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Transcript
Are You Indirectly Killing Infectious Disease Patients? How You Can Stop Contributing to Antibiotic Resistance Antibiotics are a common type of medication useful for treating bacterial infections. Antibiotic resistance is a growing problem—bacteria are evolving ways to survive common antibiotics, and the more we use antibiotics, the more bacteria evolve this resistance.1 Resistant bacterial infections are difficult and expensive to treat, often requiring the use of antibiotics of last resort.1 These antibiotics can treat otherwise resistant bacteria, but they often cause harmful side effects. In February 2016, a strain of bacteria was discovered that was resistant to colistin, the only antibiotic which had (until that discovery) evaded resistance.1,2 Problematically, resistant bacteria can transfer their resistance to non-resistant bacteria in the environment.1 Bacteria resistant to colistin have since been found all over the world, including in the United States.2 If bacteria commonly become resistant to all known antibiotics, humanity will face a return to the preantibiotic era.1 What was it like back then? • In 1930, pre-antibiotics, 22% of deaths in the US were caused by bacterial infection.3 • By 1952, with the help of antibiotics, only 0.06% of US deaths were caused by bacterial infection.3 • In 2002, that number was 0.04% — hardly changed because researchers were able to keep pace with resistance by developing new antibiotics.3 Over the coming decades, as antibiotic development increases in difficulty, the public must act to slow resistance so that researchers can keep up.4 How to Slow Resistance Down 1. Never ask for antibiotics. Trust your doctor to prescribe antibiotics when appropriate. 2. Complete your course of antibiotics as instructed. Don’t stop early, don’t save extra antibiotics, and never give them to anyone else. 3. Make sure that the meat, milk, and eggs you buy were raised without antibiotics. 4. Inform your oral surgeon that you’d prefer not to take antibiotics before or after wisdom tooth surgery unless an infection develops. Agriculture Buying meat raised on antibiotics supports the industry practice of dosing animals with antibiotics, which promotes antibiotic resistance in farm animals' gut bacteria.1 The same bacteria are the cause of diseases that come from eating contaminated meat, so these diseases may be antibiotic-resistant by the time they reach your plate.6 Colistin use in pigs is the reason colistin resistance, as referenced earlier, now exists.7 Consumer pressure has already caused some companies, including McDonald’s and Subway, to promise a transition to antibiotic-free meat. Maintaining that pressure will ensure that they keep their promise. You can help by refusing to eat at McDonald’s until they make this important change, and only eating Subway’s antibiotic-free chicken sandwich. Alternatively, you can choose vegan options at both locations.8 Since bacteria can transfer their resistance throughout the environment, it’s a good idea to buy antibiotic-free eggs and dairy even if you’re unlikely to directly contract a disease by consuming these products.6 Wisdom Tooth Removal 1. 2. 3. 4. 5. 6. 7. 8. 9. Citations Liu Y-Y, Wang Y, Walsh TR, et al. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis. 2016;16(2):161168. doi:10.1016/S1473-3099(15)00424-7. McGann P, Snesrud E, Maybank R, et al. Escherichia coli Harboring mcr-1 and blaCTX-M on a Novel IncF Plasmid: First Report of mcr-1 in the United States. Antimicrob Agents Chemother. 2016;60(7):4420-4421. doi:10.1128/AAC.01103-16. Gottfried J. History Repeating? Avoiding a Return to the Pre-Antibiotic Age. DASH. 2005. doi:10.0.6612. Spellberg B, Guidos R, Gilbert D, et al. The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(2):155-164. doi:10.1086/524891. Elies W, Huber K. Short-Course Therapy for Acute Sinusitis. Treat Respir Med. 2004;3(5):269-277. doi:10.2165/00151829200403050-00001. Chang Q, Wang W, Regev-Yochay G, Lipsitch M, Hanage WP. Antibiotics in agriculture and the risk to human health: how worried should we be? Evol Appl. 2015;8(3):240-247. doi:10.1111/eva.12185. Kurzgesagt – In a Nutshell. The antibiotic apocalypse explained. YouTube; March 16, 2016. Erbentraut J. The meat you eat is more likely to be antibiotic-free this year. Huffington Post. February 29, 2016. http://www.huffingtonpost.com/entry/an tibiotic-free-meat-subway-perduetyson_us_56d49d09e4b0871f60ec465c Accessed August 30, 2016. Lodi G, Figini L, Sardella A, Carrassi A, Del Fabbro M, Furness S. Antibiotics to prevent complications following tooth extractions. In: Lodi G, ed. Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd; 2012. doi:10.1002/14651858.CD003811.pub2. Many oral surgeons prescribe antibiotics as a preventative measure before or after removing patients’ wisdom teeth. A review of numerous studies determined that 10-17 healthy people must be treated with antibiotics to prevent one case of infection, and that antibiotics cause some mildly harmful side effects. As such, the review’s authors discouraged the prescription of preventive antibiotics for wisdom tooth removal.9 You should communicate with your oral surgeon in order to determine the best course of action. Antibiotics may still be appropriately prescribed to people recovering from wisdom tooth removal after they develop an infection.