Life in a world without antibiotics

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Itā€™s not only all of that but youā€™re going to be concerned with the ā€˜danger triangleā€™ once again. The face down to the shoulders, areas where a minor infection will cause serious problems. Iā€™d always heard stories about a great uncle who died in the 1930s from a toothpick. He stabbed his gums, got an infection, and died from it. Not sure if it was story meant to scare me about good oral hygiene or what.

Definitely going to be a heck of a lot of quarantining going on in our futures.

Iā€™ve got to admit, I worry sometimes about whether medicine ā€“ especially but not limited to surgery ā€“ is about to reach a peak and begin declining until a new generation of ā€œmiracleā€ antibiotics can be found.

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I have some understanding of antibiotics and antibiotic resistance (Iā€™m even doing phage research with my collegeā€™s biology department). But here is what I donā€™t understand. Ethnobotanical research points to a wide range of antibiotically active traditional medicines. Where I live, a poultice of usnea lichen would have been a common sense first-aid treatment for Joe McKennaā€™s wounds. We now know usnea lichen contains the antibiotic usnic acid, but itā€™s use in treating wounds greatly predates that modern information. How did european culture lose this form of pre-scientific knowledge and use of antibiotic medicines?

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I would imagine direct access to certain plant forms might have made it impractical. Also, perhaps the infections were ignored, in order to work to live, etc, until they were systemic and it was too late to apply topicals?

*Should have put lack of direct access.

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People forget what a horror syphilis used to be with countless thousands of people confined to mental asylums, hopelessly insane. How soon before we return to that because of antibiotic resistance?

http://drvitelli.typepad.com/providentia/2007/10/the-great-decei.html

Aside from any new antibiotics being developed, which from the Frontline episode it appears that all of bigpharma has gotten out of the business, hospitals desperately need to find better, more effective means of sterilizing equipment.

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There is a great future for them in Congressā€¦

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No, they need to really focus training on contamination control.

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That is true, but there is equipment used by multiple patients that spread disease. That would be part of contamination control, actually.

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I have read that women were often the ones who passed down the knowledge of natural remedies, so as male doctors/scientists came up with new options, the womenā€™s knowledge was sidelined. (Think of the history of childbirth, for example.) And of course in many times and places they would have been killed for being ā€œwitchesā€ or such. If I knew my aunt and grandmother had been killed for healing their neighbors, Iā€™d probably find another line of work instead.

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Iā€™m not sure we have in full. Development of new antibiotics looks to all sorts of places, and some traditional medicines have been kept or encorporated into chemical ones when they work well enough; witness the success of artemisin. Usnic acid has been used as a topical cream in some countries, but on a commercial scale I gather suffers because of allergic reactions. The problem is these too still need to be checked for efficacy, developed for large scale production, and used carefully so they donā€™t expire, and thatā€™s been neglected for antibiotics in general.

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Did you know that the recent outbreak of salmonella that came from three Foster Farms plants was antibiotic resistant? The strain was salmonella Heidelberg, and it is resistant to four of the major antibiotic drugs.

The dosing of chickens, pigs and cows in order to reduce disease caused by over crowding (and slightly increase weight) has led to this.

Things to note.

  1. Foster Farms was shipping out this antibiotic resistant strain of Salmonella Heidenberg on 25 percent of its chickens.
    That includes all Safeway chicken and Costco. (USDA figures from Oct 5, 2013)

  2. The USDA cut a deal with Foster farms to not recall the chicken, even though the contamination level was one out of every 4 chickens. They sent a warning letter that said, 'Yes itā€™s contaminated but if you cook it correctly and handle it correctly it is safe."

  3. Approximately 18,000 people were unable to cook it correctly or handle it perfectly (or someone who fed them made a mistake) and they got food poisoning. over 500 of those so bad they were hospitalized. (the CDC created multiplier for hospitalized to ill is 38.5)

  4. Costco DID remove the chickens from the shelves, even though it wasnā€™t recalled and was "safe. Safeway did not remove the contaminated chicken from its shelves. Safeway customers have a greater chance of being exposed to this antibiotic resistant strain of Salmonella.

In a recent story over at io9 FDA data indicates there are close to 150,000 illnesses reported every year due to eggs contaminated by Salmonella.
From the article:

The other reason Americans tend to refrigerate their eggs: our risk of Salmonella poisoning is often significantly higher than it is overseas, because our chickens are more likely to carry it. In the UK, for instance, it is required by law that all hens be immunized against Salmonella. This protection measure, enacted in the late 1990s, has seen Salmonella cases in Britain drop from 14,771 reported cases in 1997 to just 581 cases in 2009. (link to article)

The role of Big Chicken, Big Pig and Big Beef in this situation is clear. They also use their lobbying power to refuse to change their ways. That requirement to immunize chickens that the UK used? It was shot down in the US because of lobbying power.
Just another place for antibiotic strains of salmonella to rise up.

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I donā€™t know what really happens but my dentist used to steam his tools. is there a more efficient way than steaming objects?

Not just steam, high-pressure steam (which can be raised to higher temperatures). Autoclaves work pretty well for things that can be put in autoclaves. Not everything can be, due to either size or materials.

Thereā€™s another factor: as a society, weā€™ve forgotten about aseptis and antisepsis. Hospitals are kept cosmetically clean, but too often neglect such simple precautions as changing bedding and sanitizing mattresses between patients. Doctors, nurses and ward workers fail to wash their hands between patients. Individuals fail to use antiseptic on ā€œminorā€ wounds, donā€™t wash their hands before handling food and cutlery, avoid immunization, and fail to take simple precautions against the spread of infection.

Pre-antibiotic, say to the mid-1950s, there was a general awareness that bacteria caused infection, disease and death, not only from wounds and communicable disease, but also from routine food preparation and home canning. As we have become accustomed to defeating infection with a pill or a shot, and with using foods part-prepared by others, we have systematically made ourselves more vulnerable.

As Fleming predicted, weā€™re paying the price.

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A few years ago, I went to the hospital and left with an infection. It started in my elbow and every day it spread a bit more. At first, no one was worried, antibiotics would kill it. It turned out to be an MRSA of some sort and antibiotic after antibiotic failed to do anything. Every day the doctors would mark on my arm with a sharpie where the redness and swelling ended. Every day it got closer and closer to my shoulder. One day, I went in and the doctor said, ā€œIf this gets to your torso, you could die. If we canā€™t get this under control soon, we may have to amputate your arm to prevent that from happening.ā€

That was really scary. Something that started off looking like a bug bite on my elbow suddenly becoming something that could possibly kill me and was increasingly looking like would require the loss of an arm.

Luckily, the 5th or 6th antibiotic they tried finally did the trick.

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Thatā€™s why everyone should keep topical antibiotic cream handy and apply it heavily to any wound to prevent infection from getting estabished.

An autoclave is useful because it can sterilize large volumes of liquids. It can also sterilize dry goods and there is a drying cycle to remove condensation. Otherwise, boiling (even a low boil) sterilizes very effectively.

Donā€™t think itā€™s more efficient but high energy radiation is also used for sterilization. When I had my titanium dental implant inserted I remember the dentist showing me it sealed in a glass vial which had turned a beautiful ruby red color from the radiation.

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