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There are currently considerable challenges with the treatment
of infections caused by strains of clinically relevant bacteria that
show multi-drug resistance. New antibacterial are urgently needed, but
only one new class of antibacterial has been introduced in the last 30
years. Two new antibiotics introduced in 2002 are now withdrawn because
the bacteria have rapidly developed resistance.
Tabloid news papers hype-up publication about new advances,
antibiotics, antiseptics that kill bacteria in laboratory but the
reality is to find a cure is at present very bleak. We have to first
understand how bacteria develop antibiotic resistance, understand
bacterial cell wall structure and genetic make-up. New drugs must
undergo vigorous test to identify toxic effects before a safe antibiotic
can be developed.
Antibiotics market generates worldwide sales of over $26 billion,
despite the availability of low-priced generic products for many
infections. In recent years, eight antibiotics have attained annual
sales of more than $1 billion each. The growing medical problem of
drug-resistant bacteria presents a new and expanding market opportunity.
Bacterial resistance is causing many of the current antibiotics to lose
efficacy, while the pipeline of replacement products that target
antibiotic resistance is remarkably thin.
How & Why This Is Happening?
We simply don't trust our own immune systems to function properly.
Some doctors have made us all hypochondriacs we panic at the first sign
of trouble. For instance, we get the flu and rush to consult a doctor,
search for information in the internet. We demand a prescription for
some broad-spectrum antibiotic feeling like we might not actually live
to see another day. The antibiotics won't help us combat the flu since
viruses, not bacteria, cause the flu. Still, antibiotics are dangerous
since they select more virulent and more drug-resistant strains of
bacteria that are present in our digestive tracts.
Using a broad-spectrum therapy when a more specific drug would be
better, starting and stopping medications, giving leftover medications
to a friend who appears to have the same ailment you had." According to
the CDC, one-third of the 150 million outpatient prescriptions for
antibiotics written each year in the United States are unnecessary.
We feed antibiotics to livestock in order to promote growth and to
compensate for overcrowded and unsanitary conditions. In fact, nearly 70
percent of all antibiotics used in the U.S. are given to animals that
are disease-free. Overuse of antibiotics in livestock production as "a
major contributor to the creation of drug-resistant bacteria and thus a
direct assault on human health." Clearly, this use of antibiotics is
detrimental to our health, and yet it's a practice that still persists.
We must thanks antibiotic for the helping us bring in massive changes
in understanding and advances
in the quality of life possible in the western world. Bacterial
infections - in wounds, gut, lungs & brain killed most people in
the pre-antibiotic era in the west. Secondary Bacterial
infection (Staphylococcus aureus) was the reason millions died
during "The Flu Epidemic of 1918". Change in weather
helped to avert he problem as virus stopped spreading as the
crowds dispersed and was not due to miracle drug.
Influenza epidemic
The present generation of doctors and
patients are not familiar with common bacterial infections that
produce osteomylitis, epiglottis, tetanus, anthrax, syphilis, scarlet
fever, pneumonia and rheumatic fever. These conditions were not
common in the last 20 years because the antibiotics reduced the
duration of infections and prevented secondary illness.
It looks as if we are heading towards "Pre-Antibiotic era".
This is because the bacteriae have now developed resistance to
the very antibiotic invented by chance in 1940s. The doctors &
patients have abused them for conditions they should not have.
These antibiotics have been prescribed to animals, plants and
poultry making them useless to kill bacteria that infect us all.
Unless we develop another treatment soon, we see no future to
mankind and certainly not for medical profession.
People who develop, and control pharmaceutical industry, equipments, and medical device
manufacturers need to have woken up and start thinking about this
happening. They abandoned R&D and had assumed their investment on drugs
that offer symptomatic relief (arthritis, epilepsy, hypertension etc) is
going to give them the handsome reward which they are hoping for.
There are more people dying with infections in this world than people
suffering from pain, yet they ignored plea from doctors and statesmen
asking their help. This antibiotic resistant bacterial invasion is likely to bring in an abrupt
halt to all advances in healthcare, "The very technology we invented has
turned around to haunt us"
Computers revolutionised medical research but let our brain stagnate
resulting in rapid progress since 1980. One hundred years of advances in
medicine was compressed, packed in a box in the last decade and ready to
be buried in a time capsule.
Now I wonder how other doctors like me, who have published papers and
warned the healthcare professionals against abusing antibiotics,
performing irrelevant investigations and un-necessary procedure are now
thinking?
I feel sad to some extent but at the same time feel sorry for those who
are aspiring to be the doctors of tomorrow, "We have been instrumental
in bringing an end to our own profession". I personally thank the
pharmaceutical giants & medical equipment manufactures for their
contribution.
The world will be a better place for few who could weather the storm and
survive this swamp of bugs that are gathering momentum for a major
assault in this planet.
History
In 1928, Alexander Fleming
noticed that a patch of the mould Penicillium notatum had grown
on a plate containing the bacteria Staphylococcus aureus
and that around the mould there was a zone where no Staphylococcus
could grow. He named the active substance penicillin but was unable to
stably isolate it.
Several years later, in 1939, Ernst Chain and Howard Florey developed a way to isolate penicillin and used it to treat
bacterial infections during the Second World War. The new drug came into
clinical circulation in 1944 and made a huge impact on public health.
Their discovery and development revolutionized modern medicine and paved
the way for the development of many more natural antibiotics.
Antibiotics paved the way for doctors to develop
new technologies (IVF, plastic surgery, hip replacement, minimally
invasive surgery, stents, total parentral nutrition's, transplant
surgery and cardiac surgery). These technologies have made some doctors
rich and famous but now the very technology is threatening our existence
in this universe.
Identifying a fungus like Penicillium notatum
and extracting the enzyme to produce penicillin commercially took more
than 20 years. Now we have this bacteria, armed with some eight toxins,
mastered genetic manipulation and knows very well how to change and
adopt to survive.
Investing in Antibiotic research and development was not profitable to
satisfy the investors in pharmaceutical companies so was abandoned in
1970s.
Now its too late and they are unlikely to find a new treatment and so
are now busy investing in rapid testing kits to help identify the
bacteria. This makes sense to insurance companies, hospitals who are
striving to keep infection rate low and investors. As doctors we must
not forget the basic rule & ethics of performing a diagnostic test is to
identify and offer treatment. We must not perform a test knowing there
is no cure, this is likely to produce more distress than comfort.
Some drug companies are raising our hope by fast tracking publication in the media
and some are also cashing in giving us the wrong information. We don't think
any of these will help as we know the vaccination developed was found to
have short term immunity.
Using
Germicidal
Wipes can spread bacteria
because they were found not to kill and
antiseptic soap was found to increase colonization of antibiotic
resistant bacteria on our skin.
Most of us think we will have immunity to these bacteria,. Yes we would
have but the genetic make up of this is different, they know how to kill
the army of white cells in our body. White cells are necessary to defend
us from invading predators.
These drugs were also used in veterinary medicine to treat infections.
Small dose of antibiotics were widely used to promoting growth of farm
animals
and in various food industries. Now the pigs are said to be colonized
with the same bacteria which infect us. Over use of antibiotics, inadequate
dose and patients not completing the course as advised has given the
bacteria to gradually
develop resistance.
In general, healthy people are not at risk of MRSA infection in
hospital. Factors that increase the risk include length of stay in
hospital, use of multiple antibiotics, severity of illness, recent
surgery, and use of invasive procedures and presence of medical devices
(e.g. catheters, cannulae, and tubes).
"The time may come when penicillin can be bought by anyone in the
shops. Then there is a danger that the ignorant man may easily under
dose himself and by exposing his microbes to non-lethal quantities of
the drug make them resistant. " Dr Alexander
Fleming, Dec. 11, 1945
Antibiotic Use:
Inappropriate, under dosing, patients not taking prescription
as advised and overuse, contributes to resistance. If
your skin infection isn't improving after a 2-3 days of taking an
antibiotic, contact your doctor.
Taking antibiotics for common cold, viral infections leads to
staphylococcus developing resistant strains in your body. When
you're prescribed an antibiotic, make sure you take all of the
doses, even if the infection is getting better. Don't stop
until your doctor tells you to stop.
Don't share antibiotics with others or save unfinished
antibiotics for another time.
Persistent Staphylococcus aureus is said to be
device-associated infection. Patients with continuous
high-grade bacteremia who do not have acute bacterial
infections, an abscess, or a device-related infection should
be considered to have antimicrobial "tolerance" as a possible
cause. Antimicrobial "tolerance" is defined as a wide
discrepancy between the minimal inhibitory concentration and
the minimal bactericidal concentration of an isolate.
Tolerance was first described in Staphylococcus aureus and has
since been described with streptococci and enterococci.
Despite apparent in vitro susceptibility, infections caused by
"tolerant" strains are not cured by appropriate antimicrobial
therapy. The lack of bactericidal activity of the antibiotic
becomes apparent when minimal bactericidal concentrations are
determined for "tolerant" strains, and there is a great
discrepancy between the minimal inhibitory concentration being
used. Antibiotic tolerance to S. aureus has been described
with a variety of antibiotics.
Up-Date
About Antibiotics
Tomasz and colleagues found a new
antibiotic called Ceftobiprole annihilated colonies of MRSA.
Like penicillin – one of the first and still one of the most
widely used antibiotic agents – Ceftobiprole binds enzymes
crucial to making bacterial cell walls, ultimately killing the
bacteria. Although Tomasz is excited about this new potential
weapon against MRSA, he cautions that bacteria are true
survivors and capable of finding a way around any drug, even
Ceftobiprole. So the war against Staphylococcus aureus
continues.
The general claim put forth goes something like this: bacteria,
insects, rodents and other undesirables (as far as we're
concerned) are encountering manmade toxins such as antibiotics,
and toxic chemicals such as DDT and warfarin, designed to kill off
the offending nasties. In response, some of these creatures are
adapting, changing and achieving capabilities that enable them to
resist the toxins threatening to destroy them. These
drug-resistant strains, we are told, are evolving.
According to some doomsayers we are now faced with plagues of
untreatable "super germs" that will wreak havoc among Western
civilization, striking down innumerable people as doctors watch
helplessly, unable to prescribe an effective cure.
According to standard (monophyletic) evolutionary theory, all
life on earth is descended from an original population of very
simple single-celled organisms, perhaps something like algae. One
of the inescapable conclusions of evolution, therefore, is that
organisms have attained additional capabilities, additional
functional structures, and greater complexity over time. This is
unavoidable. No matter how one fudges, somewhere between algae and
man all of the structures, systems, and abilities we see in the
human body must have developed through the interplay of
non-sentient natural processes.
Malaria meds have knock-on effect in bacteria
Searching for a cure
Read about Influenza 1918 and the American experience to
understand the gravity of this situation. People infected with
Influenza virus were immune-compromised, developed secondary
infection with Staphylococcus aureus which killed them.
Estimated potential worldwide death toll ranges from 7.4
million to 180 million to 360 million, extrapolating 1918’s
deaths to today’s population. Given global air travel, the virus
could spread swiftly, possibly reaching all continents in three
months, the WHO asserts. The federal government fears that 9
million Americans may become sick; most experts now assess the
potential mortality rate at 1.5 percent to 2 percent. An index
of how overtaxed health-care resources might become is the
Centres for Disease Control and Prevention’s estimate of roughly
200 million outpatient visits and 2 million to 5 million
hospital admissions.
Keeping with the belief that doing anything to fend off
influenza was better than sitting idly by, waiting to become a
statistic.
New Antibiotic
Aminomethylcyclines (AMCs)
AMCs were evolved from tetracycline antibiotics as potential
agents to combat multiple antibiotic-resistant bacteria,
including MRSA, penicillin-resistant Streptococcus pneumoniae
(PRSP), vancomycin-resistant Enterococcus (VRE), multidrug
resistant Escherichia coli and other difficult-to-treat
pathogens. Introduced more than 50 years ago, tetracyclines
remain among the most commonly used antiinfective agents to
combat bacterial infections. However, the emergence of
resistance has curtailed their effectiveness in certain
infections. Paratek has utilized its expertise to create AMC
compounds, such as PTK 0796, that retain the appealing safety
and spectrum of activity of the tetracyclines while overcoming
tetracycline and multi-drug resistance.
Linezolid (Zyvox)
New Antibiotic was approved by the Food and Drug Administration
(FDA) in 2000 to treat a variety of infections, including some
caused by bacteria resistant to the drug methicillin.
Methicillin – resistant Staphylococcus aureus (MRSA) has become
a major cause of infections both in hospitals and communities.
For years the antibiotic vancomycin had been a last line of
defence against infections caused by MRSA and other
antibiotic-resistant “super bugs,” but now vancomycin-resistant
infections have been reported.
Linezolid is among the first new treatments
for MRSA infections since vancomycin was introduced in the
1950s. Unlike other newer antibiotics for MRSA and VRE,
linezolid can be given orally, as well as intravenously, making
it suitable for outpatient use.
Linezolid produced a clinical
cure for 81 percent of patients, while the comparator
combination was effective for 71 percent of patients.
Statistically, the overall results for the two groups were about
equal. However, linezolid outperformed the
aminopenicillin treatments in the largest subgroup: patients
with an infected ulcer, as opposed to cellulites, osteomyelitis,
or other less common types of diabetic foot infections.
Ceftobiprole
Ceftobiprole has been granted "fast-track" status from the
FDA and is licensed from, and is being co-developed with,
Basilea Pharmaceutica Ltd, Switzerland, through an exclusive
worldwide collaboration.
New drug, called Ceftobiprole, was tested against some of the
deadliest strains of multidrug-resistant Staphylococcus aureus (MRSA)
bacteria, which are responsible for the great majority of staphylococcal
infections worldwide, both in hospitals and in the community.
By targeting the gene that confers such resistance, a new drug may be
able to finally fight them. Rockefeller University scientists tested the
new drug, called Ceftobiprole, against some of the deadliest strains of
multidrug-resistant Staphylococcus aureus (MRSA) bacteria. Ceftobiprole
worked against bacterial clones that had already developed resistance to
other drugs. Previous research had already shown that — in general —
Ceftobiprole was highly effective against most clinical isolates of S.
aureus.
In the past newer antibiotic arrives on the scene, and sooner or
later resistant bacteria emerge.
Ceftobiprole vs.
Vancomycin
In patients with complicated skin infections, outcomes were similar
for ceftobiprole (a broad-spectrum cephalosporin with activity against
MRSA) and vancomycin
Dalbavancin
Pfizer announced today
that it would withdraw
marketing application being considered at FDA and the European Medicines
Agency (EMEA) for Dalbavancin an antibiotic it was developing for
complicated skin infections caused by bacteria including methicillin-resistant
Staphylococcus aureus (MRSA).
Chemicals in Marijuana May
Fight MRSA
Study Shows Cannabinoids May Be Useful Against Drug-Resistant
Staph Infection
Researchers in Italy and the U.K. tested five major marijuana
chemicals called cannabinoids on different strains of MRSA (methicillin-resistant
Staphylococcus aureus). All five showed germ-killing
activity against the MRSA strains in lab tests. Some synthetic
cannabinoids also showed germ-killing capability. The scientists
note the cannabinoids kill bacteria in a different way than
traditional antibiotics, meaning they might be able to bypass
bacterial resistance. Ref: G. Journal of Natural Products,
2008; vol 71: pp 1427-1430
Manuka Honey
Researchers have examined MRSA that has come in contact with Manuka
Honey and have determined that MRSA cannot survive in the healing
environment created by Manuka Honey. MRSA is a bacterium that grows and
divides into two similar cells every half hour. It divides by forming a
wall across the middle of the cell, which then splits in half to create
two new cells. Studies have shown that Manuka Honey interferes with the
cell cycle of MRSA by affecting the separation of new cells, so that
cells unable to complete division are disabled at that point in the cell
cycle.
All types of honey contain hydrogen peroxide which is a known antiseptic
and disinfectant. Manuka honey has an additional antibacterial component
making it much more effective for therapeutic use. This additional
component, known as UMF, is unaffected by enzymes that dilutes the
effectiveness of regular honey. It remains active when used as a wound
dressing and diffuses deeper into skin tissues.
Manuka Honey is also considered to be antimicrobial and, therefore,
capable of treating local bacterial and fungal skin infections. We are a
long way from using this as a cure or using the knowledge to develop new
antibiotics.
Bacteriophage
Use of
Bacteriophage for local and intestinal infections is still
controversial but there is no treatment available for treating
bloodstream infection. Some microbiologist think MRSA will be
more virulent when they are infected with a bacteriophage.
Bacteriphage can
carry plasmid from one bacteria to another.
MRSA and other super bugs have made many people anxious, and
they are looking for ways to avoid these germs. But everyone
needs to know that antibacterial products are NOT the best line
of attack against MRSA and other germs. While they can help in
a pinch, overuse is linked to antibiotic-resistance
The Ganges is a place of death and life. Hindus from all
over will bring their dead. Whether a body or just ashes, the
waters of the Ganga are needed to reach Pitriloka (the World of
the Ancestors). Just as in the myth with King Sargas' 60,000
sons who attained heaven by Ganga pouring down her water upon
their ashes, so the same waters of Ganga are needed for the dead
in the Hindu belief today. Without this, the dead will exist
only in a limbo of suffering, and would be troublesome spirits
to those still living on earth. The waters of the Ganges are
called amrita, the "nectar of immortality".
ATEL Ventures Invests $1.8 Million of
Financing in GangaGen, Inc.
Innovative approach revolutionize
the treatment of antibiotic resistant bacterial infections such
as Methicillin-resistant Staphylococcus aureus (MRSA) using
bacteriophage....
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