Sunday, October 27, 2013


ATLANTA, Oct. 27, 2013 (UPI) -- The world is running out of antibiotics to treat formerly treatable infections, due to overuse, a U.S. expert says.
Dr. Arjun Srinivasan, associate director at the U.S. Centers for Disease Control and Prevention, said in an interview with "Frontline" on PBS : "The more you use an antibiotic, the more you expose a bacteria to an antibiotic, the greater the likelihood that resistance to that antibiotic is going to develop," Srinivasan said. "So the more antibiotics we put into people, we put into the environment, we put into livestock, the more opportunities we create for these bacteria to become resistant.
For a long time, there have been newspaper stories and magazine articles that asked 'The end of antibiotics?'" he said. "Well, now I would say you can change the title to 'The end of antibiotics, period.'"

The world is entering an antibiotic crisis in which routine injuries such as a skinned knee could potentially be fatal, according to the World Health Organization (WHO.) Dr. Margaret Chan, director general of the WHO, has warned that bacteria carried by humans are starting to become so resistant to common antibiotics that every antibiotic ever developed, including drugs used to treat tuberculosis and malaria, is at risk of becoming useless.
As a result, Chan claimed, day-to-day treatments may become impossible, which could bring about “the end of modern medicine as we know it.”     
March 16, 2012

Continuing with Chan's statements on this, CBS reported:
Speaking at a conference in Copenhagen, Chan said antibiotic resistance could bring about “the end of modern medicine as we know it.”
 “We are losing our first-line antimicrobials,” she said Wednesday in her keynote address at the conference on combating antimicrobial resistance. “Replacement treatments are more costly, more toxic, need much longer durations of treatment, and may require treatment in intensive care units.” 
Chan said hospitals have become “hotbeds for highly-resistant pathogens” like methicillin-resistant Staphylococcus aureus, “increasing the risk that hospitalization kills instead of cures.”
Indeed, diseases that were once curable, such as tuberculosis, are becoming harder and more expensive to treat.
Chan said treatment of  multi-drug resistant tuberculosis was “extremely complicated, typically requiring two years of medication with toxic and expensive medicines, some of which are in constant short supply. Even with the best of care, only slightly more than 50 percent of these patients will be cured.” 
Antibiotic-resistant strains of salmonella, E. coli, and gonorrhea have also been discovered.
This will be a post-antibiotic era. In terms of new replacement antibiotics, the pipeline is virtually dry,” said Chan. “A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.”
The dearth of effective antibiotics could also make surgical procedures and certain cancer treatments risky or even impossible, Chan said.  
The development of new antibiotics now could help stave off catastrophe later. But few drug makers are willing to invest in drugs designed for short term use.
“It’s simply not profitable for them,” said Dr. William Schaffner, chairman of preventive medicine at Vanderbilt University Medical Center in Nashville. “If you create a new drug to reduce cholesterol, people will be taking that drug every day for the rest of their lives. But you only take antibiotics for a week or maybe 10 days.”

Antibiotic resistance: delaying the inevitable

The golden age of antibiotics proved to be a short-lived one. During the past few decades, many strains of bacteria have evolved resistance to antibiotics.
Doctors miss the "good old days," when the antibiotics they prescribed consistently cured their patients.

Are you ready for a world without antibiotics?
Antibiotics are a bedrock of modern medicine. But in the very near future, we're going to have to learn to live without them once again. And it's going to get nasty.  
The era of antibiotics is coming to a close. In just a couple of generations, what once appeared to be miracle medicines have been beaten into ineffectiveness by the bacteria they were designed to knock out. Once, scientists hailed the end of infectious diseases. Now, the post-antibiotic apocalypse is within sight.
Hyperbole? Unfortunately not. The highly serious journal Lancet Infectious Diseases yesterday posed the question itself over a paper revealing the rapid spread of multi-drug-resistant bacteria. "Is this the end of antibiotics?" it asked.

Doctors and scientists have not been complacent, but the paper by Professor Tim Walsh and colleagues takes the anxiety to a new level. Last September, Walsh published details of a gene he had discovered, called NDM 1, which passes easily between types of bacteria called enterobacteriaceae such as E. coli and Klebsiella pneumoniae and makes them resistant to almost all of the powerful, last-line group of antibiotics called carbapenems. Yesterday's paper revealed that NDM 1 is widespread in India and has arrived here as a result of global travel and medical tourism for, among other things, transplants, pregnancy care and cosmetic surgery.
"In many ways, this is it," Walsh tells me. "This is potentially the end. There are no antibiotics in the pipeline that have activity against NDM 1-producing enterobacteriaceae. We have a bleak window of maybe 10 years, where we are going to have to use the antibiotics we have very wisely, but also grapple with the reality that we have nothing to treat these infections with."
And this is the optimistic view – based on the assumption that drug companies can and will get moving on discovering new antibiotics to throw at the bacterial enemy. Since the 1990s, when pharma found itself twisting and turning down blind alleys, it has not shown a great deal of enthusiasm for difficult antibiotic research. And besides, because, unlike with heart medicines, people take the drugs for a week rather than life, and because resistance means the drugs become useless after a while, there is just not much money in it.

Studies have shown, he says, that the chances of dying from hospital pneumonia or septicaemia (blood poisoning) are twice as high if the bacteria are drug-resistant, rising in the case of pneumonia from 20-30% to 40-60%.
"Frankly, pharmaceutical companies as well as governments and the European Commission need to really get their act together," says Walsh, who has been urging co-ordinated efforts across the world to put in place good surveillance systems to find out what resistance is developing and where, and then look for interventions. He had Columbia, Mexico, Thailand and India all willingly on board for one surveillance scheme, but the European Commission would not fund it. "What we need is for somebody to give us something like €3m [£2.5m] a year. It's not a lot of money."
The fact is that many people have still got their heads in the sand. But soon we will start seeing patients in NHS hospitals whose infections won't clear up. In the battle for survival of the fittest between human beings and bacteria, just now it looks as though the best we are going to get is a draw – if we are lucky.




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