Antibiotic Resistant Bugs

Do We Still Have An Antibiotic Shield?

Since much of our dietary meat comes from central sources, any "fellow-traveling" germs are likely to be spread far and wide. A recent study of a particular antibiotic-resistant strain of E. Coli demonstrated this distribution system.

At two fairly widely separated colleges, it was shown that almost 40% of women (slightly fewer men) carried an unusual antibiotic-resistant strain of E. Coli. The authors and an editorialist commenting about the study all felt that the source of the strain was food, most likely meat. (This is not exclusively a meat thing - strawberries have been implicated as well.) Fortunately, few of those carriers became ill during the course of the study, but they were at risk (particularly the women) for urinary tract infections difficult to cure with the usual drugs.

Ever shrinking geography and excessive use of antibiotics have combined to put many of us in jeopardy of newly frightening infectious disease. Proper handling of food (thorough washing of fresh foods, and thorough cooking of meat and poultry) will reduce infection risk to nearly zero.

Item Two: Whither Cipro?

Two months after the first anthrax exposures led to widespread use of Cipro prophylaxis, reports of problems with the drug are surfacing. All of the usual side-effects (nausea, diarrhea, skin rash) plus a few cases of tendon rupture are being reported. So far, no class action suits against the US Post Office, the government or the maker of Cipro have been filed, but it's just a matter of time.

When there's a problem, somebody's to blame, and that somebody's gonna pay!

A typical course of treatment with Cipro, an excellent drug, lasts a week or so, and side effects are minimal. In the case of the (possible) anthrax exposures, there was no good beginning or end point for treatment, so everyone had to take the drug for as long as spores "might be in their bodies." That's about 60 days.

Our previous concerns about widespread use of Cipro by people who got it over the Internet, in Mexico, or from nervous doctors, are still present. Those who paid a bundle for a bottle are going to want to get something back, and they can't return the drug to Mexicali or Barbados. They are going to take Cipro the next few times they think they have an infection. That's what it's for, isn't it?

The final result of all of this is that the terrorist attacks will have successfully compromised the effectiveness of a previously good antibiotic, if not destroyed it completely.

Item Three: A Reminder

We wrote once about the amino acid homocysteine, present in the blood of all of us, which, if elevated, may be a "marker" for and possibly a cause of arterial disease. A recent patient encounter reminded us how important this can be. Anyone with the combined problems of coronary artery and peripheral vascular disease should have the homocysteine level checked. If it is high, their family members should also be tested, since there is a genetic element involved. High homocysteine can be easily treated by taking folic acid. (The amount needed requires a prescription.)