Six out of ten
BBC India correspondent Soutik Biswas reports:
At the 1,000-bed not-for-profit Kasturba Hospital in the western Indian state of Maharashtra, doctors are grappling with a rash of antibiotic-resistant “superbug infections”.
This happens when bacteria change over time and become resistant to drugs that are supposed to defeat them and cure the infections they cause.
To be a little more precise, it happens when natural selection does what it does: selects the bacteria that because of a favorable mutation are able to resist the antibiotic. The more the antibiotic is used, the more of those bacteria there are.
Such resistance directly caused 1.27 million deaths worldwide in 2019, according to The Lancet, a medical journal. Antibiotics – which are considered to be the first line of defence against severe infections – did not work on most of these cases.
This is why antibiotics should not just be thrown around like popcorn.
India is one of the countries worst hit by what doctors call “antimicrobial resistance” – antibiotic-resistant neonatal infections alone are responsible for the deaths of nearly 60,000 newborns each year. A new government report paints a startling picture of how things are getting worse.
…
Saswati Sinha, a critical care specialist in AMRI Hospital in the eastern city of Kolkata, says things are so bad that “six out of 10” patients in her ICU have drug-resistant infections. “The situation is truly alarming. We have come to a stage where you are not left with too many options to treat some of these patients.”
Meanwhile an ignorant “Health Secretary” in the UK hands out antibiotics as if they were aspirin.
A widespread lack of knowledge about antibiotics means that most patients – rural and urban – are not aware of antibiotic resistance. Even the rich and educated take antibiotics if they fall ill or pressure doctors to prescribe antibiotics.
And not just in India.
When we were in Colombia in about 1985 we were surprised to see that you could buy antibiotics over the counter in pharmacies. We bought some, but never used them because by the time we were back in England common sense prevailed and we threw them away.
One of the worst offenders is the intensive livestock industry, where conditions such as the battery caging of chickens creates a situation highly favourable to the outbreak of epidemics. I believe antibiotics are routinely added to the stock fodder in those places as a perventative measure. ‘Who cares about the long-term consequences? Let tomorrow look after itself.’ That appears to be the attitude.
The loss of antibiotic resistance has been discussed for decades. Finding new antibiotics may seem like the way to deal with it, but an arms race can only continue, it is never won.
Bacteriophages, now. That’s another option to consider. https://www.frontiersin.org/articles/10.3389/fphar.2019.00513/full
Georgia, has done a great deal of research into them, while the rest of the world steered towards antibiotics.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)66759-1/fulltext
As is mentioned in the other posts, this is a huge problem with industrial livestock raising all over the world.
There are a few antibiotic agents designated as the absolute “last line of defence” – to only ever be used in human treatment when literally *nothing else* has had any effect, and to never ever be routinely prescribed *because of that critical designation*.
These medications treat bugs that are resistant to every other antibiotic on the market, infections that cause horrible, drawn-out death. These meds are the reason we no longer have Sepsis Wards in healthcare settings in Western countries – although it looks like we might be heading back that way…
These are treatments that can save lives in extremis. They *must* be handled as the critical interventions that they are.
What happens instead? These critical medications are routinely added to animal feed, thrown around like candy in industrial farming settings, because using them means more efficient animal growth/less disease burden in atrocious conditions. This is once more focusing on profit at the expense of welfare – and a complete disregard for the wider consequences.
Areas in the Indian Subcontinent, certain countries in Africa, have been warning the rest of the world for decades. Multi-Drug Resistant TB has been an issue for many years. We are heading back to a time when a tiny scratch in the skin could be someone’s death warrant, as has been the case for most of human history. Sure, some of it is stupid people not completing the full course of antibiotics, or demanding them unnecessarily, but a huge amount of the problem is industrial farming methods. Profit *uber alles*.
All the Pharma companies have little interest in developing new anti-microbial agents because there’s no instant pay-off for their shareholders. Companies refuse to put new drugs through testing because it costs money, and that isn’t coming back to shareholders. Companies hang on to patents and refuse to make drugs availible for the same reasons.
Without firm support from governments and international health authorities, and a willingness to recognise this issue, it’s only going to get worse. Humans are stupid, and greedy. The people who are going to suffer are the same ones who always end up suffering, and only when the incredibly entitled and wealthy idiots driving the profit cycle find out that no amount of money will stop a lethal infection will there be a serious attempt to fix the issue. By then, it’ll be too late. Just like everything else.
Self administration is a particular factor too. No matter how many times they’re told, patients stop taking the drug as soon as their symptoms improve. Just about guaranteeing a new colony of resistant bacteria. If every patient followed instruction and took the FULL course of the drug, there would be much less chance of resistant strains.
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