24 March, 1999
By Bruce Sullivan
CNS Staff Writer(CNS) – They have big Latin names like staphylococcus aureus and streptococcus pneumoniae, but most people call them germs and they are changing and becoming more resistant to our current slate of antibiotics.
They can turn a scratch into a life-threatening case of blood poisoning and a cold into a fatal case of pneumonia; conditions that killed millions of people until Scottish physician Alexander Fleming invented penicillin in 1928.
Over seventy years later those bacteria, and a host of others, are still here and evolving into super-bugs that are becoming increasingly resistant to not just penicillin, but the whole family of antibiotics that followed.
"Bacteria are cagey, tenacious organisms that swiftly develop resistance to antibiotics," said Sen. Bill Frist (R-TN).
Frist, a former transplant surgeon and now chairman of the Senate Subcommittee on Public Health and Safety, is holding hearings on the growing problem of drug-resistant bacteria.
The ability of bacteria to evolve into better, tougher versions of themselves is not new, nor unexpected. They are simply obeying the same evolutionary law that gave birds their wings, snakes their venom, and men their opposing thumbs – the law of survival of the fittest. However, while it may take a primate millions of years to develop a trait by passing on a slightly improved version from one generation to the next, rapidly reproducing bacteria can acquire new defenses in a few years.
"In fact," said National Institute of Allergy and Infectious Diseases Director Anthony S. Fauci, M.D., "resistance pre-dates the discovery of antibiotics and is an inevitable result of the rapid replication and evolution of microbes."
This ability to develop defenses against antibiotics like penicillin, and its more powerful cousins like erythromycin, amoxicillin, and vancomycin, is making the medical community take a hard look at the unnecessary use of these powerful drugs.
"The innate adaptability of microbes is accelerated by the selective pressure of widespread and often inappropriate use of antimicrobial agents [antibiotics]," said Fauci when testifying before the Senate subcommittee in February.
Reducing the unnecessary use of antibiotics will take a lot of education, not only of physicians, but their patients as well, said Dr. Edward Belongia an epidemiologist at the Marshfield Medical Research Foundation.
"The golden age of antibiotics use is over," Belongia told CNS.
Belongia said that doctors are now being taught in medical school not to prescribe antibiotics indiscriminately, nor just to placate some patients who view antibiotics as cure-alls.
A common misperception is that antibiotics are effective against viruses as well as bacteria. While still effective against most known bacteria, if taken as directed, antibiotics are useless in fighting viruses, which are thousands of times smaller than bacteria and are encased in impenetrable shields.
"Unfortunately," said Belongia, "doctors sometimes give in to patients' demands for antibiotics to treat viral infections like the flu and even the common cold. These are self-limiting conditions that normally clear up within a few days, no matter what."
But the patient has now been conditioned to believe that only antibiotics will cure a cold or flu creating a psychological dependence, when in fact, chicken soup is just as effective against viral infections as penicillin.
To educate the public about the dangers of indiscriminate antibiotic use, the State Medical Society of Wisconsin has received a $2.4 million grant from the U.S. Center for Disease Control for a large-scale educational program about antibiotic resistance. "The bugs are winning because we're not using antibiotics as effectively as we could," SMSW president Jack Lockhart, MD, told CNS.
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