By Nigel Thorpe
Senior English Editor
Amman-Jordan
Impatient patients and defensive doctors, modern factory farming methods, and the secret 'sex life' of bacteria, are the three corners of the ‘superbug’ triangle that the World Health Organization believes threatens to make “once-treatable diseases incubable.”
The Superbug Triangle.
“Please doctor, I want an antibiotic for my cold (or ‘flu’).” This, according to a recent survey quoted by the Mayo Clinic, was the plea of nearly half of the patients seeking relief from the unpleasant symptoms of the common cold or influenza at primary care clinics.
According to the results of a survey published in the American journal, Archives of Family Medicine, most of 500 patients interviewed in the study knew that colds “improve on their own,” but only 43 percent were aware that viruses, and not bacteria cause colds and flu. The survey also found that most victims of the common cold believed that antibiotics would “help them get better quicker.” This common idea is completely untrue. To quote the Mayo Clinic, “Antibiotics are ineffective against the viruses that cause the runny nose, cough and other symptoms of the common cold. Dr. Bauman of the University of Hawaii suggests that “doctors (should) tell their patients that antibiotics cannot cure a cold or attack of influenza and do nothing to shorten the time that symptoms are present.” According to a 1998 report by the Institute of Medicine, up to 50 percent of the antibiotics prescribed by doctors are unnecessary and potentially harmful. The natural wish of over-worked doctors to please their patients, and the climate of ‘defensive medicine’ that came in the wake of escalating numbers of malpractice suits, are the two key factors which drive expensive and potentially lethal 'antibiotic abuse.'
The WebMD webpage explains that the only justifiable use of antibiotics to treat colds is to combat secondary “opportunistic” infections by bacteria that may follow infections by the common cold or influenza virus in very young and very old individuals. Patients already suffering from medical problems which weaken the body’s natural immune system are also likely to need antibiotics.
In these cases, the antibiotics are targeted not at the primary cause of infection, the virus, but at secondary infections by common bacteria which “sneak into” the body while its defenses are down.
Having demanded, and most case got, their antibiotics, many patients unknowingly contribute to the “superbug problem” by failing to complete their course of medication. As their unpleasant symptoms disappear, many patients feel they are “cured” and need not take the tablets remaining in the bottle. This provides the perfect opportunity for any nascent superbugs they unknowingly habour in their body to begin increasing in both numbers and virulence.
Decades of large scale misuse of antibiotics by vetinary surgeons and farmers on live stock farms forms the second corner of the deadly superbug triangle. Starting with the once “all powerful” , penicillin, modern factory farming methods demanded that antibiotic be added to animal foodstuff to improve the economically important “feed to meat conversion ratio.” In a relatively short time, the wide menagerie of farm bugs “learnt” how to manufacture an enzymes( e.g. penicillinase ) which breaks down the antibiotic peniciillin before it call kill the bacteria by inhibiting their growth. When penicillin lost its effectiveness, factory farming turned to other antibiotics to which, in turn, new strains of superbug developed resistance.
The third corner of the superbug triangle involves the transfer of antibiotic immunity from one type of bacteria to another on farms, and in hospitals. A ring of DNA ring (plasmid) that carried the instructions on how to make the penicillinase protein passing from a “farm bug” to a completely different species of bacteria that can infect humans during a form of sexual reproduction.
The human pathogen (the bacteria capable of producing disease in human beings) is converted into an antibiotic immune superbug in the process.
The invention of new “miracle” antibiotics is one way in which pharmacists and medics can keep “one step” ahead of the superbugs. In April, 2000, a new drug, Zyvox, received a great deal of publicity following clinical trials that showed that it cured two thirds of patients with “superbug” strains of the dangerous bacteria Saphylococcus aureus which were immune to all available antibiotics. Zyvox blocks the growth and multiplication of the bacteria by inhibiting the synthesis of protein within their cells raising hopes that this new type of antibiotic will also halt the mutation process (generation of new types of bacterial protein) that leads to antibiotic immunity. Medical experts and bacteriologists, however were soon asking “for how long will Zyvox be a ‘miracle drug’?” The science reporter for the TIME magazine, Janice Horowitz, for example, wrote "The truth is we don’t know who’ll win the race. Will we be able to stay ahead of the bacteria, or will they mutate (change) to be stronger than anything we can produce?” Thousands of American each year now fall victims to the expanding array of superbugs and as Horowitz notes, “Antibiotic resistance is a huge problem both in nursing homes and in hospitals, where people’s immune systems tend to be compromised to begin with.” Meanwhile, the pharmaceutical companies, are in an escalating race with both their competitors and the superbugs to produce new “miracle superdrugs” that have the ponential of earning them millions of dollars and saving millions of lives in the next decade.
Three changes could give pharmacists and biochemists the change to win this vital race: first, patients must be educated to be patient and complete their courses of antibiotic when they are really required; secondly, doctors must stop the overperscription of antibiotics; and finally, the farming industry will have to learn to live without the widespread use of antibiotics down on the farm. As for the sex life of bacteria, that is certainly the one corner of the superbug triangle that at present impossible to control.
© 2001 Al Bawaba (www.albawaba.com)
