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Global misuse of antibiotics. Should there be an international treaty?


seabhcan

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Antibiotic resistant 'superbugs' have the potential to kill more people than terrorists with nuclear weapons. Just today we learned that a deadly new bug has been spreading in the UK. This bug is resistant to even the most powerful antibiotics - those which are reserved for hospital use in the west - and this bug can pass on its resistance to other diseases.

Irish authorities monitor new bug - The Irish Times - Wed, Aug 11, 2010

Bugs like these evolve in countries where antibiotics are unregulated.

A study, published in the Lancet Infectious Diseases journal today, said bacteria containing the NDM-1 gene were becoming more common in India and Pakistan, and had now been imported into to Britain by people returning from these countries.

It also warned such comprehensive antibiotic resistance had the potential to cause a worldwide public health problem.

Dr Fidelma Fitzpatrick, consultant microbiologist with the HPSC, said the widespread use of non-prescription, over-the-counter antibiotics in India had led to the emergence of more drug-resistant bugs. “The more and more antibiotics that are used, the more likely the bugs are going to develop resistance in their quest to survive," she said.
So poor regulation of antibiotics half a world away is killing people here, where antibiotics are highly regulated.

Earlier this year there was a call for an international treaty on the use of antibiotics with the aim of preventing the outbreak of superbugs.

Combating Resistance: The Case for a Global Antibiotics Treaty ? Public Health Ethics

I think an international treaty is needed to address this problem. Minimum standards of regulation should be globally enforced. The UN should send in inspectors just as it does when illegal weapons are suspected. Non-compliance should result in export bans of antibiotics to the offending country.

Anything short of this could lead to vast numbers of people around the world dying from diseases previously easily cured.
 

Twin Towers

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Non-compliance should result in export bans of antibiotics to the offending country.
Non-compliance should result in a ban on people travelling from there to here and our own citizens returning should be quarantined on arrival.
 

seabhcan

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Non-compliance should result in a ban on people travelling from there to here and our own citizens returning should be quarantined on arrival.
That wouldn't be workable as, for example, there are no direct flights from India to Ireland. There is no way to know who was in india when the plane from Heathrow or CDG lands in Dublin. And anyway, the whole plane could be infected by that stage.
 

Twin Towers

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That wouldn't be workable as, for example, there are no direct flights from India to Ireland. There is no way to know who was in india when the plane from Heathrow or CDG lands in Dublin. And anyway, the whole plane could be infected by that stage.
Well then it should be done at European points of entry if the European Union is to be seen to be good for anything.
 

Black Cat

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Are you ready for a world withour antibiotics - western medicine as we know it could be facing collapse.
Are you ready for a world without antibiotics? | Society | The Guardian

This issue really galls me - we are just as responsible for the rise in drug resistant bacteria as any other country - I have worked in childcare for nearly ten years and too often parents cart their children off to the doctor for antibiotics when they have a virus (untreatable by antibiotics) or cold without any obvious secondary infection (not needing antibiotics).If I get a cold myself my co-workers start clucking that I should go to the doctor and get something and look patronisingly at me when I try to explain why antibiotics are unnecessary in the absence of a secondary infection.
Doctors are worse for doling them out like jelly tots, they don't have the excuse of ignorance. I think they give them to justify their extortionate consultation charges. I was in the UK around ten years ago and they were incentivising doctors to limit the amount of antibiotics they were giving out.
 

sparkey321

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Firstly the term "superbug" is nonsense hyperbole developed by the redtops.

Antibiotic resistance has been developing since antibiotics first appeared.

Yes over the counter distribution of antibiotics is a serious issue but before people get all holier than thou about what going on in India let me ask some questions.

Hands up everyone who pushed their GP for an antibiotic when they had a cold or flu ?
Hands up everyone who pushed a GP for an antibiotic because they had a viral infection ?
Hand up everyone who ever took some antibiotics they found in their medicine cabinet because its what their GP gave them the last time ?
hand up anyone who ever didn't take the complete course of antibiotics , each and every tablet in the prescription ? either because they felt it wasn't working or because they fest better.

Each and every one of you is equally responsible for the spread of antibiotic resistance...


Before people get too excited about NDM-1 lets look at some background.

NDM-1 is an enzyme, 'New Dehli Metallo-beta-lactamase', which is a type of ESBL (extended spectrum beta-lactamase). There are many many ESBL's (which is also an enzyme emitted by various pathogens). Some time ago we had a class of antibiotics called beta lactamase, When bacteria got clever and resistant to beta-lactamase enzymes by degrading them with beta-lactamase enzymes, we got a step ahead and developed extended-spectrum beta-lactam antibiotics that were resistant to destruction by beta-lactamase enzymes. However, bacteria got more clever and developed ESBLs. There are quite a few types of ESBLs, including KPC-2 (a big problem across the world now) and various OXA enzymes.

NDM-1 is also not new, its been around for a while, in 2009 numbers started to rise enough for the UK department of health to issue an alert.

NDM-1 is far from the most frightening pathogen out there.
 

imokyrok

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An international treaty won't happen. The yanks will scream from the rooftops about their "rights", "freedoms" and "one world government".
 

blacbloc

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Comparable problems are going to emerge with drugs like statins which are now being prescribed almost automtically for people over 50 by many doctors. Ditto vaccinations - peoples' immune systems are being increasingly burdened by them. By the age of six most children will have had something like 35 doses. Soon there will be a vaccination for big noses, I bet.
 

Beaker

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One of the most serious concerns globally around drugs is the counterfeiting that is taking place, mostly in Asia. Often drugs contain less than 30% of the correct active substance (e.g. antibiotic), and these are then sold at incredible profits.

Unfortunatley people then die, as they dont get the correct dose of drug, or in the case of antibiotics, if the dont die, the bacteria they harbour becomes resistant.

Many Asian countries manufacture their own drugs, so export bans etc are ineffective...
 

imokyrok

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Comparable problems are going to emerge with drugs like statins which are now being prescribed almost automtically for people over 50 by many doctors. Ditto vaccinations - peoples' immune systems are being increasingly burdened by them. By the age of six most children will have had something like 35 doses. Soon there will be a vaccination for big noses, I bet.
Statins have kept my mother alive after her heart attack a decade ago at age 56. They might have done the same for my father who died of a heart attack at age 40. They are hopefully doing the same for me now. Vaccinations have been an incredibly positive development in the world. Let's not throw the baby out with the bathwater.
 

jpc

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Firstly the term "superbug" is nonsense hyperbole developed by the redtops.

Antibiotic resistance has been developing since antibiotics first appeared.

Yes over the counter distribution of antibiotics is a serious issue but before people get all holier than thou about what going on in India let me ask some questions.

Hands up everyone who pushed their GP for an antibiotic when they had a cold or flu ?
Hands up everyone who pushed a GP for an antibiotic because they had a viral infection ?
Hand up everyone who ever took some antibiotics they found in their medicine cabinet because its what their GP gave them the last time ?
hand up anyone who ever didn't take the complete course of antibiotics , each and every tablet in the prescription ? either because they felt it wasn't working or because they fest better.

Each and every one of you is equally responsible for the spread of antibiotic resistance...


Before people get too excited about NDM-1 lets look at some background.

NDM-1 is an enzyme, 'New Dehli Metallo-beta-lactamase', which is a type of ESBL (extended spectrum beta-lactamase). There are many many ESBL's (which is also an enzyme emitted by various pathogens). Some time ago we had a class of antibiotics called beta lactamase, When bacteria got clever and resistant to beta-lactamase enzymes by degrading them with beta-lactamase enzymes, we got a step ahead and developed extended-spectrum beta-lactam antibiotics that were resistant to destruction by beta-lactamase enzymes. However, bacteria got more clever and developed ESBLs. There are quite a few types of ESBLs, including KPC-2 (a big problem across the world now) and various OXA enzymes.

NDM-1 is also not new, its been around for a while, in 2009 numbers started to rise enough for the UK department of health to issue an alert.

NDM-1 is far from the most frightening pathogen out there.
An excellent summation and technical explanation of the situation.
You have a background in pharmacology/microbiology?
Beakers (post 10) is a very relevant contributor to the issue as well.
 

myksav

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Joined
May 13, 2008
Messages
23,546
Firstly the term "superbug" is nonsense hyperbole developed by the redtops.

Antibiotic resistance has been developing since antibiotics first appeared.

Yes over the counter distribution of antibiotics is a serious issue but before people get all holier than thou about what going on in India let me ask some questions.

Hands up everyone who pushed their GP for an antibiotic when they had a cold or flu ?
Hands up everyone who pushed a GP for an antibiotic because they had a viral infection ?
Hand up everyone who ever took some antibiotics they found in their medicine cabinet because its what their GP gave them the last time ?
hand up anyone who ever didn't take the complete course of antibiotics , each and every tablet in the prescription ? either because they felt it wasn't working or because they fest better.


Each and every one of you is equally responsible for the spread of antibiotic resistance...


Before people get too excited about NDM-1 lets look at some background.

NDM-1 is an enzyme, 'New Dehli Metallo-beta-lactamase', which is a type of ESBL (extended spectrum beta-lactamase). There are many many ESBL's (which is also an enzyme emitted by various pathogens). Some time ago we had a class of antibiotics called beta lactamase, When bacteria got clever and resistant to beta-lactamase enzymes by degrading them with beta-lactamase enzymes, we got a step ahead and developed extended-spectrum beta-lactam antibiotics that were resistant to destruction by beta-lactamase enzymes. However, bacteria got more clever and developed ESBLs. There are quite a few types of ESBLs, including KPC-2 (a big problem across the world now) and various OXA enzymes.

NDM-1 is also not new, its been around for a while, in 2009 numbers started to rise enough for the UK department of health to issue an alert.

NDM-1 is far from the most frightening pathogen out there.
Ahm, what's an antibiotic? :mrgreen:
The only time I had to take antibiotics (full course) was for a serious bronchial infection 10-15 years ago. Worked fine and I haven't had need since.
The closest thing to need so far has been serious cuts and they were treated with cleaning, usually with the likes of hydorgen peroxide.

Any time I've had to see a doctor for medical reasons, and they "offer" medicines, I always ask "do I actually need that?". The most common answer is "well, no, but." In those cases, I refuse the meds.
Though, I don't get 'ill' very often, most doctor visits are just for check-up's.
 

sparkey321

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May 4, 2007
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Ahm, what's an antibiotic? :mrgreen:
The only time I had to take antibiotics (full course) was for a serious bronchial infection 10-15 years ago. Worked fine and I haven't had need since.
The closest thing to need so far has been serious cuts and they were treated with cleaning, usually with the likes of hydorgen peroxide.

Any time I've had to see a doctor for medical reasons, and they "offer" medicines, I always ask "do I actually need that?". The most common answer is "well, no, but." In those cases, I refuse the meds.
Though, I don't get 'ill' very often, most doctor visits are just for check-up's.
I 100% agree the over prescription of antibiotics in this (and most other) country is frightening.

I would guess that 80% of all prescribed antibiotics are "precautionary". That's madness. There are some valid reasons for the proactive application of antibiotics but not anywhere at the level that they are being used.

And its not all doctors fault.

I know people who have moved GP's because their current one refused to prescribe an antibiotic for a flu or sore throat.

While not in your league I rarely take antibiotics, last time was two years ago and my GP was surprised to discover that it had been 6 years previous when he last prescribed a course for me.

An excellent summation and technical explanation of the situation.
You have a background in pharmacology/microbiology?
Beakers (post 10) is a very relevant contributor to the issue as well.
My background is in a completely different field but in the last number of years I have moved into a an area where knowledge of microbiology is a must, the company employs two PhD microbiologists who are happy to share their knowledge (which i exploit mercilessly). They also pay for my subscription to a number of journals and I am encouraged to keep up to date. I fact for the initial year or so I was told to devote 40 to 50% of my time to studying microbiology, even if the area was not 100% relevant to my job. They but huge emphasis on all employees having a decent knowledge of not only what they need for their direct role but also a strong underlying understanding of all aspects of the company and what it does.

Comparable problems are going to emerge with drugs like statins which are now being prescribed almost automtically for people over 50 by many doctors. Ditto vaccinations - peoples' immune systems are being increasingly burdened by them. By the age of six most children will have had something like 35 doses. Soon there will be a vaccination for big noses, I bet.
Seriously ?

satins are not even comparable to antibiotics, there is no evidence of resistance and if it were to develop it would have no where near the impact of antibiotic resistance...

Your knowledge (or lack their of) of vaccinations is worrying but not surprising and symptomatic of another issue.
 

seabhcan

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Sep 3, 2007
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Article today on how the use of anti-biotics in farming is linked to obesity. This practice is banned in the EU, but common in the US.

Antibiotics Might Be Fueling Obesity Epidemic | Wired Science | Wired.com

“Early life antibiotics are changing the microbiome, and its metabolic capabilities, at a critical time in development,” said microbiologist Martin Blaser of New York University. “These changes have downstream effects on metabolism, including genes related to energy storage.”
Worryingly, I also read that US farmers commonly give the antibiotic Vancomycin to cattle. This is a very powerful antibiotic and supposed to be used only as a last resort if infections are highly resistant. It also has the ability to cross the membrane barrier into the brain (which is why it is used to treat meningitis) but has a side effect in causing neurological damage and hearing loss.

And they put this in food? Can't be healthy.
 

seabhcan

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New wave of 'superbugs' poses dire threat, says chief medical officer | Society | The Guardian

Antibiotic-resistant bacteria with the potential to cause untreatable infections pose "a catastrophic threat" to the population, the chief medical officer for Britain warns in a report calling for urgent action worldwide.

If tough measures are not taken to restrict the use of antibiotics and no new ones are discovered, said Dame Sally Davies, "we will find ourselves in a health system not dissimilar to the early 19th century
This is a far more serious issue than Climate change, but it gets little coverage. Plus there is absolutely no doubt that human activity - the misuse of antibiotics - is leading us on the road to ruin.

There needs to be a global framework in place. Some antibiotics need to be restricted - not used for animals and not handed out on demand without prescription - and these rules need to be global.

As many as 5,000 patients die each year in the UK of gram negative sepsis – where the bacterium gets into the bloodstream – and in half the cases the bacterium is resistant to drugs.
2500 people die each year in the UK alone from infections that used to be treatable.
 

Analyzer

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Feb 14, 2011
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No. It simply cannot be controlled.

Superbugs are not as much the problem in this country as institutional incompetence (the HSE hierarchy being full of political appointees) and rank amateurism from so called professionals in the IMO, who can count on clowns like dicey to let them away with it.
 

Quadrangle

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Jan 29, 2013
Messages
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We could also start out with educating our own population. The number of people who have no idea why you need to finish your entire run of antibiotics is frightening. Doctors are not doing a good enough job of educating their patients in this area.
 
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