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Drug Resistance To Antibiotics
Is Failing.
The list of drug options via
doctors is short and getting shorter.
New bacteria are pushing our
immune system's to the edge.
Every month more and more drugs
are failing to combat disease.
Drug resistance is partially our own fault for
trusting in doctors with blind faith and willingly allowing them to prescribe
countless poisonous drug cocktails, especially when we are desperate for
relief from pain. The doctors are first and foremost to blame as they have
long placed profit before honesty and knowledge, scribbling out prescriptions
as fast as we ask for them.
The article below explains what is happening today
and hopefully will prevent so many people reaching for quick fixes with
toxic medications. Our immune systems are shot. Detox and radical changes
in lifestyle and thinking must now take place if we are to remain healthy
and not succumb to the never ending strains of new bacteria that are flooding
populations worldwide.
Bacteria race ahead of drugs.
Falling behind: Deadly infections
increasingly able to beat antibiotics.
Sabin Russell - Sunday, January
20, 2008
At a busy microbiology lab in San Francisco, bad
bugs are brewing inside vials of human blood, or sprouting inside petri
dishes, all in preparation for a battery of tests.These tests will tell
doctors at UCSF Medical Center which kinds of bacteria are infecting their
patients, and which antibiotics have the best chance to knock those infections
down.With disturbing regularity, the list of available options is short,
and it is getting shorter.
Dr. Jeff Brooks has been director of the UCSF
lab for 29 years, and has watched with a mixture of fascination and dread
how bacteria once tamed by antibiotics evolve rapidly into forms that practically
no drug can treat. "These organisms are very small," he said, "but they
are still smarter than we are."
Among the most alarming of these is MRSA, or methicillin-resistant
Staphylococcus aureus, a bug that used to be confined to vulnerable hospital
patients, but now is infecting otherwise healthy people in schools, gymnasiums
and the home. As MRSA continues its natural evolution, even more drug-resistant
strains are emerging. The most aggressive of these is one called USA300.
Last week, doctors at San Francisco General Hospital
reported that a variant of that strain, resistant to six important antibiotics
normally used to treat staph, may be transmitted by sexual contact and
is spreading among gay men in San Francisco, Boston, New York and Los Angeles.
Yet the problem goes far beyond one bug and a
handful of drugs. Entire classes of mainstay antibiotics are being threatened
with obsolescence, and bugs far more dangerous than staph are evolving
in ominous ways. "We are on the verge of losing control of the situation,
particularly in the hospitals," said Dr. Chip Chambers, chief of infectious
disease at San Francisco General Hospital.
The reasons for increasing drug
resistance are well known:
-
- Overuse of antibiotics, which speeds the natural
evolution of bacteria, promoting new mutant strains resistant to those
drugs.
-
- Careless prescribing of antibiotics that aren't
effective for the malady in question, such as a viral infection.
-
- Patient demand for antibiotics when they aren't
needed.
-
- Heavy use of antibiotics in poultry and livestock
feed, which can breed resistance to similar drugs for people.
-
- Germ strains that interbreed at hospitals, where
infection controls as simple as hand-washing are lax.
All this is happening while the supply
of new
antibiotics from drug company laboratories
is running dry.
Since commercial production of penicillin began
in the 1940s, antibiotics have been the miracle drugs of modern medicine,
suppressing infectious diseases that have afflicted human beings for thousands
of years. But today, as a generation of Baby Boomers begins to enter a
phase of life marked by the ailments of aging, we are running out of miracles.
Top infectious disease doctors are saying that
lawmakers and the
public at large do not realize the grave implications
of this trend.
"Within just a few years, we could be seeing that
most of our microorganisms are resistant to most of our antibiotics," said
Dr. Jack Edwards, chief of infectious diseases at Harbor-UCLA Medical Center.
At Brooks' microbiology laboratory, the evolutionary
struggle of bacteria versus antibiotics is on display every day. He grabbed
a clear plastic dish that grew golden-hued MRSA germs taken from a patient
a few days earlier. Inside were seven paper dots, each impregnated with
a different drug. If the antibiotic worked, the dot had a clear ring around
it - a zone where no germs could grow. No ring meant the drug had failed.
This test was typical. Three drugs worked, four had failed.
The strategy for nearly 70 years has been to stay
a step ahead of resistance by developing new antibiotics. In the past decade,
however, major drugmakers have been dropping out of the field. The number
of new antibiotics in development has plummeted. During the five-year
period ended in 1987, the FDA licensed 16 novel antibiotics. In the most
recent five-year period, only five were approved.
For drugmakers, the economics are simple: An
antibiotic can cure an infection in a matter of days. There is much more
money in finding drugs that must be taken for a lifetime.
Toll of antibiotic resistance.
With antibiotic research lagging, the bugs are
catching up, and infections are taking a terrible toll. The federal Centers
for Disease Control and Prevention estimates that each
year 99,000 Americans die of various bacterial infections that they pick
up while hospitalized - more than double the number killed every year in
automobile accidents.
Of the 1.7 million hospital-acquired infections
that occur each year, studies show, 70 percent are resistant to at least
one antibiotic. Drug-resistant staph is rapidly becoming a major public
health menace. Last fall, the CDC estimated that MRSA alone has killed
19,000 Americans. Most of these patients picked up the bug in the hospital,
but it is now spreading in urban and suburban neighborhoods across the
nation.
Peg McQueary's struggle to survive:
"MRSA is killing people. It almost killed me,"
said Peg McQueary, whose life was upended when she nicked her leg with
a razor three years ago. Within days, her leg was grotesquely swollen,
red from foot to knee. Her husband wheeled her into a Kaiser medical office,
where her doctor took one look and rushed her to an isolation room. She
was placed on intravenous vancomycin, a drug reserved for the most serious
cases of MRSA. Since that frightening week, the 42-year-old Roseville woman
has spent much of her life in and out of hospitals, and she's learned just
how difficult these infections can be to treat. McQueary has burned through
drug after drug, but the staph keeps coming back. She's been hooked up
at her home to bags of vancomycin and swallowed doses of linezolid, clindamycin
and a half a dozen other antibiotics with barely pronounceable names and
limited effect.
One of the newest antibiotics, intravenous daptomycin
- approved by the Food and Drug Administration in 2003 - seems to work
the best, but it has not prevented recurrences. "It's just a struggle to
do everyday things," she said. "I am ready to scream about it." Today,
she moderates a Web site, MRSA Resources Support Forum, swapping stories
with other sufferers. "Giving them a place to vent is some sort of healing
for me," she said.
McQueary's travails are becoming an all-too-familiar
American experience. As bacteria evolve new ways to sidestep antibiotics,
doctors treating infections find themselves with a dwindling list of options.
Old-line drugs are losing their punch, while the newer ones are both costly
and laden with side effects.
Drugs' weakening grip.
Dr. Joseph Guglielmo, chairman of the Department
of Clinical Pharmacy at UCSF, closely tracks the effectiveness of dozens
of antibiotics against different infectious bacteria. Laminated color-coded
cards called antibiograms are printed up for hospital physicians each year.
They chart the success rate of each antibiotic against at least 12 major
pathogens. These charts show how antibiotics, like tires slowly leaking
air, are losing strength year by year.
As head of the hospital pharmacy, Guglielmo oversees
a small warehouse at the medical center that stores millions of dollars
worth of prescription drugs that are used every day to treat patients there.
Strolling down the aisles that houses bins of antibiotics, he reached for
a bottle of imipenem, and cradled the little vial in the palm of his hand.
"This one is the last line of defense," he said.
Imipenem was approved by the FDA in 1985. A powerful
member of the carbapenem family - the latest in a long line of penicillin-like
drugs - it is frequently used in hospitals today because it can still defeat
a wide variety of germs that have outwitted the earlier-generation antibiotics.
But at a cost of about $60 a day, and with a safety profile that includes
risk of seizure, it is a "Big Gun" drug that must be used carefully. As
soon as doctors discover that a lesser antibiotic will work, they will
stop prescribing imipenem, like soldiers conserving their last remaining
stores of ammunition.
Now, there are signs of trouble.
Imipenem has been the antibiotic of choice for
doctors treating Klebsiella, a vigorous microbe that causes pneumonia in
hospitalized patients. But in June 2005, New York City doctors reported
in the journal Archives of Internal Medicine outbreaks of imipenem-resistant
Klebsiella. Fifty-nine such cases were logged at just two hospitals. The
death rate among those whose infections entered their bloodstreams was
47 percent. Last year, Israeli doctors battled an outbreak of carbapenem-resistant
Klebsiella that has killed more than 400 patients.
Cipro's dramatic decline.
The antibiotic Cipro, approved by the Food and
Drug Administration in 1987, is familiar to millions of Americans because
it is widely prescribed for pneumonia, urinary tract infections and sexually
transmitted diseases. It was the drug used to treat victims of the anthrax
mailings that followed the Sept. 11 attacks.
Unlike most antibiotics, which originated from
natural toxins produced by bacteria, Cipro came from tinkering with a chemical
compound used to fight malaria. The German drug giant Bayer patented Cipro's
active ingredient in 1983, and it subsequently became the most widely sold
antibiotic in the world.
At hospitals across the country, however, clinicians
have witnessed a remarkable drop-off in the utility of Cipro against more
commonly encountered germs. Antibiograms from the UCSF lab highlight the
alarming erosion: As recently as 1999, Cipro was effective against 95 percent
of specimens of E. coli - bacteria responsible for the most common hospital-acquired
infections in the United States. By 2006, Cipro would work against only
60 percent of samples tested.
The bacterial evolution that has so quickly sapped
Cipro has also reduced the effectiveness of the entire family of related
antibiotics called fluoroquinolones - drugs such as Levaquin, Floxin, and
Noroxin. "If there is ever a group of drugs that has taken a beating, it
is these," said UCSF pharmacy chief Guglielmo.
Against Acinetobacter - a bug responsible for
rising numbers of bloodstream and lung infections in intensive care units,
as well as among combat casualties in Iraq - Cipro's effectiveness fell
from 80 percent in 1999 to 10 percent just four years later. Cipro
has also lost ground against Pseudomonas aeruginosa, a common cause of
pneumonia in hospitalized patients. Nearly 80 percent of the bugs tested
were susceptible to Cipro in 1999. That fell to 65 percent by 2004.
At UCSF, doctors carefully monitor the trends
in drug resistance and modify their prescribing patterns accordingly. As
a result, they have been able to nudge some of these resistance levels
down. Cipro's effectiveness against Acinetobacter crept up to 40 percent
last year, for example, but the overall trend remains alarming.
Although MRSA infections have been capturing headlines,
bugs such as Acinetobacter, Klebsiella and Pseudomonas are keeping doctors
awake at night. They come from a class of pathogens called Gram-negative
bacteria, which typically have an extra layer of microbial skin to ward
off antibiotics, and internal pumps that literally drive out antibiotics
that penetrate.
Gram-negative infections have always been difficult
to treat, and few new drugs are in development. Some researchers believe
that the pipeline for new antibiotics is drying up because it is simply
getting more difficult to outwit the bugs. "It may be that we've already
found all the good antibiotics," warned Chambers, San Francisco General
Hospital's infectious disease chief. "If that is so, then we've really
got to be careful how we use the ones we have."
Bacteria's natural evolution.
Terry Hazen, senior scientist at Lawrence Berkeley
National Laboratory and director of its ecology program, is not at all
surprised by the tenacity of our bacterial foes. "We are talking about
3.5 billion years of evolution," he said. "They are the dominant life on
Earth."
Bacteria have invaded virtually every ecological
niche on the planet. Human explorers of extreme environments such as
deep wells and mines are still finding new bacterial species. "As
you go deeper into the subsurface, thousands and thousands of feet, you
find bacteria that have been isolated for millions of years - and you find
multiple
antibiotic resistance," Hazen said.In his view, when bacteria develop
resistance to modern antibiotics, they are merely rolling out old tricks
they mastered eons ago in their struggle to live in harsh environments
in competition with similarly resilient species.
Drug industry economics are also a factor. "It
takes a hell of a lot of effort to find the next really good drug," said
Steven Projan, vice president of New Jersey pharmaceutical giant Wyeth
Inc. The costs of bringing a new drug to market are hotly debated. A Tufts
University study estimated $802 million; the consumer group Public Citizen
pegs it at $110 million. Either way, the investment is huge.
By 1990, according to the Infectious Diseases
Society of America, half the major drugmakers in Japan and the United States
had cut back or halted antibiotic research. Since 2000, some of the biggest
names in pharmaceutical development - Roche, Bristol-Myers Squibb, Abbott
Laboratories, Eli Lilly, Aventis and Procter & Gamble - had joined
the exodus.
By common measures used to gauge the profit potential
of new drugs, antibiotics fall way behind, Projan explained. For every
$100 million that a new antibiotic might yield, after projected revenue
and expenses are tallied, a new cancer drug will generate $300 million.
A new drug for arthritis, by this same analysis, brings in $1.1 billion.
Investors
have been placing their bets accordingly.
In 2002, Wyeth had sharply curtailed its own antibiotic
drug discovery programs. "We tried to get out of the field, but one of
the reasons we did not get out altogether is we feel we have a public responsibility
to fund more research," said Projan.
Wyeth's decision to keep some antibiotic research
alive eventually paid off. In June 2005, the FDA licensed Tygacil, an intravenous
antibiotic for complicated skin diseases such as drug-resistant staph infection.
Only one new antibiotic for oral or intravenous use has won FDA approval
since.
Pointing a finger at doctors.
The waning of antibiotics in the arsenal of modern
medicine has been going on for so long that some doctors fear a kind of
complacency has set in. Increasingly, the medical profession is pointing
a finger at itself.
"We have behaved very badly," said Dr. Louis Rice,
a Harvard-educated, Columbia-trained specialist in infectious diseases.
"We have made a lot of stupid choices." His words brought a nervous silence
to thousands of his colleagues, as he delivered a keynote speech in 2006
for the American Society for Microbiology's annual conference in San Francisco.
Rice, a professor at Cleveland's Case Western
Reserve University, said doctors and drug
companies alike are responsible for breeding resistance by "the indiscriminate
dumping of antibiotics into our human patients."
Drug-resistant germs contaminate the bedrails,
the catheter lines, the blood pressure cuffs and even the unwashed hands
of doctors, nurses and orderlies. The germs keep evolving, swapping drug-resistance
traits with other microbes. He likened American intensive-care units -
the high-tech enclaves where the most seriously ill patients are treated
- to "toxic waste dumps."
Drug companies, he said, have a responsibility
to refill the nation's depleted medicine chest. He suggested that a tax
- similar to a Superfund tax placed on polluters to clean up toxic waste
sites - be imposed on companies that have dropped antibiotic research.
It would support drugmakers that are still in the game. "Your products
that you've made billions and billions and billions and billions of dollars
on have created this problem, and you can't just walk away," he said.
Rice has stressed that the existing arsenal of
antibiotics should be used wisely, and that often means sparingly. During
a half century of antibiotic use, he said, there
is scant research on how short a course of drugs is actually needed to
cure a patient. Instead, doctors routinely
prescribe a week to 10-day course of drugs recommended by manufacturers.
If patients are taking antibiotics after their infections are truly gone,
they are creating conditions that breed resistance. Indeed, a Dutch study
showed that one kind of pneumonia can be treated just as successfully with
three days of amoxicillin as with the traditional eight.
Since drug companies cannot be expected to spend
money on research that could trim sales of their products, federally funded
agencies such as the National Institutes of Health should do the job, Rice
said in a recent interview.
He also took his own specialty to task for failing
to protect the most important weapons its arsenal. Infectious disease experts
at hospitals must find the "backbone" to stop other doctors from prescribing
antibiotics unnecessarily, Rice said. He argued they should assert
their authority to control antibiotic usage, just as cancer specialists
have a say in which chemotherapy drugs are prescribed by surgeons. And
all health care professionals, he added, "have to wash their damn hands."
http://www.sfgate.com
So how do we stay healthy?
Cell
Oxygenation - Cell
Detoxification - Hydration
- Cell Nutrition
Four machines for natural healing:
Sun Ancon
Chi Machine - Far
Infrared Hothouse Sauna - Electro
Reflexology - E-Power
Detox has never been as important
as it is today,
in order to combat what ever
happens tomorrow!
