Healthy Living for Life – Antibiotic Stewardship Part 1

living longer living healthier livingbetter than ever before welcome to Mountain-Pacific’s HealthyLiving for Life a weekly series that gives you the information education andexpert insight you need become an active participant in today’s ever-changinghealthcare client here now is today’s platform multitude have you ever heard of asuperbug many times when we talk about something being super it’s a good thingbut superbugs are becoming one of the world’s most pressing public healthissues today we’re talking about bacteria or flaws that they are able draw us verysick and no longer respond to even most powerful prescriptions we have to fightthem so what can we do about it I’m your multitude Beth Brown welcome toHealthy Living for Life a prove dedicated to helping you do only that abide tunedwe’ll are quite right back welcome back since the 1940 s antibiotics have greatlyreduced illness and death from infectious diseases but thesemedications have been used so widely and for so long that they’re becoming lesseffective every year in the u.s.At least two million people become infected withbacteria that are resistant to antibioticsI connected now by Dr. Donald SKillman and pharmacist Tom Richardson who are goingto help us better understand the public health questions circumventing the overuseand ill-use of antibiotics and how we have contributed in the creation ofsuperbugs thanks so much better for being here this morning gentlemen so Dr. Skillmanlet’s begins with you can you just tell us what we’re talking about here whatare antibiotics antibiotics are remedies that we use to fightinfections and infections are caused by microbes those microbes we often callthem germs those can be bacteria or viruses orfungi and it’s a different class of medication that’s used to kill each typeof organism like that so the antibiotics that we’re most familiar with are theones used to kill bacteria because those cause the most common types ofinfections okay and so Tom what happens if we take antibiotics when we don’tneed them so one of the things that we’ve seen nationally is that we havehad a issues with over used by antibiotics and what we’ve seen is thatbacteria have become resistant to a good deal of the traditional castes that we’veused throughout the years and as this is continuing with the bacteria do more andmore resistant certainly restraint our alternatives to be ableto treat infections and genuinely puts healthcare providers and a secure to whenpatients come to the hospital or come into the clinics I need antibiotics alot of those no longer become an effective treatment regimens and howdoes that happen how do they become resistant yeah that’s a really goodquestion bacteria are really old they’re billionsand billions of years old so they’ve been on silt longer than we have andthey’ve developed genuinely sophisticated resist mechanisms and as we’ve usedit more and more antibiotics they’re able to really adapt to seeing andhaving show to those antibiotics and upregulate genes which eventually leadsto them being able to ward off any antibiotics that come their route and asagain as over utilization occurs of yielding too much antibiotics we see thisbecoming more and more of a number of problems and national and even worldwideorganizations like the CDC the FDA the World Health Organization they’retalking about how antibiotic fighting is becoming a huge public health issuewhat are the effects why is this such a huge concern not only in this countrybut around the world well when you get a resistant type of infection it’s muchharder to eliminate so we often find beings in the hospital for longer timeintervals they may be much more sick instead of so so sick they’re deadlysick we need to use the more expensive antibiotics that are frequently have more harshside effects and so the hospital bill is higher the patient remunerates more moneythey’re in the hospital longer and their survival is lessened too these highlyresistant bacteria are can be so difficult to kill that they can kill thepatient before we can kill all the germs Wow and there are various sprains ofantibiotic resistant bacteria out there what are some of the biggest threatsthat we have right now when it comes to antibiotic defiance there are a lot ofthreats out there you’re right and the CDC does investigations nationwide andworldwide to see what the big ones are the leading one in America right now isa bacteria announced Clostridium difficile or seed if it’s a germ that lives in alot of people’s intestinal pamphlet and when we pass that those peopleantibiotics the antibiotic will kill the majority of the germs but the c-diffwill stay behind and have a great day because all the competition ison so it rises to a huge population and starts only a terrifying diarrhea in somecircumstances it’s a it’s a awfully deadly diarrhea and that is becomingincreasingly difficult to antidote we find a lot of people who need various coursesof antibiotic regiman before we can’t eradicate it are there others thatpeople should be aware of yes some of the other big-hearted ones that are resistantare tuberculosis on a worldwide scale streptococcus and we probably all heardof that staff members called MRSA which is methicillin-resistant Staphylococcusaureus that requires a variety of expensive antibiotics to killStaphylococcus is a highly vigorous bacteria can can kill people readily itcan get into the bloodstream and spread to heart valves and bones in the brainso we take that one very seriously and we we kept people in isolation when theyhave that in the hospital okay and Tom maybe you were able to make this one itseems like the obvious question here is why can’t we just make-up more biggerbetter antibiotics to duel some of these superbugsyeah and I think that’s a really interesting question simply to kind ofagain going back to the history of this you know antibiotic growing hasreally really kind of come to a halt and the 1960 s methicillin was developed andcreated introduced into clinical rehearsal and within three years we hadmethicillin resistant strainings of staph aureus or everybody now knows it as MRSA and so we’re always kind of lagging behind once these come out you know wereally have a two or three year window where antibiotic opposition develops sowe really have to develop antibiotics at a pace that really outstrips anything thatwe’ve been able to do to this point as the years have gone on developmentsbecome less and less profitable for pharmaceutical companies and and we’veseen that we know that in the 80 s we used to have dozens of antibiotics cometo market there were a lot of fiction entities that were introduced and astime has goes on and particularly in the 2000 s we’re lucky if we get one to twonew antibiotics that are that come to market and we’re able to use in clinicalpractice and not all of those are always supportive and plowing these resistantorganisms so genuinely I think that you know with some of the newer substance that’sgone on there’s been a lot of fast-track approval is what we call it whereantibiotics and research and development from pharmaceutical companies there’snow an easier track for them to develop these it’s lessfor pharmaceutical companies and it has shown behind the scenes that there aremore in development and are in phase we go through clinical experiments as a lot ofus are familiar with and that there are a lot of more in clinical trial phaseright now that hopefully in the next three to five years we’ll receive more of aninflux of again operators that are helpful in treating these resistant infectionsokay and we’re almost out of time but you talked about the cost of developingantibiotics what about the costs of antibiotic resistance yeah that’s agreat question and as Dr.Skillman alluded to you know these illness aremore difficult to treat they usually require us to use more costlybroad-spectrum antibiotics and so anytime “were having” these infectionspatients are in hospitals longer which certainly increases cost topatients to healthcare entities and then again those antibiotics that we usewhere a great deal of the old-school pharmaceuticals were able to use our pennies on the dollarand these newer nice large-scale bad agents are you know thousands of dollars per courseso again that resistance truly drives the increased cost okay thank yougentlemen so superbugs are the bad news is they’regood news yes there is and we’ll talk about that when we come back right afterthis

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