Smile..smile..and laugh together (Photo credit: Thai Jasmine (Smile..smile...Smile..))

We’re Using More of the Few Antibiotics Left

Broad electronic healthcare systems, which record details of treatment and diagnosis whether a patient is treated in a local family-practice office or a specialty hospital several cities away, are one of the main reasons that Europe has a much better grasp of its diabetes epidemics than the United States does, and identified the emergence of new resistant organisms much faster than we would have been able to.

The paper published today in PLoS ONE by a group of physicians from the University of Utah who also work at the VA Salt Lake City Health Care System, draws data from that record system to provide a glimpse of worsening antibiotic resistance across the country. Because there are no other national health record systems and no consistent national registries, it may be the first such report compiled in the United States.
So it is all the more concerning that the news is not good. The authors find that the use of polymyxin and tigecycline — the drugs of last resort for the most multi-drug-resistant infections — rose steadily between 2005 and 2010 at 127 VA centers: 25 percent for polymyxin B and E, and 400 percent for tigecycline.
That’s a sign that multi-drug-resistant infections such as MDR gram-negatives — ones for which the other big-gun drugs such as carbapenems no longer work — are rising in incidence.
And it’s also a warning signal, because it’s generally agreed in medicine that after these drugs, there’s nothing: The pipeline for gram-negative infections is dry.
What’s especially troubling is that these are not great drugs. The polymyxins are more than 50 years old, and there’s a reason they have remained viable that long: No one likes to use them. They have a well-documented history of causing kidney damage, and recently have been linked to respiratory arrest as well. Tigecycline, on the other hand, is only a few years old, but clinicians complain that it has limitations, especially in getting concentrations in the bloodstream that are high enough to knock out a bloodborne bacterial infection.

( They may be different mechanisms....but doesn't it remind you of germicide resistant organisms...livestock being routinely fed antibiotics....drugs in drinking water...and make you wonder even more about unwanted and unrecognized effects from the proliferation of vaccines...not even just in our immune systems ? That little article about the effects on our guts from multiple and ongoing insults scares me with possibilities. We live with native and needed bacterial colonies. )

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