.
It’s so hard to treat because the bacteria are resistant to most antibiotics. And the pills that can help, can also help the Ehec bacteria pump a kind of poison into the body (source:
Contagious disease specialists from the German Robert Koch institute have declared Ehec an epidemic.
Virologist, Alexander Kekule, from the University in Halle told the German newspaper “Tagesspiegel” that the outburst of Ehec is “odd and alarming”. Usually these kinds of infections are really rare, he says (source:
He also thinks that it can’t be ruled out that Ehec was let loose deliberately as a biological attack.

However, people should be aware that the abuse of antibiotics among humans and especially animals can possibly lead to a future where our trusted sword – the antibiotics – has become so blunt that it doesn’t work at all anymore.

Bacterial diseases and infections that are treated relatively easily nowadays can turn into mass murderers on a global scale: bacterial pneumonia, salmonellae, meningitis, infections with streptococcae, staphilococcae and wound fever. It will be like turning back the clock for 65 years. The first symptoms of this happening are omnipresent and the effects will be reinforced if legislation in countries all over the world does not do anything about antibiotic abuse. "Cause of death: an infected Spanish cucumber" might sound very ludicrous, but it could be the future if nothing happens.

I’m convinced that in the pharmaceutical world the awareness is already high, but the question is always: who will pay the vast expenses of research, which could amount billions of dollars. If pharmaceutical companies need to pay these costs themselves, they will try to guard their new found drugs with longlasting patents and monetize them, by delivering the medicine to everybody that will pay for it: for instance the cattle breeding and fish farming industry. And then would all research be in vain.

So I think in these special cases, the governments of the wealthy countries should step in and pay a large amount of these research costs, under the condition that the newfound drugs may not be patented and will only be used on humans under supervised conditions. Am I overly optimistic, here? Maybe, but I want my children to have good medicine and a healthy future too. As I said in the beginning: Antibiotics might save your life one day

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