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Antibiotic Resistance

This Topic Covers: The problems with antibiotics; an overview of MRSA and how to treat with proven natural alternative methods. What you can do to protect yourself and your family with alternatives to antibiotics and antibiotic resistance.

 


Introduction  
 

www.cdc.gov - Centers for Disease Control and Prevention

Scientists around the world have provided strong evidence that antibiotic use in food-producing animals can harm public health.1 Resistant bacteria can contaminate the foods that come from animals that serve as carriers of resistant bacteria, and people who consume these foods can develop antibiotic-resistant infections.1

It is important to have a better understanding of the flow of resistant genes—from the hospital ward to our communities, from one country to another, and from farms to people. 

www.idsociety.org - © Copyright IDSA - The Infectious Diseases Society of America

The discovery of antibiotics in the 1930s fundamentally transformed the way physicians care for patients, shifting their approach from a focus on diagnoses without means to intervene into a treatment-focused approach that saves lives. Now, nearly 70 years later, we’ve reached a critical point in treating infectious diseases: new drugs are not being developed at anywhere near the pace necessary to keep ahead of the natural ability of bacteria to evolve and defend themselves against antibiotics. The result is that some of our most powerful drugs are becoming useless.

Antimicrobial resistance is recognized as one of the greatest threats to human health worldwide.

Drug-resistant infections take a staggering toll in the United States and across the globe. Just one organism, methicillinresistant Staphylococcus aureus (MRSA), kills more Americans every year than emphysema, HIV/AIDS, Parkinson’s disease, and homicide combined.

Nearly 2 million Americans per year develop hospital-acquired infections (HAIs), resulting in 99,000 deaths – the vast majority of which are due to antibacterial-resistant pathogens.

Two common HAIs alone (sepsis and pneumonia) killed nearly 50,000 Americans and cost the U.S. health care system more than $8 billion in 2006.

Based on studies of the costs of infections caused by antibiotic-resistant pathogens versus antibiotic-susceptible pathogens, the cost to the U.S. health care system of antibiotic resistant infections is $21 billion to $34 billion each year and more than 8 million additional hospital days.

Antibiotics are becoming less and less effective, in part due to over-prescription and inappropriate use.

New antibiotic development has slowed to a standstill due to market failure and regulatory disincentives. Antibiotics aren’t as profitable as other drugs (e.g., drugs to treat diabetes or asthma, which patients take for years). Also, the US Food and Drug Administration has long delayed publishing workable guidances describing how companies should design antibiotic clinical trials. Moreover, once a new antibiotic makes it to market, physicians hold it in reserve for only the worst cases rather than rushing to use it on all their patients due to fear of drug resistance. These economic and regulatory disincentives have made it far too difficult for companies to continue developing new antibiotics.

If we do not act immediately we face a future that may resemble the days before these “miracle” drugs were developed; one in which people die of common infections, and where many medical interventions we take for granted – including surgery, chemotherapy, organ transplantation and care for premature infants – become impossible.

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Alarming Statistics   

www.commondreams.org Reports,

"Right now, 80 percent of the antibiotics used in the U.S. are used for industrial agriculture, and most of these drugs are routinely fed to animals to make them grow faster and compensate for filthy conditions," said Hauter. "This is done to help the meat industry execute on its highly consolidated business model for profit. And the American public pays through antibiotic-resistant infections."

Source - www.apic.org - The Association for Professionals in Infection Control and Epidemiology (APIC)

  • Antibiotic resistance is one of the world’s most pressing public health threats.

  • The bacteria known as CRE kill up to half of patients who get bloodstream infections.

  • In 2012 the Centers for Disease Control and Prevention (CDC) documented that people in 42 states had been infected with CRE bacteria.

  • Even the antibiotics known as ‘the last resort’ medications no longer work and have made some infections impossible to cure.

    •

  • Antibiotic overuse increases the development of drug-resistant bacteria.

www.cdc.gov - Centers for Disease Control and Prevention

This report, Antibiotic Resistance Threats in the United States, 2013 gives a first-ever snapshot of the burden and threats posed by the antibiotic-resistant germs having the most impact on human health. 

Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.

Antibiotic-resistant infections can happen anywhere. Data show that most happen in the general community; however, most deaths related to antibiotic resistance happen in healthcare settings such as hospitals and nursing homes.

www.pewhealth.org - Copyright © 1996-2014 The Pew Charitable Trusts

Pew Campaign on Human Health and Industrial Farming - Doctors routinely warn patients that antibiotics should be used only to treat bacterial infections, at the proper dosage, and for the full course of treatment because failure to follow these rules increases the likelihood that some of the bacteria will survive and mutate to become drug resistant. Yet many large producers of meat and poultry feed antibiotics to their healthy food animals simply to offset the effects of overcrowding and poor sanitation, as well as to promote faster growth.

In fact, up to 70 percent of all antibiotics sold in the United States go to healthy food animals. The U.S. Food and Drug Administration, the U.S. Department of Agriculture, and the Centers for Disease Control and Prevention all testified before Congress that there was a definitive link between the routine, non-therapeutic uses of antibiotics in food animal production and the crisis of antibiotic resistance in humans. This position is supported by the American Medical Association, the American Academy of Pediatrics, and other leading medical groups who all warn that the injudicious use of antibiotics in food animals presents a serious and growing threat to human health because the practice creates new strains of dangerous antibiotic-resistant bacteria.

Eighty percent of antibiotics sold in the United States are destined for food animal production. Often, these drugs are fed in low doses to livestock that are confined in unsanitary and overcrowded conditions on industrial farms, the perfect breeding ground for antibiotic-resistant bacteria and a serious threat to human health. Unfortunately, there is almost no publicly released data on how these antibiotics are being used for food animal production. This critical information is needed to better track antibiotic-resistant bacteria and determine whether policies to alleviate the problem are working.

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Why is Antimicrobial Resistance a Global Concern?

 

www.who.int - World Health Organization

AMR kills - Infections caused by resistant microorganisms often fail to respond to the standard treatment, resulting in prolonged illness and greater risk of death. The death rate for patients with serious infections treated in hospitals is about twice that in patients with infections caused by non-resistant bacteria.

AMR hampers the control of infectious diseases - AMR reduces the effectiveness of treatment, thus patients remain infectious for a longer time, increasing the risk of spreading resistant microorganisms to others.

AMR threatens a return to the pre-antibiotic era - Many infectious diseases risk becoming untreatable and uncontrollable, which could derail the progress made towards reaching the targets of the health-related United Nations Millennium Development Goals set for 2015.

AMR increases the costs of health care - When infections become resistant to first-line medicines, more expensive therapies must be used. The longer duration of illness and treatment, often in hospitals, increases health-care costs and the economic burden to families and societies.

AMR jeopardizes health-care gains to society - The achievements of modern medicine are put at risk by AMR. Without effective antimicrobials for care and prevention of infections, the success of treatments such as organ transplantation, cancer chemotherapy and major surgery would be compromised.

AMR threatens health security, and damages trade and economies - The growth of global trade and travel allows resistant microorganisms to be spread rapidly to distant countries and continents through humans and food.

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What is Antibiotic Resistance?

Antibiotic resistance is the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm.

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Why Should I Be Concerned about Antibiotic Resistance?

www.cdc.gov

Antibiotic resistance has been called one of the world's most pressing public health problems. Almost every type of bacteria has become stronger and less responsive to antibiotic treatment when it is really needed. These antibiotic-resistant bacteria can quickly spread to family members, schoolmates, and co-workers - threatening the community with a new strain of infectious disease that is more difficult to cure and more expensive to treat. For this reason, antibiotic resistance is among CDC's top concerns.

Antibiotic resistance can cause significant danger and suffering for children and adults who have common infections, once easily treatable with antibiotics. Microbes can develop resistance to specific medicines. A common misconception is that a person's body becomes resistant to specific drugs. However, it is microbes, not people that become resistant to the drugs.

If a microbe is resistant to many drugs, treating the infections it causes can become difficult or even impossible. Someone with an infection that is resistant to a certain medicine can pass that resistant infection to another person. In this way, a hard-to-treat illness can be spread from person to person. In some cases, the illness can lead to serious disability or even death.

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Why Are Bacteria Becoming Resistant to Antibiotics?

 

www.cdc.gov

Antibiotic use promotes development of antibiotic-resistant bacteria. Every time a person takes antibiotics, sensitive bacteria are killed, but resistant germs may be left to grow and multiply. Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria.

While antibiotics should be used to treat bacterial infections, they are not effective against viral infections like the common cold, most sore throats, and the flu. Widespread use of antibiotics promotes the spread of antibiotic resistance. Smart use of antibiotics is the key to controlling the spread of resistance.

www.cdc.gov

The germs that contaminate food can be resistant because of the use of antibiotics in people and in food animals. We can prevent many of these infections with careful antibiotic use and by keeping Salmonella, and other bacteria out of the food we eat.

Recent outbreaks in 2011, 2011-2012, and 2013 of multi-resistant Salmonella traced to ground beef and poultry show how animal and human health are linked.

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Impact of Antibiotic Use in Food-Producing Animals 

www.cdc.gov

Scientists around the world have provided strong evidence that antibiotic use in food-producing animals can have a negative impact on public health through the following sequence of events:

  • Use of antibiotics in food-producing animals allows antibiotic-resistant bacteria to thrive while susceptible bacteria are suppressed or die;

  • Resistant bacteria can be transmitted from food-producing animals to humans through the food supply;

  • Resistant bacteria can cause infections in humans; and

  • Infections caused by resistant bacteria can result in adverse human health consequences.

Because of the link between antibiotic use in food-producing animals and the occurrence of antibiotic-resistant infections in humans, CDC encourages and supports efforts to minimize inappropriate use of antibiotics in humans and animals.

www.cdc.gov

Antibiotic resistance is a food safety problem for several reasons. First, antibiotic resistance is increasing to some antibiotics, such as fluoroquinolones and third-generation cephalosporins. These antibiotics are commonly used to treat serious infections caused by bacterial pathogens frequently found in food, such as Salmonella and Campylobacter.

Each year, several million people in the United States are infected with Salmonella and Campylobacter, which usually cause diarrhea that lasts about a week. Antibiotics are not recommended for treatment of most of these diarrheal illnesses, but are used to prevent complications in infants, persons with weakened immune systems, and older persons.

Antibiotics may be life-saving for several thousand people each year who have serious invasive infections, such as bacteremia (infection in the bloodstream) and meningitis (infection of the lining of the brain and spinal cord).

A second reason that antibiotic resistance is a food safety problem is that more people may become ill. Ordinarily, healthy persons who consume a few Salmonella may carry them for a few weeks without having any symptoms, because those few Salmonella are held in check by the normal bacteria in their intestines.

However, even a few antibiotic-resistant Salmonella in food can cause illness if the person who consumes the contaminated food then takes an antibiotic for another reason. The antibiotic can kill normal bacteria in the gut, letting a few Salmonella that ordinarily would be unlikely to cause illness, take over and cause illness.

A third possible reason that antibiotic resistance is a food safety problem is that the food supply may be a source of antibiotic-resistant genes. Harmless bacteria present in food-producing animals could be resistant, and humans could acquire these bacteria when they eat meat products from these animals.

Once ingested, resistant genes from these bacteria could be transferred to bacteria that cause disease. Quantifying the extent to which this contributes to a food safety problem is difficult.

Antibiotic Resistant Bacteria in Food Chain

www.ncbi.nlm.nih.gov

The widespread use of antibiotics in food animal production systems has resulted in the emergence of antibiotic resistant zoonotic bacteria that can be transmitted to humans through the food chain. Infection with antibiotic resistant bacteria negatively impacts on public health, due to an increased incidence of treatment failure and severity of disease.

www.commondreams.org - Reports,

Drug-resistant "superbugs" have become an urgent public health concern, the Centers for Disease Control and Prevention warned on Monday, echoing years of research by groups such as Food & Water Watch who warn that the overuse of antibiotics on industrial farms leads to drug-resistant infections...

“For organism after organism, we’re seeing this steady increase in resistance rates,” the CDC’s director, Dr. Thomas Frieden, told Reuters in a telephone interview. “We don’t have new drugs about to come out of the pipeline. If and when we get new drugs, unless we do a better job of protecting them, we’ll lose those, also.”

As the CDC reports, the overuse of antibiotics on both humans and farm animals is the "most important factor leading to antibiotic resistance around the world." CDC writes:

Antibiotics are among the most commonly prescribed drugs used in human medicine. However, up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. Antibiotics are also commonly used in food animals to prevent, control, and treat disease, and to promote the growth of food-producing animals.

This overuse allows the targeted bacteria to eventually build resistance to those drugs. When humans are exposed to those bacterias, antibiotics are less likely to combat infection. As the report states, “much of antibiotic use in animals is unnecessary and inappropriate and makes everyone less safe."

"The use of antibiotics for promoting [farm animal] growth is not necessary, and the practice should be phased out," the report continues.

“This is scary stuff, and we want people to know about it,” said Dr. Steve Solomon, the director of the CDC’s Office of Antimicrobial Resistance.

"The link between sub-therapeutic use in food animals and antibiotic-resistance in humans is clear, and we must follow through on the Center’s recommendations to stop the misuse of antibiotics in farm animals," Wenonah Hauter, executive director of Food & Water Watch, stated Monday following the release of the report...

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GMOs Antibiotic Resistance Food Safety Problem

www.responsibletechnology.org - Copyright © The Institute for Responsible Technology

Unlike safety evaluations for drugs, there are no human clinical trials of GM foods. The only published human feeding experiment revealed that the genetic material inserted into GM soy transfers into bacteria living inside our intestines and continues to function. This means that long after we stop eating GM foods, we may still have their GM proteins produced continuously inside us. This could mean:

  • If the antibiotic gene inserted into most GM crops were to transfer, it could create super diseases, resistant to antibiotics.
  • If the gene that creates Bt-toxin in GM corn were to transfer, it might turn our intestinal bacteria into living pesticide factories.
Although no studies have evaluated if antibiotic or Bt-toxin genes transfer, that is one of the key problems. The safety assessments are too superficial to even identify most of the potential dangers from GMOs. See our Health Risks brochure and State of the Science report for more details and citations.

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How Do Bacteria Become Resistant to Antibiotics?

www.cdc.gov

Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm. Bacteria can do this through several mechanisms. Some bacteria develop the ability to neutralize the antibiotic before it can do harm, others can rapidly pump the antibiotic out, and still others can change the antibiotic attack site so it cannot affect the function of the bacteria.

Antibiotics kill or inhibit the growth of susceptible bacteria. Sometimes one of the bacteria survives because it has the ability to neutralize or escape the effect of the antibiotic; that one bacterium can then multiply and replace all the bacteria that were killed off. Exposure to antibiotics therefore provides selective pressure, which makes the surviving bacteria more likely to be resistant. In addition, bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria. 

The DNA that codes for resistance can be grouped in a single easily transferable package. This means that bacteria can become resistant to many antimicrobial agents because of the transfer of one piece of DNA.

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Trends in Drug Resistance

www.cdc.gov


Antibiotics and similar drugs, together called antimicrobial agents, have been used for the last 70 years to treat patients who have infectious diseases. Since the 1940s, these drugs have greatly reduced illness and death from infectious diseases. Antibiotic use has been beneficial and, when prescribed and taken correctly, their value in patient care is enormous. However, these drugs have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective. Many fungi, viruses, and parasites have done the same. Some microorganisms may develop resistance to a single antimicrobial agent (or related class of agent), while others develop resistance to several antimicrobial agents or classes. These organisms are often referred to as multidrug-resistant or MDR strains. In some cases, the microorganisms have become so resistant that no available antibiotics are effective against them.

  • Reports of methicillin-resistant Staphylococcus aureus (MRSA)—a potentially dangerous type of staph bacteria that is resistant to certain antibiotics and may cause skin and other infections—in persons with no links to healthcare systems have been observed with increasing frequency in the United States and elsewhere around the globe.

  • The agricultural use of antibiotics in food-producing animals also contributes to the emergence, persistence, and spread of resistant bacteria. Resistant bacteria can be transmitted to humans through the foods we eat.

  • Multi-drug resistant Klebsiella species and Escherichia coli have been isolated in hospitals throughout the United States.

  • Antibiotic-resistant Streptococcus pneumoniae infections have significantly declined, but remain a concern in some populations.

  • Antimicrobial resistance is emerging among some fungi, particularly those fungi that cause infections in transplant patients with weakened immune systems.

  • Antimicrobial resistance has also been noted with some of the drugs used to treat human immunodeficiency virus (HIV) infections and influenza.

The development of antimicrobial resistance to the drugs used to treat malaria infections has been a continuing problem in many parts of the world for decades. Antimicrobial resistance has developed to a variety of other parasites that cause infection.

As antibiotic resistance grows, the antibiotics used to treat infections do not work as well or at all. The loss of effective antibiotic treatments will not only cripple the ability to fight routine infectious diseases but will also undermine treatment of infectious complications in patients with other diseases. Many of the advances in medical treatment—joint replacements, organ transplants, cancer therapy, and treatment of chronic diseases such as diabetes, asthma, rheumatoid arthritis—are dependent on the ability to fight infections with antibiotics. If that ability is lost, the ability to safely offer people many life-saving and life-improving modern medical advantages will be lost with it. For example:

People receiving chemotherapy are often at risk for developing an infection when their white blood cell count is low. For these patients, any infection can quickly become serious and effective antibiotics are critical for protecting the patient from severe complications or death.

Transplant recipients are more vulnerable to infections. Because a patient undergoes complex surgery and receives medicine to weaken the immune system for a year or more, the risk of infection is high. It is estimated that 1% of organs transplanted in the United States each year carry a disease that comes from the donor—either an infection or cancer. Effective antibiotics help ensure that organ transplants remain possible.

Patients who receive cardiac bypass, joint replacements, and other complex surgeries are at risk of a surgical site infection (SSI). These infections can make recovery from surgery more difficult because they can cause additional illness, stress, cost, and even death. For some, but not all surgeries, antibiotics are given before surgery to help prevent infections.

Inflammatory arthritis affects the immune system, which controls how well the body fights off infections. People with certain types of arthritis have a higher risk of getting infections. Also, many medications given to treat inflammatory arthritis can weaken the immune system. Effective antibiotics help ensure that arthritis patients can continue to receive treatment.

Patients who undergo dialysis treatment have an increased risk for getting a bloodstream infection. In fact, bloodstream infections are the second leading cause of death in dialysis patients. Infections also complicate heart disease, the leading cause of death in dialysis patients. Infection risk is higher in these patients because they have weakened immune systems and often require catheters or needles to enter their bloodstream. Effective antibiotics help ensure that dialysis patients can continue to receive life-saving treatment.

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Hospital Setting Anti-Resistant Germs 

www.cdc.gov

CRE infections are spreading, and urgent action is needed to stop them.

CRE, which stands for carbapenem-resistant Enterobacteriaceae, are a family of germs that are difficult to treat because they have high levels of resistance to antibiotics.  Klebsiella  species and Escherichia coli (E. coli) are examples of Enterobacteriaceae, a normal part of the human gut bacteria, that can become carbapenem-resistant. Types of CRE are sometimes known as KPC (Klebsiella pneumoniae carbapenemase) and NDM (New Delhi Metallo-beta-lactamase). KPC and NDM are enzymes that break down carbapenems and make them ineffective.

Healthy people usually do not get CRE infections. In healthcare settings, CRE infections most commonly occur among patients who are receiving treatment for other conditions. Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for CRE infections. The Association for Professionals in Infection Control and Epidemiology (APIC) also states, to get a CRE infection, a person must be exposed to CRE bacteria. CRE bacteria are most often spread person-to-person in healthcare settings specifically through contact with:

  • infected or colonized people

  • contact with wounds or stool 

Some CRE bacteria have become resistant to most available antibiotics. Infections with these germs are very difficult to treat, and can be deadly—one report cites they can contribute to death in up to 50% of patients who become infected.

Untreatable and hard-to-treat infections from CRE germs are on the rise among patients in medical facilities. CRE germs have become resistant to all or nearly all the antibiotics we have today. Types of CRE include KPC and NDM. By following CDC guidelines, we can halt CRE infections before they become widespread in hospitals and other medical facilities and potentially spread to otherwise healthy people outside of medical facilities.

CRE infections can be prevented.

  • Medical facilities in several states have reduced CRE infection rates by following CDC's prevention guidelines (see box).

  • Israel decreased CRE infection rates in all 27 of its hospitals by more than 70% in one year with a coordinated prevention program.

  • The US is at a critical time in which CRE infections could be controlled if addressed in a rapid, coordinated, and consistent effort by doctors, nurses, lab staff, medical facility leadership, health departments/states, policy makers, and the federal government.

  • Although CRE germs are not very common, they have increased from 1% to 4% in the past decade. One type of CRE has increased from 2% to 10%.

  • CRE are more common in some US regions, such as the Northeast, but 42 states report having had at least one patient test positive for one type of CRE.

  • About 18% of long-term acute care hospitals and about 4% of short-stay hospitals in the US had at least one CRE infection during the first half of 2012.

  • CRE's ability to spread themselves and their resistance raises the concern that potentially untreatable infections could appear in otherwise healthy people.

 

Antibiotics in Health Care

Misuse of antibiotic drugs harm in another way, too, by destroying the good bacteria that normally live in your gut. For example, almost 250,000 hospital patients each year are infected with the bacterium Clostridium difficile, or C. diff, and 14,000 of them die. Those infections develop when antibiotics, which are often prescribed unnecessarily in the hospital, wipe out protective bacteria than normally live in your stomach, allowing C. diff to get a foothold.

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www.cdc.gov - Drug Resistance Threat Report-2013 pdf 

Antibiotic Resistance Threats in the United States, 2013 is a snapshot of the complex problem of antibiotic resistance today and the potentially catastrophic consequences of inaction.

The overriding purpose of this report is to increase awareness of the threat that antibiotic resistance poses and to encourage immediate action to address the threat. This document can serve as a reference for anyone looking for information about antibiotic resistance. It is specifically designed to be accessible to many audiences. For more technical information, references and links are provided.

This report covers bacteria causing severe human infections and the antibiotics used to treat those infections…The report consists of multiple one or two page summaries of cross-cutting and bacteria- specific antibiotic resistance topics.

The first section provides context and an overview of antibiotic resistance in the United States. In addition to giving a national assessment of the most dangerous antibiotic resistance threats, it summarizes what is known about the burden of illness, level of concern, and antibiotics left to defend against these infections.

(Excerpts of)… fact sheets about antibiotic safety and the harmful impact that resistance can have on high-risk groups…Regarding level of concern, CDC has — for the first time — prioritized bacteria in this report into one of three categories: urgent, serious, and concerning:

MICROORGANISMS WITH A THREAT LEVEL OF URGENT

Clostridium difficile
Carbapenem-resistant Enterobacteriaceae
Drug-resistant Neisseria gonorrhoeae

Clostridium difficile (C. difficile) causes life-threatening diarrhea. These infections mostly occur in people who have had both recent medical care and antibiotics. Often, C. difficile infections occur in hospitalized or recently hospitalized patients.

RESISTANCE OF CONCERN

  • Although resistance to the antibiotics used to treat C. difficile infections is not yet a problem, the bacteria spreads rapidly because it is naturally resistant to many drugs used to treat other infections.

  • In 2000, a stronger strain of the bacteria emerged. This strain is resistant to fluoroquinolone antibiotics, which are commonly used to treat other infections.

  • This strain has spread throughout North America and Europe, infecting and killing more people wherever it spreads.

PUBLIC HEALTH THREAT

  • 250,000 infections per year requiring hospitalization or affecting already hospitalized patients.

  • 14,000 deaths per year.

  • At least $1 billion in excess medical costs per year.

  • Deaths related to C. difficile increased 400% between 2000 and 2007, in part because of a stronger bacteria strain that emerged.

  • Almost half of infections occur in people younger than 65, but more than

  • 90% of deaths occur in people 65 and older.

  • About half of C. difficile infections first show symptoms in hospitalized or recently hospitalized patients, and half first show symptoms in nursing home patients or in people recently cared for in doctors’ offices and clinics.

Untreatable and hard-to-treat infections from carbapenem-resistant

Enterobacteriaceae (CRE) bacteria are on the rise among patients in medical facilities. CRE have become resistant to all or nearly all the antibiotics we have today. Almost half of hospital patients who get bloodstream infections from CRE bacteria die from the infection.

RESISTANCE OF CONCERN

  • Some Enterobacteriaceae are resistant to nearly all antibiotics, including carbapenems, which are often considered the antibiotics of last resort.

  • More than 9,000 healthcare-associated infections are caused by CRE each year.

  • CDC laboratories have confirmed at least one type of CRE in healthcare facilities in 44 states.

  • About 4% of U.S. short-stay hospitals had at least one patient with a serious CRE infection during the first half of 2012. About 18% of long-term acute care hospitals had one.

     

Neisseria gonorrhoeae causes gonorrhea, a sexually transmitted disease that can result in discharge and inflammation at the urethra, cervix, pharynx, or rectum.

RESISTANCE OF CONCERN

N. gonorrhoeae is showing resistance to antibiotics usually used to treat it. These drugs include:

  • cefixime (an oral cephalosporin)

  • ceftriaxone (an injectable cephalosporin)

  • azithromycin

  • tetracycline

 

PUBLIC HEALTH THREAT

Gonorrhea is the second most commonly reported notifiable infection in the United States and is easily transmitted. It causes severe reproductive complications and disproportionately affects sexual, racial, and ethnic minorities. Gonorrhea control relies on prompt identification and treatment of infected persons and their sex partners. Because some drugs are less effective in treating gonorrhea, CDC recently updated its treatment guidelines to slow the emergence of drug resistance. CDC now recommends only ceftriaxoneplus either azithromycin or doxycycline as first-line treatment for gonorrhea. The emergence of cephalosporin resistance, especially ceftriaxone resistance, would greatly limit treatment options and could cripple gonorrhea control efforts.

MICROORGANISMS WITH A THREAT LEVEL OF SERIOUS

Multidrug-resistant Acinetobacter - About 63% of Acinetobacter is considered multidrug-resistant, meaning at least three different classes of antibiotics no longer cure Acinetobacter infections.

  • Approximately 2% of healthcare-associated infections reported to CDC’s

  • National Healthcare Safety Network are caused by Acinetobacter, but the proportion is higher among critically ill patients on mechanical ventilators (about 7%).

Drug-resistant Campylobacter - Campylobacter usually causes diarrhea (often bloody), fever, and abdominal cramps, and sometimes causes serious complications such as temporary paralysis.

RESISTANCE OF CONCERN

Physicians rely on drugs like ciprofloxacin and azithromycin for treating patients with severe disease. Resistant infections sometimes last longer. Campylobacter is showing resistance to:

  • ciprofloxacin

  • azithromycin

PUBLIC HEALTH THREAT

Campylobacter is estimated to cause approximately 1.3 million infections, 13,000 hospitalizations, and 120 deaths each year in the United States. CDC is seeing resistance to ciprofloxacin in almost 25% of Campylobacter tested and resistance to azithromycin in about 2%. Costs are expected to be higher for resistant infections because antibiotic-resistant Campylobacter infections sometimes last longer.

Campylobacter spreads from animals to people through contaminated food, particularly raw or undercooked chicken and unpasteurized milk. Infections may also be acquired through contact with animals and by drinking contaminated water. Antibiotic use in food animals can result in resistant Campylobacter that can spread to humans. Resistant Campylobacter are common in many countries and cause illness in travelers.

Key measures to prevent resistant infections include:

  • Clean: Wash hands, cutting boards, utensils, sinks, and countertops.

  • Separate: Keep raw meat, poultry, and seafood separate from ready-to-eat foods.

  • Cook: Use a food thermometer to ensure that foods are cooked to a safe internal temperature.

  • Chill: Keep your refrigerator below 40°F and refrigerate food that will spoil.

  • Avoid drinking raw milk and untreated water.

  • Report suspected illness from food to your local health department.

  • Don’t prepare food for others if you have diarrhea or vomiting.

  • Be especially careful preparing food for children, pregnant women, those in poor health, and older adults.

  • Consume safe food and water when traveling abroad.

Fluconazole-resistant Candida (a fungus) -  is a fungal infection caused by yeasts of the genus Candida.

There are more than 20 species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida yeasts normally live on the skin and mucous membranes without causing infection. However, overgrowth of these microorganisms can cause symptoms to develop. Symptoms of candidiasis vary depending on the area of the body that is infected.

Candida is the fourth most common cause of healthcare-associated bloodstream infections in the United States. In some hospitals it is the most common cause. These infections tend to occur in the sickest of patients.

Extended spectrum β-lactamase producing Enterobacteriaceae (ESBLs) is an enzyme that allows bacteria to become resistant to a wide variety of penicillins and cephalosporins. ESBL-producing Enterobacteriaceae are resistant to strong antibiotics including extended spectrum cephalosporins.

RESISTANCE OF CONCERN

Some Enterobacteriaceae are resistant to nearly all:

  • penicillins

  • cephalosporins

In these cases, the remaining treatment option is an antibiotic from the carbapenem family. These are drugs of last resort, and use of them is also contributing to resistance (see CRE fact sheet).

  • Nearly 26,000 (or 19%) healthcare-associated Enterobacteriaceae infections are caused by ESBL-producing Enterobacteriaceae.

  • Patients with bloodstream infections caused by ESBL-producing Enterobacteriaceae are about 57% more likely to die than those with bloodstream infections caused by a non ESBL-producing strain.

Vancomycin-resistant Enterococcus (VRE) cause a range of illnesses, mostly among patients receiving healthcare, but include bloodstream infections, surgical site infections, and urinary tract infections.

RESISTANCE OF CONCERN

  • Enterococcus often cause infections among very sick patients in hospitals and other healthcare-settings.

  • Some Enterococcus strains are resistant to vancomycin, an antibiotic of last resort, leaving few or no treatment options.

  • About 20,000 (or 30%) of Enterococcus healthcare-associated infections are vancomycin resistant.

(Multidrug-resistant) Pseudomonas aeruginosa is a common cause of healthcare-associated infections including pneumonia, bloodstream infections, urinary tract infections, and surgical site infections.

RESISTANCE OF CONCERN

Some strains of Pseudomonas aeruginosa have been found to be resistant to nearly all or all antibiotics including aminoglycosides, cephalosporins, fluoroquinolones, and carbapenems.

  • Approximately 8% of all healthcare-associated infections reported to CDC’s

  • National Healthcare Safety Network are caused by Pseudomonas aeruginosa.

  • About 13% of severe healthcare-associated infections caused by Pseudomonas aeruginosa are multidrug resistant, meaning several classes of antibiotics no longer cure these infections.

Drug-resistant non-typhoidal Salmonella (serotypes other than Typhi, Paratyphi A, Paratyphi B, and Paratyphi C) usually causes diarrhea (sometimes bloody), fever, and abdominal cramps. Some infections spread to the blood and can have life-threatening complications.

RESISTANCE OF CONCERN

Physicians rely on drugs, such as ceftriaxone and ciprofloxacin, for treating patients with complicated Salmonella infections. Resistant infections are more severe and have higher hospitalization rates. Non-typhoidal Salmonella is showing resistance to:

  • ceftriaxone

  • ciprofloxacin

  • multiple classes of drugs

PUBLIC HEALTH THREAT

Non-typhoidal Salmonella causes approximately 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths each year in the United States. Direct medical costs are estimated to be $365 million annually. CDC is seeing resistance to ceftriaxone in about 3% of non-typhoidal Salmonella tested, and some level of resistance to ciprofloxacin in about 3%. About 5% of non-typhoidal Salmonella tested by CDC are resistant to five or more types of drugs. Costs are expected to be higher for resistant than for susceptible infections because resistant infections are more severe, those patients are more likely to be hospitalized, and treatment is less effective.

(Drug-resistant) Salmonella serotype Typhi causes typhoid fever, a potentially life-threatening disease. People with typhoid fever usually have a high fever, abdominal pain, and headache. Typhoid fever can lead to bowel perforation, shock, and death.

RESISTANCE OF CONCERN

Physicians rely on drugs such as ceftriaxone, azithromycin, and ciprofloxacin for treating patients with typhoid fever. Salmonella serotype Typhi is showing resistance to:

  • ceftriaxone

  • azithromycin

  • ciprofloxacin (resistance is so common that it cannot be routinely used)

PUBLIC HEALTH THREAT

Salmonella Typhi causes approximately 21.7 million illnesses worldwide. In the United States,

it causes approximately 5,700 illnesses and 620 hospitalizations each year. Most illnesses occur in people who travel to some parts of the developing world where the disease is common. Travel-associated infections are more likely to be antibiotic resistant.

CDC is seeing some level of resistance to ciprofloxacin in two-thirds of Salmonella Typhi tested. CDC has not yet seen resistance to ceftriaxone or azithromycin in the United States, but this has been seen in other parts of the world…

WHAT YOU CAN DO - If you’re traveling to a country where typhoid fever is common:

  • Get vaccinated against typhoid fever before you depart.

  • Choose foods and drinks carefully while traveling even if you are vaccinated. That means: boil it, cook it, peel it, or forget it.

  • Boil or treat water yourself.

  • Eat foods that are hot and steaming.

  • Avoid raw fruits and vegetables unless you peel them yourself.

  • Avoid cold food and beverages from street vendors.

  • If you get sick with high fever and a headache during or after travel, seek medical care at once and tell the healthcare provider where you have traveled.

Drug-resistant Shigella usually causes diarrhea (sometimes bloody), fever, and abdominal pain. Sometimes it causes serious complications such as reactive arthritis. High-risk groups include young children, people with inadequate hand washing and hygiene habits, and men who have sex with men.

Resistance to traditional first-line drugs such as ampicillin and trimethoprim-sulfamethoxazole has become so high that physicians must now rely on alternative drugs like ciprofloxacin and azithromycin to treat infections. Resistant infections can last longer than infections with susceptible bacteria (bacteria that can be treated effectively with antibiotics). Shigella is showing resistance to:

  • ciprofloxacin

  • azithromycin

PUBLIC HEALTH THREAT

Shigella causes approximately 500,000 diarrheal illnesses, 5,500 hospitalizations, and 40 deaths each year in the United States. CDC is seeing resistance to ciprofloxacin in 1.6% of the Shigella cases tested and resistance to azithromycin in approximately 3%. Because initial treatment can fail, costs are expected to be higher for resistant infections

  • Don’t prepare food for others if you have diarrhea or vomiting.

  • Keep children who have diarrhea and who are in diapers out of child care settings and swimming pools.

  • Avoid sexual behavior that is likely to transmit infection when you have diarrhea.

  • Consume safe food and water when traveling abroad.

Drug-resistant Streptococcus pneumonia (or pneumococcus) is the leading cause of bacterial pneumonia and meningitis in the United States. It also is a major cause of bloodstream infections and ear and sinus infections.

RESISTANCE OF CONCERN

S. pneumoniae has developed resistance to drugs in the penicillin and erythromycin groups. Examples of these drugs include amoxicillin and azithromycin (Zithromax, Z-Pak). S. pneumoniae has also developed resistance to less commonly used drugs.

PUBLIC HEALTH THREAT

Pneumococcal disease, whether or not resistant to antibiotics, is a major public health problem. Pneumococcal disease causes 4 million disease episodes and 22,000 deaths annually. Pneumococcal ear infections (otitis media) are the most common type of pneumococcal disease among children, causing 1.5 million infections that often result in antibiotic use. Pneumococcal pneumonia is another important form of pneumococcal disease. Each year, nearly 160,000 children younger than 5 years old see a doctor or are admitted to the hospital with pneumococcal pneumonia. Among adults, over 600,000 seek care for or are hospitalized with pneumococcal pneumonia. Pneumococcal pneumonia accounts for 72% of all direct medical costs for treatment of pneumococcal disease.

In 30% of severe S. pneumoniae cases, the bacteria are fully resistant to one or more clinically relevant antibiotics. Resistant infections complicate treatment and can result in almost 1,200,000 illnesses and 7,000 deaths per year. Cases of resistant pneumococcal pneumonia result in about 32,000 additional doctor visits and about 19,000 additional hospitalizations each year. The excess costs associated with these cases are approximately $96 million.

Invasive pneumococcal disease means that bacteria invade parts of the body that are normally sterile, and when this happens, disease is usually severe, causing hospitalization or even death. The majority of cases and deaths occur among adults 50 years or older, with the highest rates among those 65 years or older. Almost everyone who gets invasive pneumococcal disease needs treatment in the hospital.

WHAT YOU CAN DO NOW

www.cdc.gov

  1. Tell your doctor if you have been hospitalized in another facility or country.

  2. Take antibiotics exactly as the doctor prescribes. Do not skip doses, and complete the entire prescription, even if you start feeling better.

  3. Only take antibiotics prescribed for you; do not share or use leftover antibiotics.

  4. Do not save antibiotics for the next illness. Discard any leftover medication once the prescribed course of treatment is completed.

  5. Prevent infections by covering your cough, getting recommended vaccinations, and regularly washing your hands!  Clean your own hands often, especially: 

  • Before preparing or eating food

  • Before touching your eyes, nose, or mouth
  • Before and after changing wound dressings or bandages, or handling medical devices
  • After using the bathroom
  • After blowing your nose, coughing, or sneezing

  1. Do not ask your doctor for antibiotics if your doctor feels you don't need them.

  2. Ask questions. Understand what is being done to you, the risks and benefits.

  3. When you are in a healthcare facility, insist that everyone who takes care of you clean their hands with soap and water or an alcohol-based hand rub before touching you! And remind them to wash their hands again as they leave your room!

  4. Prevent infections by getting recommended vaccines and practicing good hand hygiene.

Drug-resistant tuberculosis (TB) is among the most common infectious diseases and a frequent cause of death worldwide. TB is caused by the bacteria Mycobacterium tuberculosis

(M. tuberculosis) and is spread most commonly through the air. M. tuberculosis can affect any part of the body, but disease is found most often in the lungs. In most cases, TB is treatable and curable with the available first-line TB drugs; however, in some cases, M. tuberculosis can be resistant to one or more of the drugs used to treat it.

Drug-resistant TB is more challenging to treat — it can be complex and requires more time and more expensive drugs that often have more side effects. Extensively Drug-Resistant TB (XDR TB) is resistant to most TB drugs; therefore, patients are left with treatment options that are much less effective. The major factors driving TB drug resistance are incomplete or wrong treatment, short drug supply, and lack of new drugs. In the United States most drug-resistant TB is found among persons born outside of the country.

Methicillin-resistant Staphylococcus aureus (MRSA) causes a range of illnesses, from skin and wound infections to pneumonia and bloodstream infections that can cause sepsis and death. Staph bacteria, including MRSA, are one of the most common causes of healthcare-associated infections.

RESISTANCE OF CONCERN

Resistance to methicillin and related antibiotics (e.g., nafcillin, oxacillin) and resistance to cephalosporins are of concern.

PUBLIC HEALTH THREAT

CDC estimates 80,461 invasive MRSA infections and 11,285 related deaths occurred in 2011. An unknown but much higher number of less severe infections occurred in both the community and in healthcare settings.

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Healthcare-Associated (HA-MRSA) 

 

www.ahrq.gov - Agency for Healthcare Research and Quality

Healthcare-associated infections (HAIs) are infections that patients get while receiving treatment for another condition in some type of health care facility. A study of patients in 2002 estimated that HAIs account for an estimated 1.7 million infections and 99,000 associated deaths annually, making them the most common complication of hospital care. The added financial burden attributable to HAIs is estimated to be between $28 billion to $33 billion each year.

Many bacterial agents are responsible for HAIs, the most common of which is methicillin-resistant Staphylococcus aureus (MRSA). The number of MRSA-associated hospital stays more than tripled after 2000, reaching 368,600 in 2005, according to the AHRQ-sponsored Healthcare Cost and Utilization Project (HCUP) database (www.hcup-us.ahrq.gov).

Patients hospitalized for MRSA have longer hospital stays and are more likely to die than patients who do not have MRSA. These infections are especially common in hospital intensive care units (ICUs).

www.apic.org - pdf - Association for Professionals in Infection Control and Epidemiology (APIC)

June 3, 2013 - Methicillin-resistant Staphylococcus Aureus (MRSA) is an important cause of illness and sometimes death, especially among patients who have had medical care. Three-fourths of Staphylococcus aureus infections in hospital ICUs are considered methicillin-resistant.

A new study has been published showing that using germ-killing soap and ointment on all intensive-care unit (ICU) patients can reduce bloodstream 2 infections by up to 44 percent and significantly reduce the presence of MRSA in ICUs.

Study conclusions:

Routine care (Group I) did not significantly reduce MRSA or bloodstream infections.
Providing germ-killing soap and ointment only to patients with MRSA (Group II) reduced bloodstream infections by any germ by 23 percent.
Providing germ-killing soap and ointment to all ICU patients (Group III) reduced MRSA by 37 percent and bloodstream infections by any germ by 44 percent.

The essential elements of an infection prevention and control program to prevent healthcare-associated infections include:

  • Rigorous hand hygiene practices that ensure healthcare providers clean their hands before and after providing patient care and after having contact with the patient’s environment

  • Patients as well as visitors need to practice good hand hygiene. We encourage our patients to be partners in their care and talk with their healthcare providers about wearing gloves and washing hands before and after delivering care

  • Use of barrier precautions, such as gloves, gowns, masks, caps, etc., by healthcare workers and visitors

  • Separating patients with serious infections from other patients to prevent the transmission of infection

  • Proper disinfection of the patient’s skin prior to medical and surgical procedures

  • Environmental cleaning and decontamination of equipment, especially items that are frequently touched or are close to patients, such as bedrails and bedside equipment

  • Monitoring the cleaning, disinfection and sterilization of instruments and equipment used for patient care

  • Removing IV and urinary catheters promptly

  • When possible, avoiding veins in the groin for IV catheter placement

  • Assure that antibiotics are used carefully

  • Staff education on best practices to prevent infections including central-line bloodstream infections and spread of resistant organisms such as CRE, MRSA, and C. difficile

  • Sharing information with patients and families so they understand the importance of infection prevention practices in all healthcare settings and at home

  • Additionally, in order to ensure patient safety, our staff is trained to identify any breaks in infection prevention and control practices and to intervene if such breaks are identified.

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Community-Associated MRSA 

Reference Source - www.stopmrsanow.org

There are two known types of MRSA. MRSA, a type of Staph bacteria that is resistant to antibiotics, used to be most commonly found in hospitals and nursing homes, Healthcare-Associated (HA-MRSA).  Recently, Community-Associated MRSA, a newer type of MRSA has been identified and is spreading more commonly in the community - among healthy people, in public settings like gyms, locker rooms, households and schools. In fact, almost 90 percent of physicians confirm that the prevalence of Community-Associated MRSA infections is increasing.

Since MRSA infections can be serious, and the bacteria can be easily passed along through contact, it is crucial to take steps to prevent the spread of infection in all places in the community where people gather.

MRSA (methicillin-resistant Staphylococcus aureus) is a type of Staph bacteria found on the skin and in the nose that is resistant to antibiotics. More than 90,000 Americans get potentially deadly MRSA infections every year and in 2005, nearly 19,000 Americans died from MRSA infections. More deaths are linked to MRSA infections than AIDS. 

MRSA is spread by skin-to-skin contact, or through personal items that have been contaminated with the bacteria such as towels or athletic equipment. MRSA is spread more easily in close quarters, like gyms and locker rooms. It is not uncommon for MRSA infections to spread among athletic team members or people who regularly visit the gym.

Athletes who play close-contact sports, such as wrestling and football, are also at an increased risk of contracting and spreading MRSA. In fact, MRSA infection rates are higher among football players than among other athletes. A total of 517 out of every 100,000 football players contracted MRSA from 2003 to 2005 as opposed to the overall national rate of 32 per 100,000 people.

MRSA, like other staph bacteria, can cause a skin infection such as pimples, rashes, abscesses, boils or what can look like a spider bite. These infections are usually warm, painful, red or swollen. If you think that you or anyone in your family may have a MRSA infection, contact a licensed health care professional, especially if the infection is large, painful, warm to the touch, or does not heal by itself.

People can carry MRSA and not have any symptoms. These "carriers" can also transmit the bacteria to other people. MRSA can be easily spread through skin-to-skin contact and by touching contaminated items.

This is why it is crucial to take measures to help reduce the spread of Community-Associated MRSA using these practical steps.

  • Scrub up - Wash your hands frequently with soap and warm water for at least 15 seconds - the time it takes to sing Happy Birthday twice - or use an alcohol-based hand rub sanitizer.

  • Wipe it down - Use a disinfecting bleach solution to wipe down and disinfect hard surfaces. Make sure to use clean cloths to avoid spreading MRSA from one surface to another. (3/4 cup of disinfecting bleach diluted in 1 gallon of water)

  • Cover your cuts - Keep any nicks or wounds covered with a clean, dry bandage until healed.

  • Keep to yourself - Do not share personal items, like towels or razors, that come into contact with bare skin.

  • Use a barrier - Keep a towel or clothing between skin and shared equipment.

For more information on MRSA and steps you can take to help reduce the spread of the bacteria, download our STOP MRSA Now  Playbook or a fact sheet. Visit The University of Chicago MRSA Research Center Web site for additional resources: 

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How Do You Protect Yourself? 

Reference Source - www.tufts.edu - Alliance for the Prudent Use of Antibiotics 

A new class of antibiotic drugs is not expected to appear in the immediate future. If bacteria become resistant to all our current antibiotics, we won't have any other alternatives. Using antibiotics wisely will help preserve their effectiveness in the years ahead.

Here are some actions you can take to limit the development of antibiotic resistance—

  • Do not demand antibiotics from your physician. When given antibiotics, take them exactly as prescribed and complete the full course of treatment; do not hoard pills for later use or share leftover antibiotics, as decreased quality may compromise effectiveness. 

  • Wash your hands properly to reduce the chance of getting sick and spreading infection. 

  • Wash fruits and vegetables thoroughly.

  • Avoid raw eggs and undercooked meat, especially in ground form. (The majority of food items which cause diseases are raw or undercooked foods of animal origin such as meat, milk, eggs, cheese, fish or shellfish.)

  • When protecting a sick person whose defenses are weakened, soaps and other products with antibacterial chemicals are helpful, but should be used according to established procedures and guidelines.

Read more: Unnecessary Deaths: The Human and Financial Costs of Hospital Infections by the Committee to Reduce Infection Deaths (RID)  See Center for Global Development Report

www.fda.gov

Patients should take antibiotics exactly as directed by their health care professional. They should not demand antibiotics to treat viral infections, such as coughs, colds and the flu. Taking an antibiotic drug when it won't treat your illness is still associated with the risk of side effects from that drug, and can contribute to the development of antibiotic resistance.

We can all play an important role—patients, healthcare providers, and health care institutions—in using antibiotics appropriately so that we have effective antibiotics when we need them to treat patients with a bacterial infection.

Thorough cooking will eliminate most bacteria—even resistant bacteria—from meat and poultry but there is always the danger of cross contamination. Consumers must carefully clean any kitchen surfaces used to prepare or store meat or poultry before using them to prepare raw ingredients that will not be cooked.

www.keepantibioticsworking.com

Eat without Antibiotics. Next time you buy meat or poultry, choose products raised without the routine use of antibiotics, using the Eat Well Consumer Guide. Use it to find retail outlets, restaurants, and producers nationwide that sell meat and poultry raised without the routine use of antibiotics. Or, find them yourself by searching out meat products with labels that say "certified organic," "raised without antibiotics," and "no antibiotics administered."

Check out Label Facts, to find a listing of other terms used to label meats and what they mean. Your choices as a consumer will bolster efforts to change public policies that currently allow routine use of antibiotics in animals that aren't sick.

Spread the Word. Tell friends and family what you have learned about how the overuse of antibiotics in animal agriculture impacts human health. Urge them to visit our website and to Take Action on this important issue.

Retrieved from - mercola.com

If you've decided to go ahead and take an antibiotic:

  1. Get the facts. Ask your doctor how many days you must take the antibiotic and if you, in fact, do you need the latest, most powerful one on the market. Simple urinary tract infections are now treated with only three days of antibiotics. Sinus infections, bronchitis, and ear infections in children over two years of age can be treated with as few as five days of antibiotics, new or old, generic or name brand. This may not be possible, however, if you have other medical conditions or if you smoke.

  2. Build trust. Commit to the full course of the antibiotic unless you experience significant side effects or an allergic reaction. You sought medical advice and agreed to the prescription. You will build trust with your doctor if you work as a team. This trust will be very important once you see number 3 below.

  3. Take an antifungal with the antibiotic. For example, you could ask your doctor for a prescription of nystatin to take during the course of your antibiotic. Many dermatologists do this when prescribing long-term antibiotic courses for acne. I suggest adults take two tablets twice a day -- 1 cc of suspension twice a day for children -- to prevent yeast overgrowth in your intestines. Most cases of upset stomach or diarrhea that kick in a few days of beginning a round of antibiotics can be cured with a single dose of the drug. Diarrhea after a two-week round of antibiotics is likely caused by a different bug altogether -- be sure to bring that to your doctor's attention. I should tell you that, in my clinical practice years, many of my patients made great strides against acne through taking nystatin and a change in diet alone, without the antibiotics.

  4. Supplement your intake. Take an antioxidant supplement, one that includes vitamin E, zinc, selenium, vitamin C, and vitamin A, among others. According to A.V. Costantini, all antioxidants are antifungal. (Costantini. 1998.)

  5. Keep your bowels moving. If antibiotics kill off your friendly, intestinal bacteria, once you cease taking antibiotics you'll run a higher risk of infection by other, more hostile bacteria. These bacteria will be quick to find and exploit pockets of debris that could be collecting and putrefying in your intestines if you happen to become constipated. So, be sure to keep your digestive tract as clear as possible until you can repopulate it with friendly bacteria. Psyllium hulls fiber from your local health food store is the best, bulk fiber to use, as long as you don't have a history of intestinal obstruction. Psyllium not only relieves constipation. It also slows diarrhea by absorbing excess water.

  6. Look back at why you became ill to begin with.  ...diet plays at least as much a role as actual exposure to germs as to whether we get sick -- when we are healthy and eating correctly, our bodies are amazingly resistant to infection.

  7. Replace the good bacteria in your intestines. Supplement with an acidophilus supplement for a few weeks following any course of antibiotics. Do not take these simultaneously with your antibiotic or you will simply end up with a lot of very dead, albeit still friendly bacteria in your intestines. At the very most, take acidophilus supplements either in between antibiotic doses or after you have completely finished your prescription.

Also Link to Patient Safety Resources

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Probiotics for Treatment of Antibiotic Resistance 

www.livestrong.com - Copyright © Demand Media, Inc.

Unfortunately, antibiotics can also kill bacteria that are part of the normal host flora in your body, resulting in an imbalance that allows the overgrowth of certain species that can result in another infection.

Normal Flora: The most noticeable effect of antibiotics on host bacteria typically occurs in the digestive tract. The intestines contain bacteria that are part of the normal gut flora that help to digest and process consumed food. These bacteria may also produce vitamins for the body such as vitamin K. In addition to the digestive system, bacteria that are part of the normal vaginal flora in women can also be affected by the use of antibiotics. Most digestive bacteria reside in the intestines since they cannot survive in the acidic environment within the stomach. However, H. pylori can reside in the stomach, but is not considered a good bacteria since it is responsible for gastric ulcers.

Antibiotic Effects on Normal Flora: The use of antibiotics can cause an imbalance of the normal flora within the digestive tract. Certain types of bacteria may take advantage of this opportunity to prosper and cause an infection. Clostridium difficile is a common intestinal infection that can occur following the use of certain antibiotics. Symptoms of a gut infection include abdominal cramps, bloating, bloody stools, fever, and excessive diarrhea. In women, antibiotics can kill normal vaginal flora, leaving the individual more susceptible to yeast infections.

Probiotics: In order to maintain a normal balance in the gut, probiotics medications can be used for patients who are using antibiotics. Probiotics are live cultures of bacteria that are normally found within the digestive system. In addition to probiotic medications, live cultures may also be available in certain food products such as yogurt. Patients should speak with a physician with concerns about the use of antibiotics and probiotics.

www.livestrong.com - Copyright ©  Demand Media, Inc.

Probiotics are a type of good bacteria similar to the ones normally found in your gut. Many people take them every day for their supposed health benefits, many of which are not scientifically proven. However, they have been shown to not only reduce the duration of the digestive symptoms associated with antibiotic use, but may even prevent them from occurring in the first place. Probiotics can be taken as a supplement, but you can also get them in your diet. Many fermented foods such as yogurt and miso contain probiotics, and they may also be added to some milk or juice products.

Timing Your Probiotic and Prebiotic Intake: After you take your antibiotic, wait several hours before eating something rich in probiotics. You can either take a probiotic supplement, or try eating a snack of yogurt that contains either acidophilus or bifidum. After your course of antibiotics is complete, the authors of "Prebiotics and Antibiotics: A Brief Overview," published in "The Internet Journal of Nutrition and Wellness" in February 2009, recommend doubling or tripling your probiotic intake. Because this may involve supplements in addition to foods rich in probiotics, it is best to talk to your doctor for more specific recommendations. Prebiotics, which are not wiped out over the course of antibiotic use, can be eaten any time. Katherine Zeratsky, a dietician for MayoClinic.com, reports that the average recommended dose of prebiotic supplements is between three and eight grams.

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What Should Women Know Before Taking Antibiotics?

Reference Source - www.tufts.edu

Antibiotics often lead to a vaginal yeast infection. Because antibiotics kill the normal bacteria in the vagina, yeast no longer have competition for foodand grow rapidly. Yeast cells begin attacking tissues in the vagina, usually causing one or all of the following symptoms: itching, burning, pain during sex and vaginal discharge. If you think you have a yeast infection, consult a physician.

Antibiotics may reduce the efficacy of birth control pills. As with other medications, some antibiotics may be transmitted to a fetus, and some may cause harm. Therefore, you should never take antibiotics without your doctor's knowledge if you are pregnant or nursing. 

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What Should Be Done?   

www.keepantibioticsworking.com - pdf

A recent study from Denmark, where the use of antibiotics in healthy farm animals was banned, demonstrates that ending this practice dramatically reduces the levels of resistant bacteria present in those animals.16 To keep antibiotics working for people who need them, we must stop the overuse of antibiotics in healthy pigs, poultry, and cattle, especially antibiotics that are also used in human medicine. Four steps must be taken:

  1. Congress or the U.S. Food and Drug Administration (FDA) should phase out the use of medically important antibiotics in healthy livestock and poultry.

  2. Companies involved in the production and marketing of meat and poultry (meat producers, supermarkets, restaurants, factory farms, etc.) should voluntarily agree to stop buying or selling meat produced with antibiotics for purposes other than treating sick animals. (A 1999 National Academy of Sciences report estimated that the elimination of all such uses of antibiotics in poultry, cattle, and swine production would cost consumers only $5 to $10 per person annually).17

  3. Congress or FDA should require the collection of accurate data on the production and use of antibiotics in both human medicine and animal agriculture, and make that information available to the public.

  4. Talk with your doctor to make sure that antibiotics, which work against bacterial infections, are not prescribed for viral infections such as the cold or flu. Also, take the full course of any antibiotic, as prescribed.

www.commondreams.org Reports,

..."For decades, the Food & Drug Administration has failed to regulate this industry’s use of antibiotics. That’s why Congress must now pass legislation (the Preservation of Antibiotics for Medical Treatment Act in the House and the Prevention of Antibiotic Resistance Act in the Senate) that would stop the abuse of medically important antibiotics on factory farms."

What is Being Done?

www.fda.gov

At FDA, the work to identify and contain antimicrobial resistance includes two parallel tracks:

  • efforts to reduce drug-resistant bacteria in foods and in animals that enter the food supply, and

  • facilitating the development of new antibiotics to treat patients while preserving the effectiveness of existing antibiotics.

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Holistic Treatments for Antimicrobial Resistance

www.PubMed.gov

Essential Oils Proven Effective Against MRSA: Patchouli, tea tree, geranium, lavender essential oils and Citricidal (grapefruit seed extract) were used singly and in combination to assess their anti-bacterial activity against three strains of Staphylococcus aureus: Oxford S. aureus NCTC 6571 (Oxford strain), Epidemic methicillin-resistant S. aureus (EMRSA 15) and MRSA (untypable).  A combination of Citricidal and geranium oil showed the greatest-anti-bacterial effects against MRSA, whilst a combination of geranium and tea tree oil was most active against the methicillin-sensitive S. aureus (Oxford strain)….

This study demonstrates the potential of essential oils and essential oil vapours as antibacterial agents and for use in the treatment of MRSA infection. To read in its entirety… The Effect of Essential Oils on MRSA

www.ncbi.nlm.nih.gov

The antimicrobial activity of 4 samples of B. citriodora oil, leaf paste, commercial tea (0.2 and 0.02 g/mL), and hydrosol (aqueous distillate) were tested against 13 bacteria and 8 fungi… The 4 essential oils were found to be effective antibacterial and antifungal agents; however, variation was apparent between oils that did not correlate with citral content.

www.ncbi.nlm.nih.gov

The essential oil of Dracocephalum foetidum, a popular essential oil used in Mongolian traditional medicine, was examined for its antimicrobial activity. Eight human pathogenic microorganisms including B. subtilis, S. aureus, M. lutens, E. hirae, S. mutans, E. coli, C. albicans, and S. cerevisiae were examined. The essential oil of Dracocephalum foetidum exhibited strong antimicrobial activity against most of the pathogenic bacteria and yeast strains that were tested…

www.ncbi.nlm.nih.gov

The essential oil of Oliveria decumbens was investigated for its components and antimicrobial activity against six bacteria and two fungal strains. The oil exhibited high antimicrobial activity against all tested Gram+ and Gram- bacteria and fungal strains.

www.ncbi.nlm.nih.gov

In the present study, the antimicrobial activity of the essential oils from clove (Syzygium aromaticum (L.) Merr. et Perry) and rosemary (Rosmarinus officinalis L.) was tested alone and in combination. Both essential oils possessed significant antimicrobial effects against all microorganisms tested…The antimicrobial activity of combinations of the two essential oils indicated their additive, synergistic or antagonistic effects against individual microorganism tests. The time-kill curves of clove and rosemary essential oils towards three strains showed clearly bactericidal and fungicidal processes of…

www.ncbi.nlm.nih.gov

This finding suggests that dietary oregano essential oil exerted a significant antioxidant effect. Dietary supplementation of oregano essential oil at the level of 200 mg/kg was more effective in delaying lipid oxidation compared with the level of 100 mg/kg, but inferior to dietary supplementation of 200 mg alpha-tocopheryl acetate per kg.

This study indirectly provides evidence that antioxidant compounds occurring in oregano essential oil were absorbed by the rabbit and increased the antioxidative capacity of tissues.

Link to Essential Oils for in-depth information...

Retrieved from - www.drweil.com

…monolaurin, a nontoxic, antiviral supplement made from lauric acid (a fatty acid found in breast milk) and glycerin. It is used to treat infections with all strains of the herpes virus along with other viral infections including measles, and HIV, the human immunodeficiency virus that causes AIDS. Monolaurin is believed to have the potential to permanently inactivate the fat coated viruses that cause these diseases by fluidizing the lipids (fats) and phospholipids in their envelopes, leading to the disintegration of viral particles.

Monolaurin, sold under the brand name Lauricidin®, comes in the form of mini pellets. Dosage should be individualized, and Dr. Jon J. Kabara, the physician/researcher who developed monolaurin, says that the usual recommended initial dose is 1.5 grams once or twice a day for one or two weeks. The dose can be increased to 3.0 grams once or twice daily thereafter. A maintenance dose can be 3.0 grams two or three times a day. The idea is to start with a low dose and then increase it gradually until you notice a positive response. Take monolaurin only under the supervision of your physician, who can prescribe it, determine your best dosage and monitor your progress. Dr. Kabara has, however, generously offered to respond to individual questions about dosage submitted with orders via his Web site, www.lauricidin.com.

www.ncbi.nlm.nih.gov

Monolaurin is a nontraditional antimicrobial agent that possesses better antimicrobial activities but causes no health problems to consumers, but the use of monolaurin in the food industry as a preservative is still limited.

www.thenews.com.pk - Reports,

Honey-helps-fight-antibiotic-resistance - ISLAMABAD: The unique property of honey lies in its ability to fight infection on multiple levels making it more difficult for bacteria to develop resistance.

According to researcher honey uses a combination of weapons including hydrogen peroxide acidity osmotic effect high sugar concentration and polyphenols all of which actively kill bacterial cells, Health news reported. For instance, the osmotic effect which is the result of the high sugar concentration in honey draws water from the bacterial cells dehydrating and killing them.

Honey inhibits the formation of biofilms or disease causing bacteria researcher added.

According to researcher, honey may also disrupt quorum sensing which weakens bacterial virulence rendering the bacteria more susceptible to conventional antibiotics.

Quorum sensing is the way bacteria communicate with one another and may be involved in the formation of biofilms. Honey is effective because it is filled with healthful polyphenols or antioxidants, the study said. These include the phenolic acids caffeic acid p coumaric acid and ellagic acid as well as many flavonoids.

Several studies have demonstrated a correlation between the non peroxide antimicrobial and antioxidant activities of honey and the presence of honey phenolics the researcher added. (APP)

cid.oxfordjournals.org - Reports,

Medical-Grade Honey Kills Antibiotic-Resistant Bacteria In Vitro and Eradicates Skin Colonization

Antibiotic-resistant bacteria pose a very serious threat to public health [1,2]. For all kinds of antibiotics, including the major last-resort drugs, the frequencies of bacterial resistance are increasing worldwide [1, 2]. Even more alarming, very few new antibiotics are being developed, because many large pharmaceutical companies have abandoned the field of antibiotic drug discovery [3]. Therefore, alternative antimicrobial strategies are urgently needed.

Since ancient times, honey has been known to possess antimicrobial properties, as well as wound-healing activity [4–6]. Microbial resistance to honey has never been reported, which makes it a very promising topical antimicrobial agent. Indeed, the in vitro activity of honey against antibiotic-resistant bacteria [7–9] and the reported successful application of honey in the treatment of chronic wound infections that were not responding to antibiotic therapy [5] have attracted considerable attention [10–12].

… Revamil medical-grade honey (B factory) is produced by bees in closed greenhouses.

… medical-grade honey has the potential to be a topical antibacterial prophylaxis or to be a treatment for topical infections caused by antibiotic-resistant bacteria… In summary, we showed that Revamil medical-grade honey has batch-to-batch reproducible and broad-spectrum bactericidal activity and is a good disinfectant for human skin. Thus, this honey has excellent potential as an anti-infective agent for topical prophylaxis or for topical treatment of skin infections caused by antibiotic-susceptible or -resistant bacteria.

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Manuka honey: The sweetness of Manuka honey is already being used in hospitals in protocols for wound care. You can place the honey directly on gauze and cover the wound. Typically, the bandage is replaced three times a day. Although studies show most honey has antibacterial activity, manuka honey seems to be especially potent due to a compound called methylglyoxal. In fact, studies have confirmed its activity against a wide range of medically important bacteria, including MRSA.

Goldenseal (Hydrastis): Hailing from the northwest United States, goldenseal is a potent antibiotic, well known to help treat sore throats as well as digestive infections which can cause diarrhea. The Native Americans taught us that goldenseal has the ability to soothe the linings of the mucous membranes of the respiratory, digestive and genitourinary tracts while effectively clearing bacterial invasion. A few drops locally can stop a sore throat in its tracks.

Oregon Grape (Berberis aquifolium): Also from the Northwest, Oregon grape contains a substance known as berberine, which can stop bacteria from adhering to the walls of the intestine and urinary tract. When used as a tea, it is a wonderful way to wash away urinary tract infections; it can be used in dried capsules or liquid tincture to treat digestive tract conditions like infectious diarrhea.

Andrographis paniculata: This Asian herb with thousands of years of traditional use is now being proven through modern research as being able to disrupt the quorum-sensing system of bacteria. This system helps bacteria attach to each other and thrive as a community. Andrographis basically helps break up the bacterial “party.” As a result, it is beneficial to treat symptoms of upper respiratory tract infections and sinus problems. Numerous studies report its ability to reduce upper respiratory infection symptoms, such as fatigue, sore throat, cough and headache.



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