WHO Ranks Antibiotics to Fight Life-Threatening Antibiotic Resistance

In June the World Health Organization (WHO) published a new classification of antibiotics aimed at fighting drug resistance, with penicillin-type drugs recommended as the first line of defense, and others only when absolutely necessary. [1]

(What’s more, although the issues outlined in the video above hold true, it is also true that creating new antibiotics isn’t so profitable for drug companies. This creates little incentive to spend money on further research, instead of just churning out what is already available in the market.)

It is the largest revision of the antibiotics section in the WHO Essential Medicines List in its 40-year history.

Scientists have warned that drug resistance is a health crisis in the making, and could kill more people than cancer. To put that in perspective, the WHO said in 2014 that it expected cancer cases to surge 57% worldwide over the next 2 decades.

Thirty-nine antibiotics for 21 common syndromes are included in the “Essential Medicines List.” They are broken down into 3 groups:

• “Access” – Bacteria are less likely to develop resistance to drugs on the “Access” list, including widely-used amoxicillin, cefalexin, azithromycin, ciprofloxacin, and doxycycline.

• “Watch” – The “Watch” group includes antibiotics with a higher potential for resistance, and so are recommended as first or second choice treatments for a few, select illnesses. The WHO says these medications – including quinolones, fluoroquinolones, and carbapenems – should be “prioritized as key targets of stewardship programs and monitoring.”

• “Reserve” – Finally, the “Reserve” group includes “last resort” antibiotics which the WHO says “should be accessible, but whose use should be tailored to highly specific patients and settings, when all alternatives have failed.” In other words, serious, life-threatening infections due to multi-drug resistant bacteria. [1] [2]

Fluoroquinolones are fluoride-based antibiotics with links to severe neurological side effects, including severe pain, neuropathy, and paralysis, as well as other complications. The FDA slapped a “black box” warning, the agency’s most serious warning, on the drug class due to its potential to cause major health issues – bigger issues than fluoroquinolones are often prescribed to treat.

Source: Business Insider

Read: A Superbug Resistant to 26 Antibiotics Takes Life of Elderly Woman

Colistin, a polymyxin, has been in the news quite a bit in recent years because its overuse in livestock has caused bacteria to grow increasingly resistant to it. It’s placement on the “Reserve” list raises questions about how producers of such antibiotics could make money, according to Suzanne Hill, WHO’s Director of Essential Medicines and Health Products. [1]

She said:

“What we need to do is stop paying for antibiotics based on how many times they are prescribed, to discourage use. We don’t want colistin used very frequently. In fact, we don’t want it used at all.

What we need to do as a global community is work out how we pay the company not to market colistin and not to promote it and to keep it in reserve.”

Hill acknowledged the economic incentive system in drug development revolves around sales and it is likely there will be “a very large economic impact” for drug companies that make antibiotics in the “Reserve” category. [3]

The list takes into account antibiotic use in farm animals, and was developed together with the UN Food and Agriculture Organization and the World Organization for Animal Health.

Source: Nature

The WHO writes that the changes are intended “to ensure that antibiotics are available when needed, and that the right antibiotics are prescribed for the right infections.” [2]

The international health body adds:

“It should enhance treatment outcomes, reduce the development of drug-resistant bacteria, and preserve the effectiveness of ‘last resort” antibiotics that are needed when all others fail. These changes support WHO’s Global action plan on antimicrobial resistance, which aims to fight the development of drug resistance by ensuring the best use of antibiotics.” [4]

Marie-Paule Kieny, assistant director-general for health systems and innovation at the WHO, said the WHO doesn’t see the list changes as “a quick-fix solution,” but scientific evidence backs the notion that it could cut the number of dangerous infections. [3]

Sources:

[1] Reuters

[2] World Health Organization Model List of Essential Medicines

[3] The Washington Post

[4] World Health Organization

Business Insider

Nature

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About Mike Barrett:
	Mike is the co-founder, editor, and researcher behind Natural Society. Studying the work of top natural health activists, and writing special reports for top 10 alternative health websites, Mike has written hundreds of articles and pages on how to obtain optimum wellness through natural health.

The Problem of Antibiotic Resistance is Getting Much Worse

Scientists have detected a disturbing form of antibiotic-resistance on U.S. farms in recent months, but it’s not the type they anticipated, and they don’t know how it wound up there.

Researchers say that they’ve discovered resistance to a class of antibiotics called carbapenems, a last-line of defensive drugs used to treat severe infections. These antibiotics are not intended for agricultural use because they are so vital to human health. In fact, they’re so potent and so valuable that they are usually reserved for patients exhibiting resistance to multiple antibiotics. [1] [2]

The bacteria had been identified among European and Asian livestock, but there was no sign of the problem in the U.S. until now. [3]

The Unsettling Discovery

Thomas Wittum, chair of veterinary preventive medicine at Ohio State University, and a team of colleagues went to a pig farm where they swabbed floors and walls over a 5-month period, collecting environmental and fecal samples. They discovered the presence of a specific carbapenem-resistant gene called blaIMP-27 growing in their petri dishes. [3]

Wittum explains that carbapenem antibiotics are illegal for farm use; even if they weren’t, they’d be too expensive anyway.

“How the [resistant bacteria] got onto the farm we really don’t know. But probably it was introduced from the outside from movements of wildlife, people, equipment, etc.” [1]

He says it’s possible that other legal antibiotics used on the farm could be helping the bacteria to grow and spread, but more research is necessary.

None of the bacteria was detected in any of the pigs, but Wittum says he and the study’s co-authors have detected it in both sows and piglets.

“We found no evidence that these organisms were entering the food supply, but that is the concern: that it could happen on this or other farms,” he says. “We need more research to really understand that risk.”

He goes on to say:

“For now, we think that this is a rare and unusual occurrence. We hope that we have caught it early enough to stop it from spreading.

[But] the risk to the public is that these are food animals that will someday enter the food supply as fresh pork products.

While we didn’t find any evidence that that has occurred on this particular farm, it is a potential concern. We want to be sure that multidrug-resistant bacteria like these are never present in food, and one way to do that is to be sure that they are not introduced onto our farms.” [3]

Source: CDC. Click for larger version.

In the spring, British Chancellor George Osborne warned that antibiotic resistance could kill up to 10 million people a year by 2050, making it a bigger threat than cancer. That’s 1 person every 3 seconds.

Wittum says that this particular strain of antimicrobial resistance “may be related to antibiotics used to treat sick pigs, for the same reason that resistant bacteria like these are present in human hospitals because of the way we treat sick people with antibiotics.”

In other words, they’ve been overused.

He adds:

“We can’t just stop treating the sick pigs with antibiotics because of the negative impact that would have on animal welfare. But it might be possible for the farm to use antibiotics in different ways to stop the spread of this particular strain.”

But treating them and preventing them from becoming sick are 2 different things. Dr. David Wallinga of the Natural Resources Defense Council says the discovery may mean we’ve passed the point of no return.

Read: 84-Page Report Outlines 9 Ways to Beat Antibiotic Resistance

“The last terrible shoe may have just dropped when it comes to drug-resistant infections. This is just one more warning that doctors may soon have nothing left in their toolkit to save patients when these bugs strike.

Our overuse of antibiotics in livestock is creating reservoirs for the spread of resistance – and this study strongly suggests resistance to carbapenems is no exception. To save our miracle drugs, we have got to stop wasting them on animals that aren’t sick.” [2]

Sources:

[1] Time

[2] Consumerist

[3] HealthDay

CDC

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About Julie Fidler:
	Julie Fidler is a freelance writer, legal blogger, and the author of Adventures in Holy Matrimony: For Better or the Absolute Worst. She lives in Pennsylvania with her husband and two ridiculously spoiled cats. She occasionally pontificates on her blog.

Genes for Antibiotic-Resistant Bacteria Are Found in Beijing Smog

Public health experts have warned that antibiotic resistance could claim 10 million people each year by 2050. In early December 2016, researchers said they had discovered that livestock had become resistant to a class of antibiotics used only in humans. Now scientists have found the genes that make bacteria resistant to antibiotics in polluted air in Beijing, China. [1]

Source: The New York Times

Read: Superbug Resistant to ALL Antibiotics Found in China

In the study, the team analyzed DNA sequencing from 864 different samples from humans, animals, and the environment. Some of those samples came from Beijing smog, and in those samples researchers identified a variety of genes that can make bacteria resistant to antibiotics.

It’s a scary announcement, but the discovery of the gene in the crowded city’s smog doesn’t necessarily mean people can get superbugs from the air. At this point, researchers only know that the aerial spread of such genes should be researched further – at least according to a paper in the journal Microbiome by researchers at the University of Gothenburg .

But if antibiotic resistance can be spread through the air, it means that the bacteria people pick up on surfaces around Beijing may become harder, if not impossible, to beat. In a city of 11.51 million people, there are plenty of bugs to go around. So even if drug-resistant bacteria can’t make someone sick through inhalation, that doesn’t mean they can’t sicken people in some other way.

W. Ian Lipkin, director of the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health, isn’t convinced that smog-borne antibiotic-resistant resistant bacteria aren’t a threat. He explained:

“It’s not clear that bacteria in smog are a health threat.

What is clear is that the air isn’t clean. Pollution results in damage to airways that increases susceptibility to a wide range of viruses as well as bacteria.

One question not addressed is whether smog stabilizes bacteria in a way that normal air does not. Bacteria probably don’t replicate in the air. More likely that they settle somewhere and do, exchanging genetic material in liquid or on surfaces.” [2]

Source: WHO

Joakim Larsson, director of the Centre for Antibiotic Resistance Research at the University of Gothenburg, is the lead author of the study. He said:

“We think this is really under-investigated and not taken seriously.” [1]

Speaking of bacteria replicating in liquid…

In addition to discovering the genes that cause antibiotic resistance in the air, Larsson and his colleagues also found a high amount of the genes in areas where there is a great deal of pollution from antibiotic manufacturing. Larsson’s past research shows that waste from manufacturing plants can end up in water sources. More regulation is needed to combat this problem, he said, adding:

“We need to apply discharge limits and have some regulation enforced. I think there’s sufficient data there to really call for some action.”

The most frightening part of the discovery was the fact that some of the genes can contribute to bacteria becoming resistant to carbapenems, a class of “last-resort” antibiotics.

How concerned people in Beijing should be about drug-resistant genes in the air seems to depend on whom you ask. But state news outlets have been doling out advice to Beijing residents, either out of genuine concern, or merely to assuage the worries of locals:

“To minimize illness during smog attacks, get enough sleep, eat foods that help you expectorate, flush out your nose with saltwater and wash your hands.” [2]

Sources:

[1] Time

[2] The New York Times

The New York Times

WHO

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About Julie Fidler:
	Julie Fidler is a freelance writer, legal blogger, and the author of Adventures in Holy Matrimony: For Better or the Absolute Worst. She lives in Pennsylvania with her husband and two ridiculously spoiled cats. She occasionally pontificates on her blog.