November 16, 2013
Bacteria Antibiotic Resistance: Running Out Of Alternatives
A group of British doctors writing in Lancet warn of the serious threat posed by the spread of antibiotic resistant bacteria.
“Rarely has modern medicine faced such a grave threat. Without antibiotics, treatments from minor surgery to major transplants could become impossible, and health-care costs are likely to spiral as we resort to newer, more expensive antibiotics and sustain longer hospital admissions.”
I agree. For starters, we really should just ban the use of antibiotics in animal feed.
The authors of the piece make a number of proposals to reduce the selective pressures that produce the resistant bacterial strains including better basic hygiene in hospitals and changes in the incentives that lead to overuse of antibiotics by physicians.
Every time we use antibiotics we select for resistant strains and basically use part of the effective life of an antibiotic. We should treat antibiotics as precious resources.
Randall Parker, 2013 November 16 07:57 PM
The misuse of anti-biotics has aggravated me since I was a kid. Anti-biotics should NEVER be used on livestock. They should never be prescribed unless absolutely necessary. And there should be a system in place to ensure people finish taking them once a course has been prescribed. Though I'm not sure how it could be done. Maybe have an electronic dispenser you rent from the pharmacy along with your script to record when you took it. If someone doesn't finish the course they get fined. One of the reasons drug resistant TB exists is that people in the 3rd world would never finish their anti-biotics. There should be a world wide program to test EVERYONE for diseases like drug resistant TB and quarantine them.
OT: I'm surprised you didn't post on this.
destructure:" There should be a world wide program to test EVERYONE for diseases like drug resistant TB and quarantine them. "
You mean put them in a concentration camp? In that case you can put some drug resistant bacteria in the houses of your enemies, and thereby infect them so that the government would quarantine them. Even better than framing your enemies.
That's a good point. However, there are easier ways to get rid of enemies. Plus, infecting someone with a serious, drug resistant disease would pretty much take the wind out of their sails whether they were confined to a sanitarium or not.
I'll mention that drug resistant TB took off in the Russian penal system where people were already quarrantined from society to a significant extent and authorities had the freedom to isolate those with drug resistant TB if they wished. But instead drug resistant strains of TB were allowed to spread because the people in charge could not be arsed to do anything about it. What was done in the Russian penal system to start coping with the problem was to start giving an arse, which hasn't solved the problem, but it has greately helped.
I don't doubt Russian prisons were partly responsible for the spread but I doubt they had much to do with creating the drug resistance. I just don't see Russian prisons caring enough to test or give prisoners antibiotics in the first place. Regardless, any incompetent use of antibiotics would lead to drug resistances whether quarantined or not. So if someone is infected it's best to get them out of the general population before they infect others.
It seems that you did not understand what I was saying. I was referring to the morally unacceptable idea that you presented. Mass quarantines without the responsibility to save the victims from the drug resistant bacteria is like saying: "Let shit happen to someone else."
Destructure, the Soviet Union was quite effective at controlling TB, however when it broke up social dislocation and breakdown of public health resulted in the spread of many strains of TB. Without effective control measures in place it spread through Russia's large prison population like a highly infectious disease and drug resistant strains established themselves. Now that Russian has returned to more effective treatment, TB among the general population has declined slightly from its 2000 peak but is still more than double its incidence in 1990. But the incidence amoung the prison population dropped by more than 75% over ten years.
There probably isn't a country in the world that doesn't have laws covering the isolation of people with infectious diseases that pose a threat to public health, such as active TB. But if you lock up everyone with latent TB about 90% of them will die of old age before they develop active TB so locking up everyone would cost society a great deal for very little benefit. And TB is not the only drug resistant pathogen out there. If we lock up everyone who is carrying some strain of antibiotic resistant prokaryote I don't think there would be many people left to look after the keys.
"Without effective control measures in place it spread through Russia's large prison population like a highly infectious disease and drug resistant strains established themselves."
That sounds a lot like my point that "any incompetent use of antibiotics would lead to drug resistances whether quarantined or not." But why make an issue of active vs latent TB when the obvious purpose of quarantine is to prevent spread? That's a straw man against something I obviously wouldn't have advocated. I suspect your real objection is that it's "morally unacceptable" the same as Wolf-Dog.
"Morally unacceptable" to whom? Certainly not to me. Should the danger become imminent, most people who currently find it "morally unacceptable" would suddenly lose their objections. Ive noticed how easily most people's morality shifts with circumstances. Regardless, it's the correct response and I won't pretend otherwise simply because I have the luxury of not being faced with it at the moment.
Mass quarantines without the responsibility to save the victims from the drug resistant bacteria is like saying: "Let shit happen to someone else."
You're more than welcome to pay for a spot in a private sanitarium with the best treatment money can buy. However, I object to your description of quarantines as saying, "Let shit happen to someone else." The purpose of a quarantine is so that it DOESN'T happen to someone else. If I were infected I'd certainly agree to whatever precautions were necessary to prevent infecting others. I find it "morally unacceptable" that someone would remain in the general population putting others at risk simply because they don't want to be inconvenienced. I think someone who violates a quarantine should be charged with murder.
Destructure, are you advocating for something that already exists? That is laws that allow the isolation of people with active TB. Or are you pushing for something else such as a program of welfare for poor countries that have trouble identifying and treating people with active TB?
Ronald, I'm advocating better screening and monitoring of infected people and, where applicable, quarantine. At present, there's no requirement to be tested for infectious disease so, even though laws may exist, there's no way they can be enforced. I have mixed feelings about welfare funding for poor countries. I don't like throwing money at a problem. But I can't help but think they could do a better job of dealing with it as well. Moreover, such a program would probably pay for itself. Because disease can't be good for their economies.