# 4352
Although a native Floridian (second generation), and born with salt water in my veins (I’ve lived aboard boats a good deal of my life), I did manage to spend a decade of my life `going back to the land’ while living on a remote piece of property in Missouri.
One of the things that surprised me (there were many) about this rural life was that the local `farm & ranch’ supply stores offered for sale – without prescription – all manner of antibiotics and veterinarian supplies.
A few of the boxes of antibiotics, from the looks of them, had been sitting on the shelf for quite some time. I saw one box, with a spider living inside it, that had been there so long he had three chevrons on his sleeve.
I asked our local vet about it (the antibiotics, not the spider), and he shrugged and said that many of the locals preferred to do their own diagnosing and treatment of their pets and livestock, and that often he was only consulted as a last resort.
It was, he said, a combination of poverty (or sometimes misplaced frugality) and distrust of doctors in general.
Living as I was, at the end of a very long country road (No . . . it wasn’t the end of the world . . . but you could see it from there), I was often at the receiving end of abandoned dogs and cats. We took many of them in and found homes for others, so I understand how vet bills can mount up.
As I wandered through those stores, looking at aged and dusty boxes of out-of-date medicines, I wondered how many of the locals felt the same way about taking their family members to the doctor. `Home cures’ were certainly not unheard of in that neck of the woods.
If Jethro is feeling poorly, I wondered, would Granny toss a dash of non-Rx Tetracycline powder into the Rhumatiz medicine for good measure?
Well, there’s nothing to stop her.
Of course, the big concern right now is that factory farms are using incredible amounts of antibiotics as preventatives and growth enhancing measures, and may be breeding bigger and better bacteria in the process.
Maryn McKenna is all over this story on her Superbug Blog.
But even small farms, where do-it-yourself diagnosis and treatment with antibiotics are common, can contribute to the problem.
The inappropriate use of antibiotics in humans is obviously a concern as well. Most of the time, this comes from a failure to take the entire course of antibiotics prescribed by their doctor, although self diagnosis and treatment no doubt are contributing factors.
(In many countries all manner of antibiotics are available off the shelf. No Prescription – and no medical knowledge required)
Which brings us (finally!) to the end of this Sunday ramble and to a study that appears in the journal Molecular Cell entitled The Fast Track to Multidrug Resistance by Benjamin B. Kaufmann, Deborah T. Hung.
Low levels of antibiotics cause multidrug resistance in 'superbugs'
Boston University bioengineers detail process
BOSTON (Feb. 11, 2010) – For years, doctors have warned patients to finish their antibiotic prescriptions or risk a renewed infection by a "superbug" that can mount a more powerful defense against the same drug. But a new study by Boston University biomedical engineers indicates that treating bacteria with levels of antibiotics insufficient to kill them produces germs that are cross-resistant to a wide range of antibiotics.
In the Feb. 12 issue of Molecular Cell, research led by Boston University Professor James J. Collins details for the first time the biomolecular process that produces superbugs. When administered in lethal levels, antibiotics trigger a fatal chain reaction within the bacteria that shreds the cell's DNA. But, when the level of antibiotic is less than lethal the same reaction causes DNA mutations that are not only survivable, but actually protect the bacteria from numerous antibiotics beyond the one it was exposed to.
"In effect, what doesn't kill them makes them stronger," said Collins, who is also a Howard Hughes Medical Institute investigator. "These findings drive home the need for tighter regulations on the use of antibiotics, especially in agriculture; for doctors to be more disciplined in their prescription of antibiotics; and for patients to be more disciplined in following their prescriptions."
There is an old adage that says that `if you plot to kill the king, you’d better not fail.’ Another version attributed to Emerson, is `When you strike at a King, you must kill him”.
The same advice holds true for bacteria. Anything less can speed the formation of resistant strains. Not a startling revelation, of course. But we are now learning the biomolecular process by which this happens.
This study provides another compelling argument against low-dose, prophylactic, incomplete, indiscriminate, or unwarranted use of antibiotics.
In the home or on the farm.
Antibiotic resistant infections were rare occurrences thirty years ago when I was a paramedic. Today they account for the loss of tens of thousands of lives, and the expenditure of billions of health care dollars every year.
Whether we are talking about MRSA or MDR- (Multi-drug Resistant) Tuberculosis, or Drug-Resistant Streptococcus Pneumoniae (DRSP), or resistant C. Difficle or E. coli, Acinetobacter or any of a number of other emerging resistant bacteria – this has the potential to adversely impact all of us.
Barring another (far more serious) pandemic, I expect that the continual rise in MRSA and other antibiotic resistant bacteria will be the big medical story of the next decade.
Antibiotic resistance is, ironically, pretty much a self inflicted wound. One for which, alas, there are few effective treatments.
We’d do well to avoid this injury, through the judicious use of antibiotics today, rather than try to manage it without the proper drugs tomorrow.
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