Science's Response to Antibiotics Resistance

ttruong's picture

Senior Seminar in Biology and Society

September 22, 2009

 

Scientists' Responsibilities in the Antibiotics Resistance Crisis 

In the first half of the 20th century, the majority of people in hospitals were plagued with bacterial infections, such as tuberculosis, pneumonia, meningitis, typhoid fever, and syphilis, rather cancer and heart disease as it is the case today. However, by 1960s the discovery of antibiotics led medicine to victory over most bacterial infections. Antibiotics' success was so great that in 1969 the surgeon general of the United States declared that it was time to "close the book on infectious diseases."

Unfortunately, he was wrong. The same bacteria that we supposedly defeated are now back, but they are even stronger than before because they have acquired resistance to antibiotics. We ourselves have instigated their rapid evolution and acquisitions of resistance by misusing antibiotics as doctors, pharmacists, and patients.

Here are a number of ways in which antibiotics are misused:

1. Doctors wrongly diagnose a viral disease as a bacterial disease and unnecessarily prescribe antibiotics.

2. Patients think they should get antibiotics and would fight with doctors who try to prescribe an alternative, resulting in doctors prescribing antibiotics to avoid conflicts.

3. Patients do not commit to the entirety of the treatment.

4. Pharmaceuticals and hospitals profit from sales of these drugs, so prescriptions are encouraged.

5. Patients can purchase antibiotics online without a prescription, and use it at their own untrain discretion.

 

With so many factors contributing to the problem of antibiotics resistance, which factor should we devote our attention to most? Who does the responsibility fall to in fixing the problem? Is it the government's responsibility to educate the public about the consequences of the overusage of antibiotics. Is it the doctors' responsibilty to educate patient despite time restraints and potential conflict? Are the scientists who help produce and subsequently sell antibiotics responsible for preventing resistance by discouraging excessive use of it, and in turn lowering their profits?

 


Readings:

 

Combating Antibiotic Resistance www.fda.gov/ForConsumers/ConsumerUpdates/ucm092810.htm

Who is to blame for antibiotic overuse in China? www.interfax.cn/news/10790

Misuse of Antibiotic Creating Resistant TB www.voanews.com/english/Science/2009-08-25-voa9.cfm

Study Explores Antibiotic Misuse www.sciencedaily.com/releases/2005/01/050111162856.htm

Do your part for antibiotic resistance latimesblogs.latimes.com/booster_shots/2009/09/do-your-part-for-antibiotic-resistance-dont-bother-with-a-prescription.html

 

 

 

Comments

Anna Dela Cruz's picture

Antibacterial Usage, Increased Allergy, and History

The discussion on the over-usage of antibiotics got me thinking about our nation's over-usage of antibacterial soaps and current war on germs. According to the CDC, there is a link between "too much hygiene and increased allergy". Children exposed to germs such as those living on farms had less allergies than those who were not constantly exposed to bacteria. This is because the immune system matures much like a brain in the sense that it must be exposed to "antigenic information". 
From a historical standpoint I am reminded of the use of bio-terrorism by Europeans to conquer the Americas. By the sixteenth century, European nations had already been domesticating livestock for thousands of years. This closeness to animals resulted in the transfer of animals infections onto humans and thus putting an evolutionary strain in European human populations. Over time, Europeans who survived these animal infections formed antibodies and passed them onto subsequent generations. Populations in the Americas did not have these antibodies because there societies did not domesticate animals, preferring plant farming over livestock. Thus, the indigenous peoples' lack of immunity to these animal derived diseases facilitated European conquest.  
So taking historical precedence into account, I agree in domesticating germs through human exposure versus eliminating them through antibiotics.

ttruong's picture

Probiotics

http://esciencenews.com/articles/2009/09/07/designing.probiotics.ambush.gut.pathogens

I think this article about probiotics is another great example of how we can bypassthe antibiotics resistance problem. Instead of creating new drugs that simply kills the pathogen, we can create another competitive, harmless bacteria that can eliminate the other bacteria's pathogenic mechanism.

RachelBrady's picture

Must Watch

Evolutionary Arms Race, is on YouTube
Episode 4 - and I'm pretty sure Liam Neeson is the narrator.
Two thumbs up.
http://www.youtube.com/watch?v=9CuhqQzBACQ

Also, check out
http://www.nytimes.com/2009/09/25/health/research/25aids.html?_r=1&scp=1&sq=HIV%20vaccine&st=cse
Possible break through in HIV vaccine. Makes you wonder what's possible.
So maybe directing bacterial evolution isn't so far fetched.

ttruong's picture

Short-term, long-term

I really like the idea that instead of propelling bacteria to evolve around the obstacles of antibiotics to more resistant strains, scientists should devote attention manipulating bacteria to evolve commensal qualities. Some ways I would imagine is developing we can approach this is by identifying the pathogenic genes, and then attenuating them or inhibiting them altogether without destroying their viability. These new benign strains would then be introduced to compete with the pathogen forms in the host, thus reducing pathogenic proliferation.

While we are taking new approach, we should still continue to develop antibiotics. Just as what happened in the story about the villages and cholera, people will die while this new strategy is being explored. Before the new approach can be successfully implemented, we still need to make sure we are using antibiotics appropriately to extend their effectively. Our resources can be diverted to the short-term strategy of antibiotics, and long-term project of developing commensal relationships between pathogenic bacteria and humans.

 

Paul Grobstein's picture

antibiotic resistance ... and broader issues

Some things that I want to mull further ...

Pharmaceutical company executive: "My scientists (and the company) can make more money if people overuse antibiotics"

Research scientist: "Its easier to get research funding if I am clearly targeting an agreed upon social problem."

Medical practitioner: "I can make more money if I overprescribe antibiotics, and make my patients happier at the same time."

Patient: "I want to feel better right now"

There's a seriously interesting problem here, not unrelated to matters that have come up earlier in this set of conversations.  Should we be making decisions, individually and/ or collectively in terms of what makes money, or are there relevant "codes of behavior" that also should be taken into consideration?   Where do/should those codes of behavior come from?  What role should science play in them?  Perhaps we should, as scientists, be conveying a greater sense of the importance of context and scale: encouraging people to think not only about now and the next few years but longer time spans and wider communities?  And about evolution?  Would it make sense to try and move toward replacing antibiotics (get out of an infinite arms race) with something that acknowledges the dynamic and evolving interaction between humans and bacteria and uses that understanding to shift the balance of those interactions in a more positive direction for both?  

 

jrlewis's picture

bacteria anyone?

I really liked the idea we discussed in class about abandoning the search for new antibiotics and instead directing bacterial evolution a different way.  That as a strategy for applying selection pressure, humans might attempt domesticating bacteria.  Perhaps, humans can hope to engineer either a commensal or a symbiotic relationship with the bacteria.  It is possible that humans could benefit from working with bacteria instead of against them…

Lisa B.'s picture

What about the dangers associated with illegal drugs?

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The above articles caution that the overuse of antibiotics is linked with resistant strains of bacteria, but the authors fail to warn about the more obvious dangers of illegal drug abuse. Why are people not more concerned about dying from tainted antibiotics? Drug companies provide medications for free or at reduced cost to people who are unable to afford their prescriptions. Pursuing a legitimate route for filling prescriptions could be a better option than risking your life on counterfeit antibiotics.
 

 

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