Antibiotic Resistance: The Message Is Getting Through

By day, I work for an organization that combats the spread of antibiotic resistant microorganisms. One source of antibiotic resistance is the misuse of antibiotics by patients. Often patients will stop using antibiotics early because they feel better. Not only does this make it more likely that the treatment will fail, but the bacterium has been exposed to a lower dose of antibiotics, selecting for ‘intermediately’ resistant organisms, which is often the first evolutionary step towards therapeutic resistance (i.e., the antibiotic won’t work against these organisms).
But reading the reaction to someone who wanted to discontinue taking antibiotics early cheers me up. Sometimes, the public health messages do get through.
Update: Welcome Pandagonians. Feel free to look around, just don’t drink all the beer in the fridge…
Another brief thought: There’s been much talk about taxing energy, oil, and gasoline to decrease these resources use. While I’ll have to write a separate post to discuss the details, many antibiotics are very cheap, so there’s little economic incentive not to overprescribe. Would a tax on off-patent antibiotics be a good idea? Have at it, hivemind.

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10 Responses to Antibiotic Resistance: The Message Is Getting Through

  1. coturnix says:

    I really like this imagery from one of the commenters:
    “This is the image they gave us in pharmacy school:
    The antibiotic is like a guy with a machine gun standing in a pitch-black room full of 1,000,000 bad guys, firing wildly. Say every clip of ammunition (every tablet) kills 90% of the villains.
    So, after tablet #1, there are 900,000 dead bad guys and 100,000 left alive.
    After tablet #2, 10,000 left alive
    After #3, only 1,000 left alive.
    So it’s no wonder you feel better after 3 tablets. But the 1000 guys left are the wiliest and strongest ones. If antibiotic resistant bugs are going to develop, they will be decendants of those 1000. Also, to really get rid of the infection, you need to expend a LOT of ammunition on the last couple of bad guys.”

  2. Chris says:

    Yeah, I was the one who pointed the hive mind towards your blog for more reading on antibiotic resistance. Keep up the good work!

  3. Chris,

  4. smartalek says:

    Yow — I never knew that (“that” = benefit of finishing the antibiotic script / cost of not doing so), and I like to consider myself not totally stupid and not totally uninformed. (Specifically, I have been aware of the issue of the evolution of drug-resistant bacteria strains, and of the role that over-prescribing antibiotics in general plays in same.) Makes perfect sense now that you explained it, but it had never crossed my mind to even consider the possibility of a connection.
    Might want to suggest to bloggers who link to you to carry the warning over to their blogs. If I hadn’t stuck my nose in from over to Pandagon, I would still not know, and would not be able to adjust my future behavior accordingly.

  5. paul says:

    I’m amazed at how hard it seems to be to get this message out. I know it was current 30 years ago among people studying antibiotic-resistant bacteria even at the undergraduate level (and the people trying desperately to get subclinical doses of common antibiotics out of the food chain). I guess there’s so much magical thinking working against the meme that we should be glad it makes headway at all. (And nice metaphor up there.)
    I wonder how some kind of financial disincentive for using antibiotics (and not just the off-patent ones, since it’s the latest greatest versions that we’d really prefer bugs not get so much experience with) might work. It would have to hit the right people, and hard enough to affect their behavior but not so hard that the antibiotics stop being prescribed when they are still useful. This probably means not doctors or patients. Maybe if the money were assessed as a percentage of pharma marketing budgets (with the percentage varying according to some measure of the amount of resistance being generated and maintained).

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