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Health-ignorant patients one of many problems exacerbating antibiotic resistance

Antibiotic resistance

(NaturalNews) As 2015 begins, many of us take stock of the year just passed and find that there is much to be grateful for, but the fact that approximately 2,000,000 people in the US have been afflicted with illness from antibiotic-resistant bacteria and 23,000 of those people died this past year is certainly not among those things. The majority of the deaths occurred in a hospital or nursing home, according to the U.S. Centers for Disease Control (CDC).

Seattle Children's Hospital researchers reviewed results from studies conducted between 2001 and 2011, focusing in on treatment of childhood respiratory infections with symptoms such as sore throats, ear infections and sinusitis. The review found, according to an ABC News report, that approximately twice as many prescriptions for antibiotics were written as was necessary. Of the cases studied, only 27.4 percent were caused by bacteria, and therefore treatable with an antibiotic, yet 57 percent of them were given an antibiotic to deal with the symptoms. That averages out to 11.4 million unnecessary prescriptions each year for the period studied.

The campaign to slow the rate of prescribing antibiotics is clearly not working, as the study found that prescribing rates did not appreciably differ over the 10-year period. "Whatever we are doing now, it isn't working," lead study author Dr. Matthew Kronman told ABC News. "We need to come up with new strategies to understand why this gap exists," he added.

George Washington University led a recent study, "Germs Are Germs, and Why Not Take a Risk? Patients' Expectations for Prescribing Antibiotics In an Inner-City Emergency Department," which found that public health education materials are lacking in information about the misconceptions shaping patients' expectations of getting a prescription for antibiotics, which is driving doctors to prescribe them more. The research was published in the October issue of Medical Decision Making. Assisted by researchers from Cornell and Johns Hopkins universities, they were able to reach this widespread conclusion after surveying only 113 patients in "an urban hospital."

Given the complexity of the antibiotic resistance dilemma and its global reach, that this minor study has gained such media traction is remarkable. Far-reaching problems, such as antibiotics used to promote growth in livestock, the incentives for research and development of new antibiotics and improved methods of distribution, including prescription protocol for physicians, deserve far more consideration and attention regarding this near-crisis issue than the lack of information in some pamphlets.

For example, a November 2014 article on the website Food Safety News illustrates how little the Food and Drug Administration (FDA) actually does to keep Big Pharma in compliance with extra-label marketing. In the article, Lydia Zuraw explains that Novartis is using marketing language to promote a feed additive to increase production rather than the additive's intended use to treat dysentery, pneumonia and enteric disease in pigs. The additive, Denagard, is an antibiotic meant to treat disease that is being promoted by the company as a nursery to finisher product, essentially eaten by the animal its' entire life.

Kevin Outterson, co-director of the Health Law Program at the Boston University School of Law and member of the antimicrobial resistance working group at the CDC, authored a paper, "New Business Models for Sustainable Antibiotics,"[PDF] published in February 2014 by Chatham House. He argues that among the causes of antibiotic resistance is the currently accepted business model for antibiotic use which, when combined with current patent law, actually encourages resistance to occur.

Under traditional 'linkage', sales volumes and price determine the return on investment for a
drug. Owing to resistance, maximizing sales volumes of antibiotics is not in the interest of global
public health. Delinkage removes the link between the funding of antibiotic R&D and sales

Outterson goes on to describe three problems that delinkage seeks to solve: inadequate incentives for companies to invest in research and development, protecting antibiotics as a valuable resource from overuse, and inadequate incentives to ensure global access to effective antibiotics. He concludes that the current business model is broken because drug companies have curtailed research and development of new antibiotics, providers prescribe in the absence of proven clinical need due to incentives and "antibiotic business models built on sales volumes are inappropriate, given the evolutionary path of resistance."

The "Germs are Germs" study concluded that, in a broader sense than just pamphlets, healthcare officials need to find better communication methods and educational materials to address patients' understanding about antibiotic use and risks. While this is true, it is only a small part of the large, complex and increasingly deadly issue of antibiotic resistance. Pointing to patient understanding as the source of this global issue is like sounding the iceberg warning from the crow's nest of the RMS Titanic, and will yield a similar result.








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