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When the "Cure" is Worse Than the Cause

Antibiotic resistant "super-bugs" are evolving at an alarming rate, according to a just-published study in the New England Journal of Medicine. Soon, say experts, many infections will be un treatable altogether. As a prevention specialist, Dr. Borio is concerned about the misuse and overuse of antibiotic medication in the community. That's why this week's Optimal Health University handout includes a summary of the alfove-mentioned study. Dr. Borio encourages patients to familiarize themselves with the information and to share it with friends and family - it may one day save their lives.

The problem

When infection-causing bacteria are killed with antibiotic medications, not all of the bacteria die. The extrahardy bacteria that survive reproduce - creating indestructible legions of super-bugs. These strains trigger serious, untreatable, infections. New, stronger, antibiotics are then created to annihilate the super-bugs, perpetuating the vicious cycle.

What's even more frightening is that drug technology cannot possibly keep up with the super-bugs. "It takes seven to 10 years to develop a new antibiotic and bacteria just a few months or years to develop resistance to it," explains Dr. Pharm Schentag, one of the developers of The Resistance Web, a Web site dedicated to tracking antibiotic resistance trends (http:// resistancewe b. pharmacy -ce. org/).

Super-bugs evolve due to the misuse and overuse of antibiotic drugs. Quite often, antibiotics are prescribed for viral conditions that do not respond to antibiotic treatment - or are given indiscriminately to children whose conditions don't warrant medication, in order to ease parents' anxiety.

Antibiotics and drug-resistant bacteria may also sneak into a person's system through the foods he or she eats. "Factory farming" frequently involves dosing animals with excessive amounts of antibiotics. These drugs are present in dairy goods and other products. In addition, meat from antibiotic-fed livestock may be infected with resistant bacteria, which triggers food poisoning - some cases of which are fatal.

Solution seekers

The study, upon which the New England Journal of Medicine article was based, was conducted by the Active Bacterial Core Surveillance team - a program of the United State's Centers for Disease Control and Prevention in Atlanta, Georgia. Dr. Cynthia G. Whitney led the 14member research team.

Researchers focused on antibiotic resistance to Streptococcus pneumoniae bacteria. Streptococcus pneumoniae is the main culprit behind middle ear infection, pneumonia, meningitis and several other common conditions. The research team pooled data from 12,045 samples taken from patients with Streptococcus pneumoniae diseases between 1995 and 1998.

And the answers were...

Findings revealed that 24 percent of the bacteria in the samples were resistant to penicillin. And, resistance to at least three different types of antibiotics among patients with Streptococcus pneumoniae infection jumped from 9 percent in 1995 to 14 percent in 1998.

The study concluded that "Multidrug-resistant pneumococci are common and are increasing."

All of this means what?

The results of the study show that super-bugs are evolving at a frenzied rate. If the explosion of antibioticresistant bacteria remains unchecked, more and more resistant bacteria will emerge, triggering diseases that are impossible to fight.

Despite the widespread use of antibiotics, the rate of Streptococcus pneumoniae infections is rocketing. For instance, cases of bacterial pneumonia more than doubled in children under the age of four - and in seniors aged 70 to 79 years between 1993 and 1997.

An editorial accompanying the report pointed out that "Each year in the United States, 160 million prescriptions are written for antibiotics and 22.7 million kg (25,000 tons) of antibiotics are prescribed."

"In a population of 275 million, this degree of use in terms of exposure is equivalent to nearly 30 prescriptions per 100 persons per year and to 4.1 kg (9 lb) of antibiotics per 100 persons per year. This enormous level of use of antibiotics has great potential for selecting for or enhancing the growth of resistant strains. Probably half of all such uses are inappropriate, as is represented by the needless treatment of viral upper respiratory tract infections, bronchitis, and pharyngitis."

The editorial also highlighted the influence of antibiotic resistance in nosocomial infections (infections that patients pick up during a hospital stay, which.they did not have prior to hospitalization). Nosocomial infections of the bloodstream are the eighth leading cause of death in the United States. The three leading causes of these infections are resistant bacteria.

"The :mtibiotic era is barely 60 years old, yet the inappropriate use of these drugs threatens our ability to cope with infections," noted the authors of the ed'ttorial.

How may patients obtain a copy of the article?

The article, Increasing Prevalence of Multidrug-Resistant Streptococcus pneumoniae in the United States, which appeared in the December 28, 2000 issue of The New England Journal of Medicine (N Engl J Med 2000;343:1917-24), may be viewed for no cost at the journal's Web site at www.nejm.org. Most chiropractic school and medical school libraries also carry the journal.