strep and penicillin

Bob Morrell bmorrell at ISNET.IS.WFU.EDU
Wed Jan 11 21:15:40 EST 1995


On Wed, 11 Jan 1995, HANS BUSK wrote:
> JC> for the the TIME perscribed.  The reason that we have antibiodic
> JC> immune strains is primarily from people who do NOT use as directed.
> 
> I know this is a very common misconception.
>
I believe the reference was to antibiotic resistance in general not to 
strep pyogenes.
 
> The main reason for the widespread problems of multiresistant bacteria
> is caused by the common practice of using an antibiotic 'just to be
> sure' and to use a widespectrum antibiotic 'just to be sure'.

I am not sure anyone has real proof whether incomplete treatment or 
overuse is the main source of resistance. My bet would be on the later, 
but in the case of MDR TB, everything I have seen indicates incomplete 
treatment. And my own institution's experience (or lack of experience) 
with Vanco resistance run against the overuse therapy (since we have 
been overusing vanc for longer than just about everyone. Then 
there is the argument that low level animal dosing develops it...

> Probably in a few years time we will be in the postantibiotic era, where
> most infectious diseases will take their natural cause, because we have
> wasted our ingenious antibiotics.

I believe that this concept of a post antibiotic era, an outgrowth of the 
infamous Newsweek article considerably overstates the case. Certainly we 
are not as far ahead of the bugs as we once were, but a two step lead vs 
a ten step lead does not mean the end of an era. Smarter use (actually 
reading the lab MIC's would be a start!) will, combined with increased 
development, keep us ahead in most infections. (a humble and optimistic 
opinion)

*                     Bob Morrell                       *
*              bmorrell at isnet.is.wfu.edu                *
* The operation was a success, as the autopsy will show *




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