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Old Yesterday, 12:48 AM
 
10,697 posts, read 4,968,106 times
Reputation: 14140

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I then corrected to acknowledge that all actions have an impact. My main point was that you (and CDC) admonishments imply that if only everyone followed all their recommended procedures, we could avoid the inevitable outcome of antibiotic resistance. Go ahead and kick the can down the road a few years, maybe even a few decades, but you're doing the public a gross disservice.



You're "dubious" that Mexico usage rate is low despite giving you stats from an organization devoted to bacterial resistance? Did you even read the stats?



Not sure what you think you're proving by pointing out India's stringent enforcement but since India has one of the world's highest resistance rates, it isn't proving that antibiotic policies have a positive effect on resistance.



Yes, I pointed out that Sweden has low resistance rates but I doubt it has to do with anything they have banned. All countries above the 60th parallel have low resistance rates. Explain that one.


The correlation to climate is undeniable. That tells me the resistance isn't developing within the human body which is a constant temperature for both people living in the arctic or at the equator, but is developing in the environment. Eventually, the experts will realize they didn't know as much as they thought they knew.
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Old Yesterday, 12:51 AM
 
10,697 posts, read 4,968,106 times
Reputation: 14140
"We explored the role of climate (temperature) and additional factors on the distribution of antibiotic resistance across the United States, and here we show that increasing local temperature as well as population density are associated with increasing antibiotic resistance (percent resistant) in common pathogens. We found that an increase in temperature of 10 °C across regions was associated with an increases in antibiotic resistance of 4.2%, 2.2%, and 2.7% for the common pathogens Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. The associations between temperature and antibiotic resistance in this ecological study are consistent across most classes of antibiotics and pathogens and may be strengthening over time."
https://www.nature.com/articles/s41558-018-0161-6
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Old Yesterday, 08:36 AM
 
7,270 posts, read 3,967,467 times
Reputation: 6876
Quote:
Originally Posted by coschristi View Post
Oh brother.

Doctors like you are why I have 'sulfa abx' listed as an allergy on my chart.

I am not allergic to Sulfa's.

Sulfa's seem to work on my infections for the first 24 hours. Within 48 hours I will be on a tilt table in the ER with IVs running wide open, trying to mitigate my 105 degree fever. This has happened to me over & over & over ...

The C&S will state the bug is resistant to Sulfa's. But that bug in ME + Sulfa results in a 'super-bug'. You know why? Because I had chronic strep as a child & was on antibiotics for sometimes 9 months out of 12.

I AM resistant to many broad-spectrum abx & doctors do not LISTEN to me; so now I just keep it simple for them so they don't put me into septic shock with their 'Bacteria are either susceptible or not; not the patient' trope.

And the CDC is gaming us here. They have their annual 'Antibiotics awareness week/month' to coincide with the start of flu season. Then doctors are wary of treating the secondary pneumonia's with antibiotics which inevitably leads to higher 'influenza & pneumonia' mortality.

Guess what that increases the demand for?

This excessive pearl-clutching of 'antibiotic awareness' this year is just a preliminary fear-mongering for the upcoming ETVAX, for diarrhea from E Coli. E. Coli is treatable with antibiotics.
Why are you so sick in the first place?
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Old Yesterday, 08:51 AM
 
1,064 posts, read 305,233 times
Reputation: 2890
Quote:
Originally Posted by mike1003 View Post
...

We did know, and always told patients, to completely finish the antibiotic fill, even when feeling better. Yet they still stop treatment all the time...
Would it surprise you to learn that the number of days the patient suppose to take antibiotics- usually 7 or 10 days- has absolutely no scientific basis and completely pulled out of the doctors ***?
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Old Yesterday, 09:13 AM
 
Location: Georgia, USA
24,185 posts, read 29,258,171 times
Reputation: 30057
Quote:
Originally Posted by oceangaia View Post
I then corrected to acknowledge that all actions have an impact. My main point was that you (and CDC) admonishments imply that if only everyone followed all their recommended procedures, we could avoid the inevitable outcome of antibiotic resistance. Go ahead and kick the can down the road a few years, maybe even a few decades, but you're doing the public a gross disservice.



You're "dubious" that Mexico usage rate is low despite giving you stats from an organization devoted to bacterial resistance? Did you even read the stats?



Not sure what you think you're proving by pointing out India's stringent enforcement but since India has one of the world's highest resistance rates, it isn't proving that antibiotic policies have a positive effect on resistance.

Yes, I pointed out that Sweden has low resistance rates but I doubt it has to do with anything they have banned. All countries above the 60th parallel have low resistance rates. Explain that one.


The correlation to climate is undeniable. That tells me the resistance isn't developing within the human body which is a constant temperature for both people living in the arctic or at the equator, but is developing in the environment. Eventually, the experts will realize they didn't know as much as they thought they knew.
Yes, I am dubious about stats collected on Mexico. They cannot know what the usage rate is when antibiotics are being dispensed across the counter without a prescription in defiance of the law. Tourists can buy them.

I did not point out "India's stringent enforcement". I pointed out the opposite.

The countries "above the 60th parallel" are actively trying to control antibiotic use.

The association with climate does not explain all of the increase in resistance.

Bacteria that are not already inherently resistant to a particular antibiotic do develop it in response to exposure to that antibiotic.

The human body is an "environment", and antibiotic resistance does develop within that environment.

Bacteria in the body respond to the presence of antibiotics by altering their physical form:

https://www.sciencedaily.com/release...0926073344.htm

I am always amused when posters here think they know more than "the experts".

Quote:
Originally Posted by oceangaia View Post
"We explored the role of climate (temperature) and additional factors on the distribution of antibiotic resistance across the United States, and here we show that increasing local temperature as well as population density are associated with increasing antibiotic resistance (percent resistant) in common pathogens. We found that an increase in temperature of 10 °C across regions was associated with an increases in antibiotic resistance of 4.2%, 2.2%, and 2.7% for the common pathogens Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. The associations between temperature and antibiotic resistance in this ecological study are consistent across most classes of antibiotics and pathogens and may be strengthening over time."
https://www.nature.com/articles/s41558-018-0161-6
From your link:

"Antibiotic resistance in bacteria is believed to develop largely under the selective pressure of antibiotic use; however, other factors may contribute to population level increases in antibiotic resistance. We explored the role of climate (temperature) and additional factors on the distribution of antibiotic resistance across the United States, and here we show that increasing local temperature as well as population density are associated with increasing antibiotic resistance (percent resistant) in common pathogens."

The authors are not claiming that climate is the only factor responsible for increasing bacterial resistance.

It is irresponsible to tell people that there is no reason to reduce the unindicated use of antibiotics.
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Old Yesterday, 10:17 AM
 
6,727 posts, read 3,833,872 times
Reputation: 23750
Quote:
Originally Posted by Nik4me View Post
Would it surprise you to learn that the number of days the patient suppose to take antibiotics- usually 7 or 10 days- has absolutely no scientific basis and completely pulled out of the doctors ***?
I'd like to see reliable data on that. I'm familiar with the one study from England.

Perhaps what you are saying is that we have a ways to go (keeping up with rapid mutation) before we can predict the "sweet spot" for each infection and each individual patient. That may not ever be possible, hence the "one size fits all." I understand the reasoning behind over-prescribe rather than under-prescribe.

This is not news to me, either. In the early Seventies I had one mean anaerobic infection in a tooth root that spread to my sinus and had to take increasingly stronger antibiotic to rid myself of it. The medicine made me sick as a dawg and I remember my Dentist explaining the process of microbial resistance. And I most certainly remember him saying, "Soon the medicine we'll have to take will be nearly as awful as the infection." Hopefully they're finding some solutions to this.

Just wanted to make a comment that it's not just those problematic moms who are contributing to the more rapid progression of resistance. Another, huge factor has been our free health clinics. They often deal with an itinerant clientele and there is no monitoring patients' condition or compliance with recommendations.
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Old Yesterday, 10:52 AM
 
285 posts, read 117,270 times
Reputation: 481
Quote:
Originally Posted by Nik4me View Post
Would it surprise you to learn that the number of days the patient suppose to take antibiotics- usually 7 or 10 days- has absolutely no scientific basis and completely pulled out of the doctors ***?
I recall that the standard antibiotic course in France is 5 days, 7 days in Britain, and 10 days in the U.S. It's rather arbitrary.

And I've read that the common advice "You must take your full prescribed course or the bacteria may become resistant" is not actually scientifically sound. (You can find interviews online with physicians/scientists discussing this issue).
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Old Yesterday, 11:22 AM
 
Location: Georgia, USA
24,185 posts, read 29,258,171 times
Reputation: 30057
Quote:
Originally Posted by Nik4me View Post
Would it surprise you to learn that the number of days the patient suppose to take antibiotics- usually 7 or 10 days- has absolutely no scientific basis and completely pulled out of the doctors ***?


Dosing studies are done. Consideration is how well the drug is absorbed, the blood level needed to kill the bacteria (or, for some, to stop them from multiplying and allow the immune system to eliminate them), how long it takes to get to that level, and how long it takes for the drug to be eliminated by the body. Drugs that are eliminated more quickly need o be taken more often. Shorter, three to five day courses are not uncommon for some uncomplicated infections, since they have proven effective with a minimal decease in cure rates.
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Old Yesterday, 11:56 AM
 
10,697 posts, read 4,968,106 times
Reputation: 14140
Quote:
Originally Posted by suzy_q2010 View Post
Yes, I am dubious about stats collected on Mexico. They cannot know what the usage rate is when antibiotics are being dispensed across the counter without a prescription in defiance of the law. Tourists can buy them.

I did not point out "India's stringent enforcement". I pointed out the opposite.

The countries "above the 60th parallel" are actively trying to control antibiotic use.

The association with climate does not explain all of the increase in resistance.

Bacteria that are not already inherently resistant to a particular antibiotic do develop it in response to exposure to that antibiotic.

The human body is an "environment", and antibiotic resistance does develop within that environment.

Bacteria in the body respond to the presence of antibiotics by altering their physical form:

https://www.sciencedaily.com/release...0926073344.htm

I am always amused when posters here think they know more than "the experts".
So the data sources you cite are inviolable but the data sources I cite are unreliable? What is the basis for your doubts about The Center for Disease Dynamics Economics & Policy? Where they do not have reliable statistics they clearly mark as not available.

"In the current iteration, which is supported by a new grant from the Bill & Melinda Gates Foundation, CDDEP has expanded ResistanceMap to include more up-to-date AMR data from invasive isolates only (blood and cerebrospinal fluid) from the countries included in the previous iteration of ResistanceMap, as well as additional countries including South Africa, India, Thailand, Vietnam, Kenya, Argentina, Chile, Equador, Mexico, Venezuela, Australia, and New Zealand. Where available, data are displayed at the national, subnational or regional level. The primary sources of data are public and private laboratory networks that routinely collect AMR test results."

Right, so it's just a coincidence that the countries trying to control antibiotics are in colder climates? Including below the 60th parallel as Chile, Argentina, Australia, and New Zealand also have usage rates equal or greater than the US but lower resistance rates.

I didn't say climate was the only factor. Thanks for pointing out that population density is another. Again, my primary intent was to dispel the bunk perpetuated by "experts" that if we all would only follow the CDC gods then life will be good.

I'm always amused when "experts" cite the opinions of other experts yet cannot look at raw data and draw their own conclusions. The term I have for them is "parrots".


Btw, that last link you cited about bacteria hiding their cell wall to evade antibiotics was interesting. It's also a great demonstration of how the "experts" can all think one way and then find out they were all wrong. What discovery will be made in ten years to change views about the driving force of antibiotic resistance?



"The research by the Errington lab which turns on its head current thinking about the bacteria's ability to survive without a cell wall, known as "L-form switching," is published today in Nature Communications."
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Old Yesterday, 02:06 PM
 
Location: Georgia, USA
24,185 posts, read 29,258,171 times
Reputation: 30057
Quote:
Originally Posted by oceangaia View Post
So the data sources you cite are inviolable but the data sources I cite are unreliable? What is the basis for your doubts about The Center for Disease Dynamics Economics & Policy? Where they do not have reliable statistics they clearly mark as not available.

"In the current iteration, which is supported by a new grant from the Bill & Melinda Gates Foundation, CDDEP has expanded ResistanceMap to include more up-to-date AMR data from invasive isolates only (blood and cerebrospinal fluid) from the countries included in the previous iteration of ResistanceMap, as well as additional countries including South Africa, India, Thailand, Vietnam, Kenya, Argentina, Chile, Equador, Mexico, Venezuela, Australia, and New Zealand. Where available, data are displayed at the national, subnational or regional level. The primary sources of data are public and private laboratory networks that routinely collect AMR test results."

Right, so it's just a coincidence that the countries trying to control antibiotics are in colder climates? Including below the 60th parallel as Chile, Argentina, Australia, and New Zealand also have usage rates equal or greater than the US but lower resistance rates.

I didn't say climate was the only factor. Thanks for pointing out that population density is another. Again, my primary intent was to dispel the bunk perpetuated by "experts" that if we all would only follow the CDC gods then life will be good.

I'm always amused when "experts" cite the opinions of other experts yet cannot look at raw data and draw their own conclusions. The term I have for them is "parrots".


Btw, that last link you cited about bacteria hiding their cell wall to evade antibiotics was interesting. It's also a great demonstration of how the "experts" can all think one way and then find out they were all wrong. What discovery will be made in ten years to change views about the driving force of antibiotic resistance?



"The research by the Errington lab which turns on its head current thinking about the bacteria's ability to survive without a cell wall, known as "L-form switching," is published today in Nature Communications."
Let's look at this way. What do the sources you cite say about reducing antibiotic use?

Oh, look! It's right here on the CDDEP site:

https://cddep.org/research-area/antibiotic-resistance/

"CDDEP views antibiotic effectiveness as a shared resource: using an antibiotic now increases the opportunity for bacteria to develop resistance and thus reduces our ability to use that antibiotic in the future. Addressing antibiotic resistance is difficult because patients, physicians, hospitals, pharmaceutical companies, and agricultural users have insufficient incentives to act in ways that would conserve antibiotic effectiveness.

These challenges suggest the simultaneous deployment of multiple strategies: vaccination to prevent illness and reduce demand for antibiotics, aggressive hospital infection control, judicious prescribing and cycling of antibiotics, treatment with narrow-spectrum antibiotics, development of new antibiotics, AMR communication strategies, and coordinated federal policies that steward this resource."

The site links to this via Twitter:

https://www.pewtrusts.org/en/researc...ities-for-2020

How to Combat Antibiotic Resistance: 5 Priorities for 2020

1. Reduce antibiotic use in human medicine
2. Improve animal antibiotic use
3. Fix the broken antibiotic market
4. Ensure adequate funding for stewardship and innovation
5. Continue international focus

And links to this one:

https://www.thehindubusinessline.com...e30048614.ece#

"The situation is particularly dire in India, which has the highest antibiotic resistance in the world, according to a recent study by Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health and the Center for Disease Dynamics, Economics & Policy, all in the US. India also tops the world in antibiotic consumption per person."

"The reasons for the high resistance in India are being studied by researchers. One of the factors, health experts rue, is that antibiotics are given to a patient even when they are not needed. For instance, antibiotics do not cure viral infections, but the drugs are often prescribed anyway. Second, unlike in the West, antibiotics are easily available over the counter across the country."

Others about reducing antibiotic use here:

https://twitter.com/cddep

So is CDDEP just "parroting" the "CDC gods"?
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