bill missett ([email protected]) thought you might be interested in this
Las Vegas Sun (http://www.lasvegassun.com/) story:

http://www.lasvegassun.com/sunbin/stories/thrive/2003/mar/09/030905665.html

Message from sender:
Making the case for CS

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Sharp Jump Seen for Drug-Resistant Germs

By RANDOLPH E. SCHMID
ASSOCIATED PRESS


WASHINGTON (AP) -
Drug-resistant germs are on the rise in the United States and experts predict a 
sharp jump in the strains of a dangerous form of strep that can overcome two 
common antibiotics.

By the summer of 2004, as many as 40 percent of the strains of Streptococcus 
pneumoniae could be resistant to both penicillin and erythromycin, researchers 
warn. That form of strep causes thousands of cases of meningitis, sinusitis, 
ear infections and pneumonia every year.

Researchers based at the Harvard School of Public Health studied reports from 
sites in eight states, measuring how common the drug resistance was in 1996 and 
how it increased by 1999.

Penicillin resistance rose from 21.7 percent of strep strains in 1996 to 26.6 
percent in 1999, and for erythromycin it increased from 10.8 percent to 20.2 
percent, the team reports in a paper appearing in Monday's online edition of 
the journal Nature Medicine.

The report provides further support for arguments against unnecessary 
antibiotic use, said Marc Lipsitch, one of the researchers.

For years, public health experts have warned that overuse of antibiotics - 
often when they are not needed - is leading to more and more drug-resistant 
bacteria.

For example, many people demand antibiotics when they have a cold, even though 
colds are caused by viruses, which are not affected by antibiotics.

Just last month the Food and Drug Administration announced plans to require a 
new warning on antibiotics, pointing out that overusing them makes them less 
effective.

Doctors must be sure a patient is suffering a bacterial infection, not a virus 
with similar symptoms, before prescribing antibiotics, the warnings say. The 
government estimates that half of the 100 million antibiotic prescriptions 
written in physician offices each year are unnecessary.

The new research "puts it on the doctor's plate," said Dr. Donald Low of Mount 
Sinai Hospital in Toronto. "Can we change the future? Yes, there are things we 
can do, but can we do them quickly enough?"

Doctors need to make the decision to use antibiotics the right way, in the 
proper dose, he said, and to encourage vaccination, which reduces illness and 
thus the need for antibiotics.

Vaccines against that form of strep are recommended for infants and older 
persons, the two groups most likely to get the infection.

Germs resistant to just one of the antibiotics can still be killed by the 
other, so the researchers project either a slow growth or a decline for these 
bacteria.

But using a new statistical formula that takes into account how the bacteria 
are transmitted, the researchers forecast rapid growth for strains of S. 
pneumoniae that are resistant to both of the antibiotics, reaching 40.6 percent 
by the summer of 2004. That's up from just 8.6 percent in 1996.

"That's a bit of a chilling message," said Low, who was not part of the 
research team. "Within a year and a half, we're know whether they're right or 
wrong," he said. If the technique works, it will be a valuable tool in the 
future, he added.

Dr. Allison McGeer, also at Mount Sinai, added: "We have always known this is 
what will happen to resistance unchecked, and there is no reason to believe 
that their predictions will not come true."

---

On the Net:

Nature Medicine: http://www.nature.com/nm 

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