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Old Yesterday, 04:50 PM
 
10,712 posts, read 4,971,514 times
Reputation: 14149

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Quote:
Originally Posted by suzy_q2010 View Post
The resistance rate is the percentage of a specific bacterial isolate that is resistant to a specific antibiotic.

I doubt the magnitude of those numbers. Do you really think Tunisia is giving 18 doses of antibiotics to every person in the country every day? The number is not plausible.

Nations vary widely in antibiotic use, WHO data show | CIDRAP


"A report today from the World Health Organization (WHO) shows a wide range in the amount of antibiotics being consumed in different countries.

The report, released on the first day of World Antibiotic Awareness Week, found that overall antibiotic consumption in 65 countries in 2015 ranged from 4.4 defined daily doses (DDD) to 64.4 per 1,000 inhabitants per day, a 16-fold difference."

WHO has Romania at 28.5 DDD. It does not list Tunisia:

https://www.who.int/medicines/areas/...t-20181109.pdf

"While excess use of antibiotics is a challenge in many high- and middle-income countries, poor access to affordable and quality-assured antibiotics is a problem in countries with limited resources, and particularly for some population groups. This can be reflected in their low antibiotic consumption, as well as in the specific patterns of antibiotic use."

Bacteria do not become resistant to antibiotics that they are never exposed to. The climate association is interesting but has not been established as causative. If it is, it is not the only factor determining antimicrobial resistance. All countries in all climate zones are seeing resistance develop.

Your thesis that using antibiotics where they are not indicated does not contribute to antibiotic resistance is false.

The numbers are annual totals, as in 18,000 defined daily doses per 1000 over the course of a year, not a day. But even that is ridiculously high for any country. I think CDDEP is using the European number formatting where a comma separates the decimal part, versus the point/period that we use in the U.S. You might have noticed the CDDEP and WHO numbers seem to be on a differenct scale by 1000.



You're the one that said CDDEP and WHO use the same source data. Yet you're dubious of the numbers you don't like. If you believe the CDDEP is a garbage site whose data is not credible that's fine, but you can't pick and choose to believe some of the numbers and doubt some of the numbers. I'd be fine using WHO data but I haven't found where they present both usage and resistance data in a convenient format for comparison. You have yet to cite any WHO numbers for resistance rate.



It was hardly a thesis, it was an offhand comment that I walked back 40-50 posts ago. I've stated several times since my point is that usage is not the only factor and that the implication if we would all just follow CDC guideliness we could solve the problem is false. It will require nanotechnology.
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Old Yesterday, 07:47 PM
 
Location: Georgia, USA
24,199 posts, read 29,264,425 times
Reputation: 30065
Quote:
Originally Posted by oceangaia View Post
The numbers are annual totals, as in 18,000 defined daily doses per 1000 over the course of a year, not a day. But even that is ridiculously high for any country. I think CDDEP is using the European number formatting where a comma separates the decimal part, versus the point/period that we use in the U.S. You might have noticed the CDDEP and WHO numbers seem to be on a differenct scale by 1000.



You're the one that said CDDEP and WHO use the same source data. Yet you're dubious of the numbers you don't like. If you believe the CDDEP is a garbage site whose data is not credible that's fine, but you can't pick and choose to believe some of the numbers and doubt some of the numbers. I'd be fine using WHO data but I haven't found where they present both usage and resistance data in a convenient format for comparison. You have yet to cite any WHO numbers for resistance rate.


It was hardly a thesis, it was an offhand comment that I walked back 40-50 posts ago. I've stated several times since my point is that usage is not the only factor and that the implication if we would all just follow CDC guideliness we could solve the problem is false. It will require nanotechnology.
Well, it would have been helpful if you had said the numbers were annualized from the beginning. Defined daily doses are daily doses, not annual. It was confusing because they both claimed to be using the same source data. I do not believe the CDDEP site is garbage. The figures just did not make sense.

WHO does not seem to have the resistance data tabulated by country

No one has ever said reducing antibiotic use would completely solve the problem. It must be part of the solution, though. We will need novel antimicrobials that work in different ways from traditional antibiotics. Developing them is going to be expensive. Preventing infections is going to be important, too. Hospitals will need to be militantly obsessive about infection control. There is now a C. diff toxoid vaccine in Phase III trials and work on one for enterotoxigenic E. coli. The more infections we can prevent, the less we will need to use antibiotics.
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Old Yesterday, 07:54 PM
 
10,712 posts, read 4,971,514 times
Reputation: 14149
Quote:
Originally Posted by suzy_q2010 View Post
Well, it would have been helpful if you had said the numbers were annualized from the beginning. Defined daily doses are daily doses, not annual. It was confusing because they both claimed to be using the same source data. I do not believe the CDDEP site is garbage. The figures just did not make sense.

WHO does not seem to have the resistance data tabulated by country

No one has ever said reducing antibiotic use would completely solve the problem. It must be part of the solution, though. We will need novel antimicrobials that work in different ways from traditional antibiotics. Developing them is going to be expensive. Preventing infections is going to be important, too. Hospitals will need to be militantly obsessive about infection control. There is now a C. diff toxoid vaccine in Phase III trials and work on one for enterotoxigenic E. coli. The more infections we can prevent, the less we will need to use antibiotics.
Defined daily doses are the units of measure, not the time span in which they are measured. Maybe we should all move to the Arctic where we will be less likely to get infected and the bacteria ejected from our bodies less likely to survive outside a human host.
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Old Today, 09:18 PM
 
Location: colorado springs, CO
5,964 posts, read 2,640,888 times
Reputation: 18927
Quote:
Originally Posted by suzy_q2010 View Post
Aren't you in Colorado? You should have a primary care doc through Medicaid.

https://www.healthfirstcolorado.com/

"Every member of Health First Colorado (Colorado’s Medicaid Program) has a primary care provider and belongs to a regional organization that helps connect you with the health care you need.

Your primary care provider is your first contact for your health and wellness services. Health First Colorado will assign you to a primary care provider.

You and your primary care provider belong to a regional organization that helps you make sure you get the health care and services you need."

How to find your PCP is at the link.
Bah. Thank you for checking but I know all the docs here. None of the ones I would have take Medicaid. The best two do not even take insurance at all. Private pay only.

I like my docs old & grouchy, lol.

My OBGYN is a literal dinosaur. Anyone who has been practicing here for longer than I have been having kids would have to be ... my oldest is almost 34. He's not actually grouchy but he doesn't take any crap from anybody; practices medicine with full autonomy.

I'm reading the stuff about the immune-issues, not quite ready to comment on it.
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