<story><title>Antibiotic resistance: The grim prospect</title><url>http://www.economist.com/news/briefing/21699115-evolution-pathogens-making-many-medical-problems-worse-time-take-drug-resistance</url></story><parent_chain><item><author>atmosx</author><text>&amp;gt; Medical professions risk losing a patient or being sued if hey misdiagnose a condition, so the understandable reaction is to throw antibiotics at the problem rather than waiting for test results to come-back to determine whether a specific course of care is appropriate.&lt;p&gt;As a pharmacist, my experience says otherwise. I think the following are the main reasons for bacterial resistance:&lt;p&gt;a) Patient doesn&amp;#x27;t respect doctor&amp;#x27;s&amp;#x2F;pharmacist&amp;#x27;s guidelines. He feels &lt;i&gt;much better&lt;/i&gt; after day 3, so he stops his class X ATB in day 4 instead of day 7. If bacteria survives, might very well be class X ATB-resistant.&lt;p&gt;b) Patient has a relative who when &lt;i&gt;was feeling sick&lt;/i&gt; took ATB XYZ and got better. The main reason for this is poverty: A visit to the doctor might cost 25-120 EUR.&lt;p&gt;c) Hospitals. MRSA became &amp;quot;MR&amp;quot; in hospitals, where bacteria conjugation takes place.&lt;p&gt;That said, at some in point, we should expect bacterial organisms to evolve some kind of resistance. That&amp;#x27;s how evolution works.</text></item><item><author>uptown</author><text>Medical professions risk losing a patient or being sued if hey misdiagnose a condition, so the understandable reaction is to throw antibiotics at the problem rather than waiting for test results to come-back to determine whether a specific course of care is appropriate.&lt;p&gt;The good news is that some test times are decreasing dramatically ... from days to minutes in many cases:&lt;p&gt;&lt;a href=&quot;http:&amp;#x2F;&amp;#x2F;nanologix.com&amp;#x2F;test_results.html&quot; rel=&quot;nofollow&quot;&gt;http:&amp;#x2F;&amp;#x2F;nanologix.com&amp;#x2F;test_results.html&lt;/a&gt;&lt;p&gt;&lt;pre&gt;&lt;code&gt;  * tuberculosis from 21+ days to 1.5 hours.

  * e.coli from 18 - 24 hours to 30 minutes

  * salmonella from 24 hours to 30 minutes

  * group b streptococcus from 48 - 72 hours to under an hour
&lt;/code&gt;&lt;/pre&gt;
My hope is that faster results leads to fewer unnecessary prescriptions being administered, and better overall care for the patients.</text></item></parent_chain><comment><author>iLoch</author><text>Regarding (a) - do you know that I&amp;#x27;ve never been told &lt;i&gt;why&lt;/i&gt; I need to finish my antibiotics? For some reason (arrogance?) doctors don&amp;#x27;t &lt;i&gt;explain&lt;/i&gt; their reasoning in many cases (I live in Canada FWIW.)&lt;p&gt;If I was told &amp;quot;hey, you need to finish your antibiotics or you&amp;#x27;ll risk becoming immune to them, potentially putting yourself or your family, colleagues, or friends at risk&amp;quot; I don&amp;#x27;t think even the dumbest person would ignore that warning. Then they could even explain WHY that is, if the patient was curious.&lt;p&gt;Instead, here in Canada, you say you&amp;#x27;re sick, the doctor will likely immediately perscribe antibiotics, then shuffle you out the door in less than 5 minutes.</text></comment>
<story><title>Antibiotic resistance: The grim prospect</title><url>http://www.economist.com/news/briefing/21699115-evolution-pathogens-making-many-medical-problems-worse-time-take-drug-resistance</url></story><parent_chain><item><author>atmosx</author><text>&amp;gt; Medical professions risk losing a patient or being sued if hey misdiagnose a condition, so the understandable reaction is to throw antibiotics at the problem rather than waiting for test results to come-back to determine whether a specific course of care is appropriate.&lt;p&gt;As a pharmacist, my experience says otherwise. I think the following are the main reasons for bacterial resistance:&lt;p&gt;a) Patient doesn&amp;#x27;t respect doctor&amp;#x27;s&amp;#x2F;pharmacist&amp;#x27;s guidelines. He feels &lt;i&gt;much better&lt;/i&gt; after day 3, so he stops his class X ATB in day 4 instead of day 7. If bacteria survives, might very well be class X ATB-resistant.&lt;p&gt;b) Patient has a relative who when &lt;i&gt;was feeling sick&lt;/i&gt; took ATB XYZ and got better. The main reason for this is poverty: A visit to the doctor might cost 25-120 EUR.&lt;p&gt;c) Hospitals. MRSA became &amp;quot;MR&amp;quot; in hospitals, where bacteria conjugation takes place.&lt;p&gt;That said, at some in point, we should expect bacterial organisms to evolve some kind of resistance. That&amp;#x27;s how evolution works.</text></item><item><author>uptown</author><text>Medical professions risk losing a patient or being sued if hey misdiagnose a condition, so the understandable reaction is to throw antibiotics at the problem rather than waiting for test results to come-back to determine whether a specific course of care is appropriate.&lt;p&gt;The good news is that some test times are decreasing dramatically ... from days to minutes in many cases:&lt;p&gt;&lt;a href=&quot;http:&amp;#x2F;&amp;#x2F;nanologix.com&amp;#x2F;test_results.html&quot; rel=&quot;nofollow&quot;&gt;http:&amp;#x2F;&amp;#x2F;nanologix.com&amp;#x2F;test_results.html&lt;/a&gt;&lt;p&gt;&lt;pre&gt;&lt;code&gt;  * tuberculosis from 21+ days to 1.5 hours.

  * e.coli from 18 - 24 hours to 30 minutes

  * salmonella from 24 hours to 30 minutes

  * group b streptococcus from 48 - 72 hours to under an hour
&lt;/code&gt;&lt;/pre&gt;
My hope is that faster results leads to fewer unnecessary prescriptions being administered, and better overall care for the patients.</text></item></parent_chain><comment><author>Retric</author><text>This ignores livestock which is both a huge vector for resistance and part of the food chain.  It&amp;#x27;s not like this is new, Sulfa drugs worked really well for a short period of time before penicillin  and are now somewhat useful.</text></comment>