Thursday, September 20

Number of antibiotic-resistant bacterial strains up due to improper use, prescription


Medicine has come a long way since the 1940s. Back then, even a
simple infected cut could be life-threatening.

Then the discovery of penicillin and a number of other
antibiotics changed this. Today, from ear infections to anthrax,
antibiotics are now routinely prescribed to treat various medical
conditions caused by bacteria.

While these “miracle drugs” are effective,
complacent doctors and uneducated patients are contributing to an
epidemic of bacterial infections that are less likely to respond to
standard treatment.

Now the world is faced with a potential crisis, as we discover
new infectious agents and familiar bacteria begin showing
antibiotic-resistance, forcing doctors into a vicious cycle: more
infections means more prescriptions for antibiotics, which lead to
more resistant strains.

It’s a frightening Catch-22.

When prescribed and taken correctly, these drugs work wonders
against bacterial infection. Even so, resistant strains are bound
to develop.

The number of antibiotic-resistant bacterial strains rose more
quickly than expected in recent years. In 1987, only .02 percent of
pneumococcus (the bacteria that causes pneumonia, meningitis and
ear infections) were resistant to penicillin. That number rose to
6.6 percent in 1994, and now estimates place the number of
resistant strains around 12 percent.

UCLA is affected as well; the Arthur Ashe Student Health and
Wellness Center has stopped prescribing the
“sulfa-type” antibiotics for bladder infections because
they have been documented as ineffective against this type of
infection all over the nation.

Antibiotics (and their synthetic counterpart, antimicrobials)
either kill bacteria or render them unable to reproduce. Most of
these drugs interfere with processes specific to bacteria, such as
inhibiting or interfering with the production of the cell wall,
which is present in bacteria but not in animal cells, or inhibiting
the bacteria’s ability to make proteins by targeting
bacteria-specific points in their protein-making machinery.

Resistance arises for a number of reasons: patients not taking
their full course or popping a leftover pill or two when they feel
ill ““ often times from a viral infection that will not
respond to antibiotics. But this only leaves heartier
drug-resistant strains to multiply.

These low doses of antibiotics also provide enough
“selective pressure” to encourage the bugs to mutate
their genetic code and avoid antimicrobial agents. The fast
growth rate of bacteria ““ some doubling every 20 minutes
““ contributes to the ease with which they can mutate and
multiply.

The fast rate of the rise in antibiotic-resistance is also
partially due to doctors overprescribing antibiotics in the 1980s
and early 1990s.

In 1995, antibiotics were the second-most prescribed class of
drug, and bacteria quickly “learned” ways around
them.

Researchers focused their work on variations of drugs already in
existence, and consumer products such as dish soap and laundry
detergent, which contain antimicrobials that bacteria can
“learn” around.

Livestock, which are fed massive amounts of antibiotics, have
resistant bacterial strains that are also passed to humans via
undercooked meat.

The threat is so severe that a number of national and private
organizations have taken notice; the Food and Drug Administration,
Centers for Disease Control, World Health Organization, National
Institutes of Health, and a private organization called Keep
Antibiotics Working have all released fact sheets and formed task
forces to deal with the potential epidemic of antibiotic-resistant
bacteria.

Universities are beginning to recognize the need for student
education about proper use of these drugs, and at the suggestion of
the CDC, medical schools are implementing a curriculum to teach
medical students the proper use of antibiotics in both hospital and
outpatient settings.

Slowing the rise of resistant bugs requires proper policy and
education regarding prescription and usage.

Susan Quillan, director of nursing at the Arthur Ashe Center,
and Dr. Howard Lehrhoff, a physician at Student Health Services,
said that while there is no specific policy in place at UCLA
covering the prescription of antibiotics, they do follow some
clinical guideline’ that recommend when to use
antibiotics.”

Quillan also notes that “usage has actually gone down in
recent years,” most likely due to the Center “making an
increased effort to educate patients and clinicians about the
appropriate use of antibiotics.”

Less patients are “demanding” antibiotics ““
hopefully proof of a better-educated student body. Bacterial
infections will never be eradicated, but education can be an
important first step in keeping them under control.

Researchers are also refocusing their efforts on developing
non-natural compounds to use as antimicrobial agents.

Bacteria has an easier time finding ways around the
naturally-occurring antibiotics like penicillin, and finding new
synthetic compounds may prove effective over a longer period of
time.

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