Antibiotics are still overprescribed

A study of patients in Belgium found that when people have a sore throat, what they want is pain relief, but what they ask for is antibiotics.

The conclusion of the authors is that:

Trials are needed to test whether exploring patients’ expectations about pain management and offering adequate analgesia can assist physicians in managing sore throats without prescribing antibiotics.

Personally, I think every consulting room should have a poster listing all the things antibiotics cannot fix, and telling us the long-term risks of overprescription (millions of deaths from scratches…)

Vibrio vulnificus – flesh-eating bacterium

In the US there is great concern, more people who enter the ocean with just a scratch can get sick or die. That is because climate change = warmer waters = oceans more north are affected.

 it’s the other portion of Vibrio infections, caused by the species Vibrio vulnificus, that is raising so much concern right now. These infections happen when bacteria-laden seawater infiltrates a break in the skin. In an average year there are believed to be 28,000 cases [in the US], but that’s widely considered an undercount.

Those infections can be treated, if people get antibiotics quickly.

Yes, antibiotics. We are not far from a future when a scratch can kill you.

Cockles and Watercress Can Kill You

In New Zealand, kai is the Maori word for food, and in common usage…

E. Coli is well-known and food poisoning can be a horrible experience and sometimes kill people. Antibiotics are now no longer always able to fix such poisoning.

We identified E. coli on plants (watercress) and in animals (mussels and cockles) taken for kai. In some samples, up to 20% of the E. coli were resistant to the frontline antibiotic drug ampicillin.

This means infections by one in five E. coli might fail to respond to a frequently prescribed antibiotic, leading to more suffering or medical complications.

We also detected resistance to last-resort drugs such as ciprofloxacin. Ciprofloxacin is usually prescribed to treat bacterial infections when other antibiotics have already failed. Often, the bacteria we found were resistant to drug concentrations that exceeded what could be safely given to a patient.

Source: The Conversation

AMR Deaths On the Rise in Africa

We all know about the terrible problem of AIDS in Africa. Well, a study shows that in 2019, antimicrobial-resistant (AMR) infections killed more than a million people – twice as many as who died from AIDS.

It used actual records and extrapolated the data across places that are lacking in hard data.

On the basis of our predictive statistical models, there were an estimated 4·95 million (3·62-6·57) deaths associated with bacterial AMR in 2019, including 1·27 million (95% UI 0·911-1·71) deaths attributable to bacterial AMR. At the regional level, we estimated the all-age death rate attributable to resistance to be highest in western sub-Saharan Africa, at 27·3 deaths per 100 000 (20·9-35·3), and lowest in Australasia, at 6·5 deaths (4·3-9·4) per 100 000.

So, even in wealthy countries like Australia, it is also a problem, just not as bad.

 

Fabimycin Shows Promise

Fabimycin has worked well in testing, against over 200 clinically isolated colonies of antibiotic-resistant bacteria, which included more than 50 strains of bugs like E. coli, Klebsiella pneumoniae and Acinetobacter baumannii.

In tests performed on mice, fabimycin was found to clear up drug-resistant cases of pneumonia or urinary tract infections, and it actually reduced the bacteria levels even lower than they were pre-infection.

That is very promising, but it is still early days.

Press release found here:
https://www.acs.org/content/acs/en/pressroom/presspacs/2022/acs-presspac-august-10-2022/new-drug-candidate-fights-off-more-than-300-drug-resistant-bacteria.html

 

Mycoplasma genitalium now 80-90% resistant

It is the second most common STI for gay men. Currently 9% of those tested are infected. But treatment is difficult:

15 years ago , MG resistance to antibiotics was around 10-20% among patients at the Melbourne Sexual Health Clinic, but now it was closer to 80-90%.

“It is very difficult to treat this bug,” he said.

When people presenting to the clinic have a resistance to antibiotics, they are prescribed multiple rounds of antibiotic treatments, Ong said.

“Our standard treatment now is already two weeks of antibiotics and then if they are resistant, then they get an extra two weeks, and then if they are resistant to that, there’s another lot of antibiotics.

“It’s quite a lot of antibiotics.”

https://www.theguardian.com/australia-news/2021/mar/17/gps-urged-not-to-test-gay-men-for-sti-super-bug-over-fears-it-will-become-more-antibiotic-resistant

Doctors are recommending not treating asymptomatic people, as that will lead to greater resistance.

Americans Are Using Fish Antibiotics

Unfortunately many Americans cannot afford to visit a doctor and get a prescription for antibiotics. Because humans and animals use the same antibiotics, many Americans are using antibiotics for pet fish. They can buy them over the counter at pet stores.

This has three main issues:

  • The product is intended to be dissolved in water and absorbed through a fish’s skin. So it isn’t the same
  • Antibiotics can have side-effects, so you need a doctor to make the decision
  • Abuse of antibiotics leads to resistance

Flies in Hospitals Carrying Super Bugs

The article doesn’t mention if the flies are spreading the bacteria, but it is a fair presumption.

Flies in hospitals may pose a greater threat than a buzzing annoyance. A study published Friday found almost 9 out of 10 flying insects collected from seven hospitals in England carried potentially harmful bacteria on or in their bodies.

Over half of the bacterial strains identified were ‘superbugs,’ meaning they were resistant to at least one class of antibiotic, with almost 20% resistant to multiples classes of antibiotics. Penicillin was the least effective antibiotic against the bacteria that was found.

“What’s quite interesting, though, is the high proportion of drug-resistant bacteria found in these samples. It’s a vivid reminder of how our over-use of antibiotics in healthcare settings is making infections more difficult to treat.”

Typhus Spreading in California

The answer to typhus is antibiotics, specifically Doxycycline. But the more you use an antibiotic, the more likely the disease will mutate.

There were 167 cases of typhus from January 1, 2018, through February 1 of this year, up from 125 in 2013 and 13 in 2008, according to the California Public Health Department.
https://www.theatlantic.com/health/archive/2019/03/typhus-tuberculosis-medieval-diseases-spreading-homeless/584380/

Mostly homeless people. A growing illness and potentially no more medicine that works = potential plague.