Posted on 01/19/2018 10:00:38 PM PST by nickcarraway
With the rise of superbugs, the impact of drug resistance is becoming more serious. One woman tells Talking Point how it left her blind and "like a child". Read more at
It started with a fever. To fight off the infection, Madam Siti Hajar had to rely on antibiotics, as her immune system was weak owing to her diabetes.
But even when she returned to work, she did not feel any better. In fact, her vision began to be affected. So the next day, she went to Changi General Hospital’s accident and emergency department.
“I only remember going to hospital and then registering and seeing the nurse, and from there, I can’t remember anything else,” she told the Mediacorp programme Talking Point. (Watch the episode here.)
After admission, she was diagnosed with a strain of klebsiella pneumoniae that was resistant to multiple antibiotics. That bacterial infection in 2016 left her blind and in embattled health as it spread to her other organs.
Since their discovery, antibiotics have been wonder drugs for millions of patients in the fight against diseases. But they could not help Mdm Siti, 45, who is now living with the effects of a superbug infection.
WATCH: "It affected my whole life" (2:28)
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4 IN 5 WRONGLY THINK THEY CURE COLDS
Like her, one in nine hospital patients here have now been infected by superbugs, bacteria that have become invulnerable to antibiotics over years of exposure.
Worldwide, overuse of antibiotics has led to the rise of antimicrobial resistance. And in Singapore, the problem is compounded by a lack of knowledge of how these drugs work.
Research done by public health experts has found that 78 per cent of Singaporean patients think antibiotics cure infections like common colds and sore throats.
And 66 per cent also believe that antibiotics help these upper respiratory tract infections, which are commonly caused by viruses, to heal faster.
That is why a third of patients expect to be prescribed these drugs - which work only against bacteria, not viruses - when they visit their general practitioners. And if these are not given, some patients would visit another doctor.
Family physician Kelvin Goh from the Northeast Medical Group has faced such pressure from patients, some of whom may insist on antibiotics owing to a “bad experience”.
“They may have seen a doctor for a viral infection. They were told (they) didn’t need antibiotics and subsequently developed a bacterial infection that necessitated either hospital or specialist care,” he explained.
TEST BEFORE PRESCRIBING
The way to distinguish between bacterial and viral infections, he said, is through a good clinical history and good physical examination, supplemented by blood tests and other culture infection tests.
A minority of infections are caused by bacteria, noted Assistant Professor Mark Chen from the National University of Singapore’s Saw Swee Hock School of Public Health, and “some doctors may prescribe antibiotics because they’re worried about missing these respiratory infections”.
But doctors should be more willing to take swabs and do simple tests instead, highlighted Dr Goh.
“We need to educate both the professionals and the public. The doctors must gain the patients’ trust,” he added. “(Only then would) the patient take the advice of the doctor that … no antibiotic is needed.”
If all else has failed, Dr Goh has given these drugs to patients who asked for them, “but we’ll tell them clearly that (they have) a viral infection”.
There are patients, he said, who obtain antibiotics online or from overseas if they cannot get them from any one of the 2,600 GPs here.
While such behaviour is not common, Talking Point did find a number of websites claiming to be online pharmacies – operating outside Singapore – that sold these drugs, allowing patients to get them without prescription.
Though antibiotics cannot be bought over the counter here, patients could still buy them on established platforms like eBay and Carousell, and have them delivered to their home.
WHEN EVEN A CUT BECOMES DEADLY
But the consequences of misusing and developing a resistance to these drugs can be “very worrisome”.
For one thing, the discovery of new antibiotics has slowed in the past few years because the endeavour “is no longer profitable”, said Dr Andrea Kwa, a clinician scientist and specialist pharmacist (infectious diseases) at the Singapore General Hospital.
Resistance to the new drugs occurs within two to three years now, which is “way shorter than their patent period”, she explained.
“Simple procedures like hip replacement, appendectomy (and) emergency caesarean may get more and more difficult to perform, because the infections that could come about as a complication can be more resistant,” she added.
It could get worse if no antibiotic will be effective.
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Associate Professor Hsu Li Yang, who leads the Saw Swee Hock School of Public Health’s Antimicrobial Resistance Programme, said:
We’re concerned that … people with the simplest types of infections, like (from) a prick on a rose thorn or cuts, can die.
To prevent the build-up of bacterial resistance, the development of new drugs must be accelerated or the improper use of antibiotics must be reduced, he said, citing the example of patients with viral infections.
“We can also increase vaccination, even (against) conditions like influenza,” he added. “If patients do not present (themselves) at the doctor’s with coughs and colds, then the doctors won’t prescribe antibiotics, so … we also reduce the antibiotic pressure overall.”
To help stop the rise of superbugs in hospital, Dr Kwa has a team monitoring antibiotic use and also developing counter-strategies, such as by designing tests of antibiotic combinations if an individual drug is not useful.
As new cases start to reveal the effects superbugs can have, the war against them is likely to intensify.
Mdm Siti is already one of the casualties. “This bacterium (klebsiella pneumonia) has affected my whole life,” she said. “Now I’m like a child, a toddler learning to how to walk … how to carry on with life.”
Watch this episode of Talking Point here. New episodes air on Mediacorp Channel 5 every Thursday, 9.30pm.
Truly the dumbest article on the topic I’ve ever read.
If this is the apex of modern medicine’s knowledge, I’d like to know where to get the doctorate I deserve for knowing more.
Could you explain what was dumb about it?
we should not expect antibiotics for colds, sore throats, runny nose, sinus headaches, etc....
but we do...and many demand it or its the fault of the mean old doctor who "didn't do anything"....
its the same problem with the overuse of opioids and the resultant abuse....
Americans in particular think everything is solved by a pill....
heck look at Viagra.....Viagra for old men who normally would have lost that function years ago NATURALLY but we can't accept natural aging anymore...
This is apples and oranges and pears and grapenuts.
The issue with antibiotics is that their casual use selects for the resistant strains in the general population, which then become predominate, ( according to this logic ) and the casually used antibiotic becomes ineffective.
I don’t think this line of reasoning applies to the other examples you mention. Correct me if I’m wrong ... and I mean that sincerely!
It completely fails to address antibiotics’ impacts on human health by wiping out the core of the immune system, made worse by citing development of “new drugs” rather than restoring health to the overmedicated, sickly population.
The next flu pandemic won’t be a repeat of 1918; it will simply be a culling of those with inadequate immune systems due to a combination of lifestyle and self-abuse by all types of medications (pharma, OTC & herbal), plus the atypical vulnerable victims (young & old).
But the facts will be as elusive as those on Paddock.
Yes, it’s true that it’s good that overuse of antibiotics is being openly discussed (/s)...if those promoting that view of this article are ignorant that they were warning about overuse of antibiotics and resistant strains nearly a half century ago.
Look it up.
History lesson is in order:
Overuse of Antibiotics
From the very beginning the sense that antibiotics were risk-free led to overuse and abuse. Leighton Cluff, testifying before the US Senate in 1967, stated that “drugs are used excessively by the public and are prescribed excessively by physicians,” and that this “excessive and indiscriminate use,” especially of antibiotics, should be curtailed: “In the surveillance of the use of antibiotics at the Johns Hopkins Hospital in the months of December and January it is not at all uncommon for forty percent of the patients in the hospital to receive at least one antibiotic, and it is inconceivable to me, because one of my major interests is infection, to believe that forty percent of the patients in the hospital require an antimicrobial drug, so that in this instance I think that there is no question but that these drugs are being used excessively. It is not at all uncommon for a physician in practice to administer penicillin, for example, or any other antimicrobial drug to patients with viral respiratory disease when it is patently clear from the scientific literature that this is absolutely of 110 value.”73
In 1972 US authorities certified twenty-four tons of the eight most commonly used antibiotics—enough to treat two illnesses of average duration for each man, woman, and child in the country, whereas the average individual suffers from such an illness about once in five or ten years. Between 1960 and 1970 the production of antibiotics for medicinal purposes increased 320 percent.74
By the late 1970s up to fifty tons of penicillin were being sold in the United States each year; one person in every’ four was taking it, and ninety percent of this use was a waste.75 In this decade Americans were consuming ten to twenty thousand tons of aspirin every year as well.76
In 1973 Calvin Kunin concluded that nine physicians in ten will prescribe a drug for a patient with the “common cold”; sixty percent of the prescriptions will be for antibiotics, such as tetracycline or penicillin, which are of 110 use in the “common cold”; and over half of the hospital patients receiving antibiotics either showed no evidence of infection or received the wrong medicine.77
A 1976 federally funded study of antibiotic use in Pennsylvania hospitals announced that surgery patients were being routinely given these substances for days after their operations, as a prophylactic measure, and that this irrational use accounted for one-fifth of the hospitals’ antibiotic consumption.78
Overall, one-third of patients in US hospitals receive a course of antibiotic treatment, accounting for up to twenty percent of all new and refill prescriptions.79
Careless prescribing is often exacerbated by incorrect diagnosis. A 1972 analysis of a thousand patient records in Ohio hospitals found that 340 received antibiotic treatment: the prescription was justified in only thirteen percent of the cases, questionable in twenty-one percent, and entirely irrational in the remaining sixty-six percent.80
Antibiotic therapy is common in chronic bronchitis, and yet the death rate in England from this condition was the same in
1970 as in 1935. A trial was done on two groups of patients, one given physical therapy and bronchial dilators, the other given antibiotics as well:
We found that there wasn’t much difference in recovery and mortality rates of the two groups. This sort of evidence makes me worried as to whether antibiotic therapy is a very good thing in chronic bronchitis.—Owen L. Wade, 197 l81
The physician may prescribe an antibiotic rather than refine his diagnosis. Kunin observed in 1973: “The ready availability of the new agents ... has changed the approach of physicians to the care of desperately ill patients. This change in practice also affects the care of patients with only minimal infection or in whom infection is only threatened. The physician, desiring to provide his patient with the very best in modern care, and separated from an effective diagnostic bacteriologic laboratory system, has resorted to overuse of these powerful and expensive agents. He is now resorting more and more to the drugs of fear, agents that help him resolve his fear of failing to give his patient what he believes is the very best drug. But, if he were willing and able to perform and properly interpret a few simple tests ... and if he recognized the limitations of antibiotics, the possibility of failure would be greatly lessened, and the patient would be spared toxic hazards and unnecessary expense.”82 And the US Food and Drug Administration Commissioner noted a year later: “As long as the treatment of disease is as nonspecific as it is, I think we are going to continue to overuse antibiotics.”83
Indeed, stated Paul Stolley and Louis Lasagna in 1969, since a GP cannot usually establish the diagnosis at the first visit, a prescription given at this time will be “based on a hunch, on in-
tuition, on the balance of probability, and on experience rather than on established certainty.”84
A particular source of concern is the “prophylactic” use of antibiotics—to compensate for unhygienic conditions or just on general principles:
Antibiotic prophylaxis against the bacterial world at large is not practical and, in fact, may induce more infection than it aims to prevent ... [It] does little more than ensure that the superimposed infections will be resistant to the antibiotics used. One survey showed that two-thirds of all patients who were admitted, exclusive of the obstetric and newborn services, received antibiotics, most of which were given prophy-lactically before operations. In another study, bacterial complications in clean operations were five times higher in prophylactically treated patients than in patients not given antibiotics prophylactically ... Prophylaxis is often used but is not only valueless, but also sometimes dangerous in viral infections, routine preoperative or postoperative care, comatose patients, bulbar poliomyelitis, tracheotomized patients, very ill patients with noninfectious diseases, and patients receiving steroid therapy.—B. M. Kagan et al., 197385
http://vaksinite.info/divided%20legacy.html#bookmark164
The only question remaining now is this: Who do you trust now?
I used to be a “don’t take antibiotics” guy. Still kinda am, but, when you think about it all.... Say your sick, you have a virus... And you take a full course of antibiotics, it won’t do anything to the virus. You didn’t have a bacterial infection, so how could that bacterial infection (that you don’t have) mutate to into a resistant strain?
Now, if you had a bacterial infection you would take antibiotics to kill it off, and yes maybe there might be a resistant couple of bactiurm there.
So I don’t know how taking antibiotics when you don’t have a bacterial infection causes antibiotic resistant bacteria.
Guess I need to read the article again.
I would rather let my body’s miraclus immune system do what it was programmed to do and then build up some antibodies.
“The issue with antibiotics is that their casual use selects for the resistant strains in the general population, which then become predominate, ( according to this logic ) and the casually used antibiotic becomes ineffective.”
That is essentially correct. The problem is increased by some countries where antibiotics are sold over the counter. To make matters worse, bacteria have very efficient ways of transferring antibiotic resistance between individuals and even between very different species.
Yep - I have seldom used antibiotics and my 65 year old system manages to fight off most maladies by itself. Seldom get the Flu shot and have caught some “bad colcs” over the years but cannot remember the last time I had the actual Flu.
What’s the height of medical malpractice is the use of antibiotics to treat a viral infection. If you have viral pneumonia and you are given antibiotics it is as useless as a placebo. Doctors should give an intiviral medication to inhibit the spread of the virus. Such medications are oseltamivir (Tamiflu), zanamivir (Relenza), or peramivir (Rapivab).
You can lower your risk of viral infections by healthy health practices and vaccines. One important step is washing ones hands:
Before, during, and after preparing food
Before eating food
Before and after caring for someone who is sick
Before and after treating a cut or wound
After using the toilet
After changing diapers or cleaning up a child who has used the toilet.
After blowing your nose, coughing, or sneezing
After touching an animal, animal feed, or animal waste
After touching garbage
Another step is not engaging in practices that compromise your immune system. Smoking cigarettes, excessive use of alcohol or being undernourished adversely affects ones immune system. Picking up HIV from lifestyle practices destroys the immune system.
Finally, stay away from people who have colds, the flu, or other respiratory tract infections.
I got really sick from a pneumonia shot called Prevnar 13. The same doc who pushed the shot on me said it could not make me sick and my illness shortly after the shot was just a coincidence prescribed an antibiotic for 10 days. When that one didn’t work he prescribed another for 10 days which didn’t work either.
I finally went to an ENT specialist who found the one that worked and he was open to the fact that the shot caused the problem
Here is an article about the dangers of the Prevnar antibiotic: https://articles.mercola.com/sites/articles/archive/2012/05/22/pneumonia-vaccine-shown-to-actually-increase-bacterial-infections.aspx
When an anti-biotic is proscribed you are supposed to take the full course as directed, all of them and not stop taking it when you feel better. Stopping taking it as soon as you feel better may mean that the bacterial hasn’t been completely killed and therefore has an opportunity to mutate into a strain that is more resistant to the anti-biotic – that which does not kill it makes it stronger.
A lot of people do this and they save them and take some or the rest of the Rx at the first sign of a sniffle, not understanding that 1) an anti-biotic is not to relieve symptoms but to kill bacteria and 2) does nothing against viruses.
Any doc that prescribes antibiotics for a runny nose is an idiot. Viruses are not treated with antibiotics.
Having a runny nose? Odds are it’s fungal, so have a few drops of Mediterranean Oregano oil. Beats catching a cold. My favorite brand is North American Herb and spice P73 brand.
The natural anti fungal components that grow in spicy oregano are it’s fungal defense and are concentrated in an oil extract.
It is best taken when you first notice that scratchy throat/runny nose feeling. 9 out of 10 times it stops right there.
Also works great on mild food poisoning cases, commonly called a stomach flu. I don’t travel without it.
That gives me hope. I’ve had the same view even years before my health took a nosedive, leading to my recovery and my (still writing) unpublished books.
In fact, during the H1N1 scare (I write that sarcastically, given my view on the flu in this country) I had an open call out to anyone who got it, as I wanted to come over and make them dinner. I view illness as immune system exercise.
We live in a hostile environment (our biosphere) and far too many people take for granted the ability we have to survive in it. Public health in this country is a disaster...
...this 50 year “debate” on antibiotics is but one symptom of the problem I’m shocked more FReepers aren’t engaged in:
Control of the population by making them dependent upon doctors/government.
It almost sounds ‘conspiracy theory-ish’ but those who know the truth about radiation experimentation upon the American public by government agencies who were later responsible for the implementation of water fluoridation have some insight into this aspect. The topic was so voluminous that it became a large, significant part of the third volume in my book series.
Notably, I never, EVER expected the tone of my books to demonstrate that government was responsible for the public health disaster in this country, but the evidence is there in nearly every single chapter not weighted by lack of personal responsibility alone.
I grew up in the ‘50s and there were only a few vaccines. When a kid got measles or mumps, the Moms would get together and hold a measles/mumps party to get all the kids exposed - while there were some potential serious issues with both, none of us had them and I believe the non-sterile environment helped us develpp decent immune systems. Hope your health is on the uptake.
For common cold take oil of oregano and colloidal silver. You can get both at the health food store. If you start taking oil of oregano at the first sign of a cold it will either stop it from progressing or greatly shorten it. Its a strong anti viral. Colloidal silver acts as an antibiotic.
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