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href=\"http://www.un.org/ga/search/view_doc.asp?symbol=A/71/L.2&referer=/english/&Lang=E\" target=\"_blank\" rel=\"noopener\">United Nations General Assembly\u003c/a> — has issued this grave warning to the world.[contextly_sidebar id=\"XV9iH3usDUjTEoRS7VEResmysvKM5CrO\"]\u003c/p>\n\u003cp>A \u003ca href=\"https://theconversation.com/canada-could-lead-the-fight-for-life-in-a-post-antibiotic-world-80864\" target=\"_blank\" rel=\"noopener\">post-antibiotic future is daunting\u003c/a>. When the drugs don’t work, we get sicker more often. We stay sicker longer. This hurts the economy because sick people don’t work.\u003c/p>\n\u003cp>In response, we really only have two options.\u003c/p>\n\u003cp>One is to gather more arrows in our quiver — by discovering new antibiotics to which microbes like bacteria are not currently resistant.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The second is to manage our current arsenal of drugs better so that they remain effective for as long as possible. The key to doing this is to reduce the global burden of antibiotic resistance by decreasing the quantity of drugs we use.\u003c/p>\n\u003cp>\u003cstrong>Delivering drugs differently\u003cbr>\n\u003c/strong>The first strategy of response to antibiotic resistance is not as easy as it sounds. While there are many potential new therapies that could be effective, there are few incentives for industry to invest in their development.\u003c/p>\n\u003cp>If an antibiotic works well, it is used for a short time — a few days to a couple of weeks at the most. The \u003ca href=\"https://www.pharmaceutical-journal.com/news-and-analysis/features/why-are-there-so-few-antibiotics-in-the-research-and-development-pipeline/11130209.article\" target=\"_blank\" rel=\"noopener\">commercial return on a drug designed to treat longer lasting non-communicable illnesses, like cancer, for instance, can be much higher\u003c/a> because the drugs are used for longer.\u003c/p>\n\u003cp>The logic of the second strategy is straightforward. The widespread use of antibiotics in medicine and agriculture means that a drug-resistant variant of a bacterium will enjoy a strong selective advantage and can quickly spread. So by reducing the use of drugs, we reduce the selection pressure on resistance and slow the rate at which resistance evolves and spreads. Simple.[contextly_sidebar id=\"VbydMq0RqS7R9WIF0Ye7B1EZAyZoMl2y\"]\u003c/p>\n\u003cp>Except it’s not. How, precisely, should we reduce the volume of drugs we use?\u003c/p>\n\u003cp>We can’t just introduce a blanket ban on prescriptions and stop using drugs altogether. If my loved one is sick and there is a drug that can make them better, I want that drug.\u003c/p>\n\u003cp>But maybe we could deliver our drugs in ways that would make it harder for resistance to evolve and spread? And so prolong the amount of time a drug remains effective?\u003c/p>\n\u003cp>\u003cstrong>Creating drug sanctuaries\u003cbr>\n\u003c/strong>One suggestion that\u003ca href=\"http://kassenlab.weebly.com/\" target=\"_blank\" rel=\"noopener\"> my research group\u003c/a> has been exploring is to make use of \u003ca href=\"https://onlinelibrary.wiley.com/doi/abs/10.1002/evl3.43\" target=\"_blank\" rel=\"noopener\">drug sanctuaries, or drug-free environments\u003c/a> — to effectively reduce the strength of selection for resistance.\u003c/p>\n\u003cp>If drug-sensitive variants of microbes have a growth advantage over resistant ones when no drug is around, then sensitive variants would predominate in drug-free refuges and help keep resistant ones from taking over the population.\u003c/p>\n\u003cp>Drug sanctuaries could be used in hospitals. For example, different wards could restrict the use of certain drugs (generating a form of spatial sanctuary) or could alternate the use of a drug on the same ward over time (a form of temporal sanctuary).\u003c/p>\n\u003cp>Evolutionary models can help guide us here. Variation in time is like paying taxes: You can’t avoid it. A variant that evolves in a temporally varying environment is the one that does best across all conditions experienced.\u003c/p>\n\u003cp>Variation in space, on the other hand, provides more options because the different locations can act as refuges for the specialized variants of bacteria. Because those locations are always available, then specialists can coexist indefinitely. At least in theory.\u003c/p>\n\u003cp>\u003cstrong>Buying us time\u003cbr>\n\u003c/strong>This seems to be what happened when we did an experiment to test the theory.\u003c/p>\n\u003cp>Resistance to the commonly used antibiotic ciprofloxacin took longer to spread in laboratory populations of the opportunistic pathogen Pseudomonas aeruginosa — a bacterium that causes acute infections in hospitals, especially intensive- care units, and chronic infections in the lungs of cystic fibrosis patients — when drug sanctuaries were experienced in space rather than time.\u003c/p>\n\u003cp>Resistant and sensitive genetic variants actually coexisted in spatial sanctuaries because of a trade-off between resistance and growth rate.\u003c/p>\n\u003cp>Resistant variants could withstand the drug, but grew far more slowly than sensitive ones in the sanctuary. The result was that neither could be eliminated by natural selection.[contextly_sidebar id=\"MjDUXQparIcTA4fgoyev9hL5QsR382iY\"]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>What surprised us, though, was that over time, this trade-off broke down.\u003c/p>\n\u003cdiv class=\"post__col \">\n\u003cdiv class=\"post__col-right\">\n\u003carticle>\n\u003cdiv class=\"body-text\">\n\u003cp>The resistant strains actually gained mutations that improved their ability to grow in the absence of the drug. By the end of the experiment, most populations in the spatial sanctuary were dominated by antibiotic-resistant strains.\u003c/p>\n\u003cp>Evidently drug sanctuaries in space could allow us to keep using drugs for longer, but not indefinitely. Eventually we will need new arrows in our quiver.\u003c/p>\n\u003cp>\u003cstrong>A challenge for evolutionary biology\u003cbr>\n\u003c/strong>Our experiments are highly contrived and restricted to one strain of one pathogen evolving in response to one drug in the defined and controlled conditions of a laboratory.\u003c/p>\n\u003cp>Whether our conclusions hold for other bugs and other drugs, or more complicated networks of transmission characteristic of hospitals and the communities they are embedded in, remains to be seen.\u003c/p>\n\u003cp>What our work allows us to do is get directly at the ecological and genetic mechanisms responsible for the emergence, coexistence and eventual demise of diversity.\u003c/p>\n\u003cp>Using these evolutionary principles in more complex, real-world situations to manage our arsenal of drugs for as long as possible will be a major challenge for evolutionary biology in the years to come.\u003c/p>\n\u003c/div>\n\u003c/article>\n\u003c/div>\n\u003c/div>\n\n","blocks":[],"excerpt":"One key to reducing the global burden of antibiotic resistance is by decreasing the quantity of drugs we use. But we can’t just introduce a blanket ban on prescriptions and stop using drugs altogether. ","status":"publish","parent":0,"modified":1525173275,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":919},"headData":{"title":"‘Drug Sanctuaries’ Offer Hope for a Post-Antibiotic World | KQED","description":"One key to reducing the global burden of antibiotic resistance is by decreasing the quantity of drugs we use. But we can’t just introduce a blanket ban on prescriptions and stop using drugs altogether. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"‘Drug Sanctuaries’ Offer Hope for a Post-Antibiotic World","datePublished":"2018-05-01T19:00:06.000Z","dateModified":"2018-05-01T11:14:35.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441174 https://ww2.kqed.org/futureofyou/?p=441174","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/01/drug-sanctuaries-offer-hope-for-a-post-antibiotic-world/","disqusTitle":"‘Drug Sanctuaries’ Offer Hope for a Post-Antibiotic World","source":"Health","nprByline":"Rees Kassen\u003cbr />The Conversation","path":"/futureofyou/441174/drug-sanctuaries-offer-hope-for-a-post-antibiotic-world","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>We are at risk of entering a post-antibiotic era.\u003c/p>\n\u003cp>Each year since 2013, a major global institution — including the \u003ca href=\"http://reports.weforum.org/global-risks-2013/risk-case-1/the-dangers-of-hubris-on-human-health/\" target=\"_blank\" rel=\"noopener\">World Economic Forum\u003c/a>, the \u003ca href=\"http://www.who.int/antimicrobial-resistance/global-action-plan/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization\u003c/a> and the \u003ca href=\"http://www.un.org/ga/search/view_doc.asp?symbol=A/71/L.2&referer=/english/&Lang=E\" target=\"_blank\" rel=\"noopener\">United Nations General Assembly\u003c/a> — has issued this grave warning to the world.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A \u003ca href=\"https://theconversation.com/canada-could-lead-the-fight-for-life-in-a-post-antibiotic-world-80864\" target=\"_blank\" rel=\"noopener\">post-antibiotic future is daunting\u003c/a>. When the drugs don’t work, we get sicker more often. We stay sicker longer. This hurts the economy because sick people don’t work.\u003c/p>\n\u003cp>In response, we really only have two options.\u003c/p>\n\u003cp>One is to gather more arrows in our quiver — by discovering new antibiotics to which microbes like bacteria are not currently resistant.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The second is to manage our current arsenal of drugs better so that they remain effective for as long as possible. The key to doing this is to reduce the global burden of antibiotic resistance by decreasing the quantity of drugs we use.\u003c/p>\n\u003cp>\u003cstrong>Delivering drugs differently\u003cbr>\n\u003c/strong>The first strategy of response to antibiotic resistance is not as easy as it sounds. While there are many potential new therapies that could be effective, there are few incentives for industry to invest in their development.\u003c/p>\n\u003cp>If an antibiotic works well, it is used for a short time — a few days to a couple of weeks at the most. The \u003ca href=\"https://www.pharmaceutical-journal.com/news-and-analysis/features/why-are-there-so-few-antibiotics-in-the-research-and-development-pipeline/11130209.article\" target=\"_blank\" rel=\"noopener\">commercial return on a drug designed to treat longer lasting non-communicable illnesses, like cancer, for instance, can be much higher\u003c/a> because the drugs are used for longer.\u003c/p>\n\u003cp>The logic of the second strategy is straightforward. The widespread use of antibiotics in medicine and agriculture means that a drug-resistant variant of a bacterium will enjoy a strong selective advantage and can quickly spread. So by reducing the use of drugs, we reduce the selection pressure on resistance and slow the rate at which resistance evolves and spreads. Simple.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Except it’s not. How, precisely, should we reduce the volume of drugs we use?\u003c/p>\n\u003cp>We can’t just introduce a blanket ban on prescriptions and stop using drugs altogether. If my loved one is sick and there is a drug that can make them better, I want that drug.\u003c/p>\n\u003cp>But maybe we could deliver our drugs in ways that would make it harder for resistance to evolve and spread? And so prolong the amount of time a drug remains effective?\u003c/p>\n\u003cp>\u003cstrong>Creating drug sanctuaries\u003cbr>\n\u003c/strong>One suggestion that\u003ca href=\"http://kassenlab.weebly.com/\" target=\"_blank\" rel=\"noopener\"> my research group\u003c/a> has been exploring is to make use of \u003ca href=\"https://onlinelibrary.wiley.com/doi/abs/10.1002/evl3.43\" target=\"_blank\" rel=\"noopener\">drug sanctuaries, or drug-free environments\u003c/a> — to effectively reduce the strength of selection for resistance.\u003c/p>\n\u003cp>If drug-sensitive variants of microbes have a growth advantage over resistant ones when no drug is around, then sensitive variants would predominate in drug-free refuges and help keep resistant ones from taking over the population.\u003c/p>\n\u003cp>Drug sanctuaries could be used in hospitals. For example, different wards could restrict the use of certain drugs (generating a form of spatial sanctuary) or could alternate the use of a drug on the same ward over time (a form of temporal sanctuary).\u003c/p>\n\u003cp>Evolutionary models can help guide us here. Variation in time is like paying taxes: You can’t avoid it. A variant that evolves in a temporally varying environment is the one that does best across all conditions experienced.\u003c/p>\n\u003cp>Variation in space, on the other hand, provides more options because the different locations can act as refuges for the specialized variants of bacteria. Because those locations are always available, then specialists can coexist indefinitely. At least in theory.\u003c/p>\n\u003cp>\u003cstrong>Buying us time\u003cbr>\n\u003c/strong>This seems to be what happened when we did an experiment to test the theory.\u003c/p>\n\u003cp>Resistance to the commonly used antibiotic ciprofloxacin took longer to spread in laboratory populations of the opportunistic pathogen Pseudomonas aeruginosa — a bacterium that causes acute infections in hospitals, especially intensive- care units, and chronic infections in the lungs of cystic fibrosis patients — when drug sanctuaries were experienced in space rather than time.\u003c/p>\n\u003cp>Resistant and sensitive genetic variants actually coexisted in spatial sanctuaries because of a trade-off between resistance and growth rate.\u003c/p>\n\u003cp>Resistant variants could withstand the drug, but grew far more slowly than sensitive ones in the sanctuary. The result was that neither could be eliminated by natural selection.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>What surprised us, though, was that over time, this trade-off broke down.\u003c/p>\n\u003cdiv class=\"post__col \">\n\u003cdiv class=\"post__col-right\">\n\u003carticle>\n\u003cdiv class=\"body-text\">\n\u003cp>The resistant strains actually gained mutations that improved their ability to grow in the absence of the drug. By the end of the experiment, most populations in the spatial sanctuary were dominated by antibiotic-resistant strains.\u003c/p>\n\u003cp>Evidently drug sanctuaries in space could allow us to keep using drugs for longer, but not indefinitely. Eventually we will need new arrows in our quiver.\u003c/p>\n\u003cp>\u003cstrong>A challenge for evolutionary biology\u003cbr>\n\u003c/strong>Our experiments are highly contrived and restricted to one strain of one pathogen evolving in response to one drug in the defined and controlled conditions of a laboratory.\u003c/p>\n\u003cp>Whether our conclusions hold for other bugs and other drugs, or more complicated networks of transmission characteristic of hospitals and the communities they are embedded in, remains to be seen.\u003c/p>\n\u003cp>What our work allows us to do is get directly at the ecological and genetic mechanisms responsible for the emergence, coexistence and eventual demise of diversity.\u003c/p>\n\u003cp>Using these evolutionary principles in more complex, real-world situations to manage our arsenal of drugs for as long as possible will be a major challenge for evolutionary biology in the years to come.\u003c/p>\n\u003c/div>\n\u003c/article>\n\u003c/div>\n\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441174/drug-sanctuaries-offer-hope-for-a-post-antibiotic-world","authors":["byline_futureofyou_441174"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_1184","futureofyou_697","futureofyou_952","futureofyou_1056","futureofyou_294"],"featImg":"futureofyou_441195","label":"source_futureofyou_441174"},"futureofyou_437589":{"type":"posts","id":"futureofyou_437589","meta":{"index":"posts_1591205157","site":"futureofyou","id":"437589","score":null,"sort":[1513012642000]},"guestAuthors":[],"slug":"research-looks-at-probiotic-for-diarrhea-in-kids","title":"Research Looks at Probiotic for Diarrhea in Kids","publishDate":1513012642,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>It's a typical hectic morning at Michele Comisky's house in Vienna, Va., when she gets a knock on her front door.\u003c/p>\n\u003cp>\"Hi, how are you?\" Comisky says as she greets Keisha Herbin Smith, a research assistant at Georgetown University. \"Come on in.\"\u003c/p>\n\u003cp>Comisky, 39, leads Herbin Smith into her kitchen.\u003c/p>\n\u003cp>\"Which one isn't feeling good?\" asks Herbin Smith, glancing at Comisky's children. \"That one,\" Comisky says, pointing to her 8-year-old son, Jackson.\u003c/p>\n\u003cp>Jackson has an ear infection. So he just started 10 days of antibiotics to kill the strain of bacteria that's giving him an earache. That's why Herbin Smith's here.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"What time did he take his antibiotic?\" Herbin Smith asks.\u003c/p>\n\u003cp>She asks because the antibiotics won't just wipe out the bad bacteria. They could also disrupt the good bacteria in Jackson's body, which can lead to stomach problems, including severe diarrhea.\u003c/p>\n\u003cp>Herbin Smith had rushed to Comisky's house to deliver a special yogurt drink that scientists are testing in hopes of preventing those serious problems.\u003c/p>\n\u003cp>\"We want him to take the first yogurt within 24 hours of taking his first antibiotic,\" she says.\u003c/p>\n\u003cp>The yogurt contains a \u003ca href=\"https://nccih.nih.gov/health/probiotics/introduction.htm\">probiotic\u003c/a> — a living strain of bacteria that researchers think could help prevent diarrhea and other complications of the antibiotic.\u003c/p>\n\u003cp>Some previous research has hinted that probiotics could help, and some doctors already are recommending probiotics to parents of children taking antibiotics.\u003c/p>\n\u003cp>But researchers hope the new yogurt study will provide clearer evidence as to whether that's a good idea. It's the first large, carefully designed test of a probiotic to get reviewed by the Food and Drug Administration, says \u003ca href=\"https://ctc.georgetown.edu/merenstein\">Dr. Daniel Merenstein,\u003c/a> who is leading the study. He's the director of research programs in the department of family medicine at Georgetown University.\u003c/p>\n\u003cp>\"The problem with a lot of probiotic research is that they haven't always been the best of studies,\" Merenstein says. \"Many are done by industry. Many were done in other countries. We're looking to see if it actually prevents diarrhea in kids.\"\u003c/p>\n\u003cp>Merenstein's study is part of an explosion of interest in research on the \u003ca href=\"https://www.npr.org/series/218987212/microbiome\">microbiome\u003c/a> — the billions of friendly bacteria, yeast and other microorganisms that live in the human body. There's mounting evidence these microbes play important roles in human health.\u003c/p>\n\u003cp>In addition to helping prevent diarrhea in children taking antibiotics, there is some evidence that probiotics could help prevent complications from antibiotics in adults as well, and might help prevent \u003ca href=\"https://wwwnc.cdc.gov/travel/page/travelers-diarrhea\">gastrointestinal infections\u003c/a> that sometimes occur when people travel to other countries. Other people have suggested probiotics might help treat vaginal infections in women, or possibly alleviate colic in infants or perhaps prevent eczema in some babies. Probiotics are also being looked at as a possibility to prevent a serious condition in newborn babies — \u003ca href=\"https://emedicine.medscape.com/article/977956-overview\">necrotizing enterocolitis\u003c/a>.\u003c/p>\n\u003cp>Some researchers even argue there's enough evidence to recommend that healthy adults take a probiotic regularly to help maintain their health.\u003c/p>\n\u003cp>\"I think there's a generic benefit in ingesting high numbers of safe, live bacteria every day,\" says \u003ca href=\"http://publish.ucc.ie/researchprofiles/D010/chill\">Colin Hill,\u003c/a> a professor of microbiology at University College Cork in Ireland. \"If I had my way, there would be a recommended daily allowance of bacteria.\"\u003c/p>\n\u003cp>But many scientists \u003ca href=\"https://www.npr.org/2016/08/18/490432969/eating-yogurt-is-not-enough-rebalancing-the-ecosystem-of-the-microbes-within-us\">question whether there's enough evidence\u003c/a> to support that suggestion or the many claims some companies are making about the alleged benefits probiotics. Some products are being promoted to help prevent obesity, heart disease and even alleviate mental health conditions such as \u003ca href=\"https://www.npr.org/sections/thesalt/2015/07/14/422623067/prozac-in-the-yogurt-aisle-can-good-bacteria-chill-us-out\">anxiety and depression\u003c/a>.\u003c/p>\n\u003cp>\"The marketing of every claim under the sun with every product under the sun is definitely questionable,\" says \u003ca href=\"https://nccih.nih.gov/grants/contact/lduffy\">Linda Duffy\u003c/a>, a program director at the National Center for Complementary and Integrative Health. \"There's not much in the way a magic bullet anywhere.\"\u003c/p>\n\u003cp>The net benefit of probiotic use with certain conditions \"is looking very, very promising,\" she says. But there are still a lot of unanswered questions.\u003c/p>\n\u003cp>While probiotics are probably safe for most otherwise healthy people, Duffy and others note that the products could pose some risk for people with weakened immune systems, such as those infected with the AIDS virus or for people undergoing cancer chemotherapy.\u003c/p>\n\u003cp>Another caution is that probiotics are not regulated as closely as prescription and over-the-counter medications. So there's no guarantee that what's on the label is actually in the bottle — or that whatever organisms were originally in the bottle are still alive. There are also concerns about potentially dangerous contaminants in products that could pose a risk even to healthy people.\u003c/p>\n\u003cp>\"Are there contaminants out there? Are there adulterated products? Are there marketed products without the appropriate claims? Absolutely,\" Duffy says. \"Like anything, you have to be a wise consumer.\"\u003c/p>\n\u003cp>For his part, Merenstein hopes his study will provide strong new evidence that probiotics provide benefits for children taking antibiotics.\u003c/p>\n\u003cp>In the \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03181516?term=merenstein&cond=bb12&rank=1\">study\u003c/a>, 300 children will drink specially made strawberry yogurt. Half will drink yogurt that contains a probiotic called \u003ca href=\"https://medlineplus.gov/druginfo/natural/891.html\">bifidobacteria\u003c/a>. The researchers will then compare the incidence of diarrhea and other gastrointestinal problems in the two groups of kids.\u003c/p>\n\u003cp>In addition, the researchers are gathering fecal samples from the children to try to determine exactly how probiotics might work.\u003c/p>\n\u003cp>\"One of our goals is to show that taking a probiotic will get your microbiome back to what it was before you started the antibiotic — and/or protect you from the changes,\" Merenstein says.\u003c/p>\n\u003cp>So, back at Comisky's house, Jackson takes his first gulp of Merenstein's special yogurt.\u003c/p>\n\u003cp>\"All right, here you go — you can drink it right out of here,\" Comisky says as she takes a bottle out of the refrigerator, opens the cap and hands it to her son.\u003c/p>\n\u003cp>\"Is it good?\" she asks.\u003c/p>\n\u003cp>\"Yeah,\" says Jackson, as he gulps down the yogurt and declares: \"Done!\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It will take years for Merenstein's team to gather and analyze the results of the study. So it will be a while before they can say for sure whether this particular probiotic treatment works or not.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Could+Probiotics+Protect+Kids+From+A+Downside+Of+Antibiotics%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Many marketing claims about the potential benefits of probiotics have raced ahead of the science, say researchers who are now trying to catch up. One NIH study is investigating kids' gut microbes.","status":"publish","parent":0,"modified":1513012716,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1028},"headData":{"title":"Research Looks at Probiotic for Diarrhea in Kids | KQED","description":"Many marketing claims about the potential benefits of probiotics have raced ahead of the science, say researchers who are now trying to catch up. One NIH study is investigating kids' gut microbes.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Research Looks at Probiotic for Diarrhea in Kids","datePublished":"2017-12-11T17:17:22.000Z","dateModified":"2017-12-11T17:18:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"437589 https://ww2.kqed.org/futureofyou/?p=437589","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/11/research-looks-at-probiotic-for-diarrhea-in-kids/","disqusTitle":"Research Looks at Probiotic for Diarrhea in Kids","nprByline":"Rob Stein\u003cbr />NPR Shots","nprImageAgency":"Rob Stein/NPR","nprStoryId":"567746569","nprApiLink":"http://api.npr.org/query?id=567746569&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2017/12/11/567746569/could-probiotics-protect-kids-from-a-downside-of-antibiotics?ft=nprml&f=567746569","nprRetrievedStory":"1","nprPubDate":"Mon, 11 Dec 2017 11:34:00 -0500","nprStoryDate":"Mon, 11 Dec 2017 05:16:00 -0500","nprLastModifiedDate":"Mon, 11 Dec 2017 11:35:13 -0500","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2017/12/20171211_me_could_probiotics_protect_kids_from_a_downside_of_antibiotics.mp3?orgId=1&topicId=1128&d=383&p=3&story=567746569&ft=nprml&f=567746569","nprAudioM3u":"http://api.npr.org/m3u/1569815415-110b69.m3u?orgId=1&topicId=1128&d=383&p=3&story=567746569&ft=nprml&f=567746569","path":"/futureofyou/437589/research-looks-at-probiotic-for-diarrhea-in-kids","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2017/12/20171211_me_could_probiotics_protect_kids_from_a_downside_of_antibiotics.mp3?orgId=1&topicId=1128&d=383&p=3&story=567746569&ft=nprml&f=567746569","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's a typical hectic morning at Michele Comisky's house in Vienna, Va., when she gets a knock on her front door.\u003c/p>\n\u003cp>\"Hi, how are you?\" Comisky says as she greets Keisha Herbin Smith, a research assistant at Georgetown University. \"Come on in.\"\u003c/p>\n\u003cp>Comisky, 39, leads Herbin Smith into her kitchen.\u003c/p>\n\u003cp>\"Which one isn't feeling good?\" asks Herbin Smith, glancing at Comisky's children. \"That one,\" Comisky says, pointing to her 8-year-old son, Jackson.\u003c/p>\n\u003cp>Jackson has an ear infection. So he just started 10 days of antibiotics to kill the strain of bacteria that's giving him an earache. That's why Herbin Smith's here.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"What time did he take his antibiotic?\" Herbin Smith asks.\u003c/p>\n\u003cp>She asks because the antibiotics won't just wipe out the bad bacteria. They could also disrupt the good bacteria in Jackson's body, which can lead to stomach problems, including severe diarrhea.\u003c/p>\n\u003cp>Herbin Smith had rushed to Comisky's house to deliver a special yogurt drink that scientists are testing in hopes of preventing those serious problems.\u003c/p>\n\u003cp>\"We want him to take the first yogurt within 24 hours of taking his first antibiotic,\" she says.\u003c/p>\n\u003cp>The yogurt contains a \u003ca href=\"https://nccih.nih.gov/health/probiotics/introduction.htm\">probiotic\u003c/a> — a living strain of bacteria that researchers think could help prevent diarrhea and other complications of the antibiotic.\u003c/p>\n\u003cp>Some previous research has hinted that probiotics could help, and some doctors already are recommending probiotics to parents of children taking antibiotics.\u003c/p>\n\u003cp>But researchers hope the new yogurt study will provide clearer evidence as to whether that's a good idea. It's the first large, carefully designed test of a probiotic to get reviewed by the Food and Drug Administration, says \u003ca href=\"https://ctc.georgetown.edu/merenstein\">Dr. Daniel Merenstein,\u003c/a> who is leading the study. He's the director of research programs in the department of family medicine at Georgetown University.\u003c/p>\n\u003cp>\"The problem with a lot of probiotic research is that they haven't always been the best of studies,\" Merenstein says. \"Many are done by industry. Many were done in other countries. We're looking to see if it actually prevents diarrhea in kids.\"\u003c/p>\n\u003cp>Merenstein's study is part of an explosion of interest in research on the \u003ca href=\"https://www.npr.org/series/218987212/microbiome\">microbiome\u003c/a> — the billions of friendly bacteria, yeast and other microorganisms that live in the human body. There's mounting evidence these microbes play important roles in human health.\u003c/p>\n\u003cp>In addition to helping prevent diarrhea in children taking antibiotics, there is some evidence that probiotics could help prevent complications from antibiotics in adults as well, and might help prevent \u003ca href=\"https://wwwnc.cdc.gov/travel/page/travelers-diarrhea\">gastrointestinal infections\u003c/a> that sometimes occur when people travel to other countries. Other people have suggested probiotics might help treat vaginal infections in women, or possibly alleviate colic in infants or perhaps prevent eczema in some babies. Probiotics are also being looked at as a possibility to prevent a serious condition in newborn babies — \u003ca href=\"https://emedicine.medscape.com/article/977956-overview\">necrotizing enterocolitis\u003c/a>.\u003c/p>\n\u003cp>Some researchers even argue there's enough evidence to recommend that healthy adults take a probiotic regularly to help maintain their health.\u003c/p>\n\u003cp>\"I think there's a generic benefit in ingesting high numbers of safe, live bacteria every day,\" says \u003ca href=\"http://publish.ucc.ie/researchprofiles/D010/chill\">Colin Hill,\u003c/a> a professor of microbiology at University College Cork in Ireland. \"If I had my way, there would be a recommended daily allowance of bacteria.\"\u003c/p>\n\u003cp>But many scientists \u003ca href=\"https://www.npr.org/2016/08/18/490432969/eating-yogurt-is-not-enough-rebalancing-the-ecosystem-of-the-microbes-within-us\">question whether there's enough evidence\u003c/a> to support that suggestion or the many claims some companies are making about the alleged benefits probiotics. Some products are being promoted to help prevent obesity, heart disease and even alleviate mental health conditions such as \u003ca href=\"https://www.npr.org/sections/thesalt/2015/07/14/422623067/prozac-in-the-yogurt-aisle-can-good-bacteria-chill-us-out\">anxiety and depression\u003c/a>.\u003c/p>\n\u003cp>\"The marketing of every claim under the sun with every product under the sun is definitely questionable,\" says \u003ca href=\"https://nccih.nih.gov/grants/contact/lduffy\">Linda Duffy\u003c/a>, a program director at the National Center for Complementary and Integrative Health. \"There's not much in the way a magic bullet anywhere.\"\u003c/p>\n\u003cp>The net benefit of probiotic use with certain conditions \"is looking very, very promising,\" she says. But there are still a lot of unanswered questions.\u003c/p>\n\u003cp>While probiotics are probably safe for most otherwise healthy people, Duffy and others note that the products could pose some risk for people with weakened immune systems, such as those infected with the AIDS virus or for people undergoing cancer chemotherapy.\u003c/p>\n\u003cp>Another caution is that probiotics are not regulated as closely as prescription and over-the-counter medications. So there's no guarantee that what's on the label is actually in the bottle — or that whatever organisms were originally in the bottle are still alive. There are also concerns about potentially dangerous contaminants in products that could pose a risk even to healthy people.\u003c/p>\n\u003cp>\"Are there contaminants out there? Are there adulterated products? Are there marketed products without the appropriate claims? Absolutely,\" Duffy says. \"Like anything, you have to be a wise consumer.\"\u003c/p>\n\u003cp>For his part, Merenstein hopes his study will provide strong new evidence that probiotics provide benefits for children taking antibiotics.\u003c/p>\n\u003cp>In the \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03181516?term=merenstein&cond=bb12&rank=1\">study\u003c/a>, 300 children will drink specially made strawberry yogurt. Half will drink yogurt that contains a probiotic called \u003ca href=\"https://medlineplus.gov/druginfo/natural/891.html\">bifidobacteria\u003c/a>. The researchers will then compare the incidence of diarrhea and other gastrointestinal problems in the two groups of kids.\u003c/p>\n\u003cp>In addition, the researchers are gathering fecal samples from the children to try to determine exactly how probiotics might work.\u003c/p>\n\u003cp>\"One of our goals is to show that taking a probiotic will get your microbiome back to what it was before you started the antibiotic — and/or protect you from the changes,\" Merenstein says.\u003c/p>\n\u003cp>So, back at Comisky's house, Jackson takes his first gulp of Merenstein's special yogurt.\u003c/p>\n\u003cp>\"All right, here you go — you can drink it right out of here,\" Comisky says as she takes a bottle out of the refrigerator, opens the cap and hands it to her son.\u003c/p>\n\u003cp>\"Is it good?\" she asks.\u003c/p>\n\u003cp>\"Yeah,\" says Jackson, as he gulps down the yogurt and declares: \"Done!\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It will take years for Merenstein's team to gather and analyze the results of the study. So it will be a while before they can say for sure whether this particular probiotic treatment works or not.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Could+Probiotics+Protect+Kids+From+A+Downside+Of+Antibiotics%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437589/research-looks-at-probiotic-for-diarrhea-in-kids","authors":["byline_futureofyou_437589"],"categories":["futureofyou_1062","futureofyou_1"],"tags":["futureofyou_697","futureofyou_68","futureofyou_688"],"featImg":"futureofyou_437590","label":"futureofyou"},"futureofyou_435129":{"type":"posts","id":"futureofyou_435129","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435129","score":null,"sort":[1504508465000]},"guestAuthors":[],"slug":"column-the-never-ending-debate-over-finishing-your-antibiotics","title":"The Never-Ending Debate Over Finishing Your Antibiotics","publishDate":1504508465,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>One of the most well-known concepts in medicine, to both doctors and patients, is that you must absolutely finish a course of antibiotics. The thinking goes that if you don’t eradicate every last bacterium causing your illness, the survivors can develop resistance and wreak further havoc.\u003c/p>\n\u003cp>This concern was voiced by the venerated Alexander Fleming himself — discoverer of penicillin, the first true antibiotic — which is part of why the idea is so enduring. Toward the end of his 1945 Nobel Prize acceptance speech, Fleming warned that “there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to nonlethal quantities of the drug make them resistant.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Overdosing antibiotics is a bigger threat than underdosing.\u003c/aside>\n\u003cp>This proclamation is only half true. If humanity truly wants to slow the spread of antibiotic resistance, we need to also look at the overprescription of antibiotics.\u003c/p>\n\u003cp>Recently, a group of British health professionals penned a compelling analysis in The BMJ, advocating for shorter antibiotics courses — even going so far as to say that maybe patients should stop taking antibiotics once they feel better.\u003c/p>\n\u003cp>That’s because Fleming only described one version of resistance: Where bad bugs get worse by surviving an “underdosing” of antibiotics. Researchers call that “target selection.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But there’s a flip side: Overusing antibiotics can cause usually nice bugs, with which we coexist, to gain resistance. The germs jump at the opportunity to take over ecological niches, like the gut of a patient on antibiotics. This form of resistance is called “collateral selection.”\u003c/p>\n\u003cp>The BMJ analysis, led by infectious disease specialist Martin Llewelyn, proposes that “most of the bacterial species now posing the greatest problems do not develop resistance through target selection” and that “collateral selection is the predominant driver of the important forms of antibiotic resistance affecting patients today.”\u003c/p>\n\u003cfigure id=\"attachment_435130\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-435130\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/08/infographic-800x800.png\" alt=\"\" width=\"800\" height=\"800\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-800x800.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-160x160.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-768x768.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-960x960.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-240x240.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-375x375.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-520x520.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-50x50.png 50w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-96x96.png 96w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-128x128.png 128w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-150x150.png 150w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic.png 1000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The different mechanisms by which bacteria acquire antibiotic resistance. \u003ccite>(Fedor Kossakovski)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In other words, overdosing antibiotics is a bigger threat than underdosing.\u003c/p>\n\u003cp>Yet many health practitioners and patients are so worried about breeding superbugs through underdosing that antibiotics courses are often unnecessarily long. The researchers’ analysis showed that shorter courses of several quinolone-class antibiotics are just as effective as the longer courses that are currently prescribed. But the team conceded that more research on the topic is needed.\u003c/p>\n\u003cp>“No such data exist for β-lactams, which are the main antibiotic class used,” Llewelyn and colleagues wrote. “Current international guidelines recommend 10-14 days’ treatment with β-lactams, based purely on absence of data for shorter courses.”\u003c/p>\n\u003cp>Many health professionals are so worried about underdosing that most antibiotics prescriptions for adults are not calibrated to account for differences in patients. For example, “under current practices, a 200-pound, 6-foot-2-inch man diagnosed with pneumonia would receive the same dose of antibiotics as a 124-pound, 5-foot woman with the same condition, despite their dramatically different body sizes.”\u003c/p>\n\u003cp>Though antibiotic resistance is a growing problem due to overuse of the drugs at home, the issue is already grave in hospitals where the concentration of antibiotics and at-risk people is high. That’s why hospital staffs around the world are on the front lines of developing more appropriate protocols for using antibiotics through a collective effort called “antimicrobial stewardship.”\u003c/p>\n\u003cp>During our recent reporting for the PBS NewsHour series “Stopping Superbugs,” science correspondent Miles O’Brien met some antimicrobial stewards at Tufts Medical Center in Boston.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=F42NPOnMIwQ\u003c/p>\n\u003cp>\u003cem>As the list of antibiotic resistant bacteria grows, so have the extraordinary efforts to prevent the spread of infection. Science correspondent Miles O’Brien and economics correspondent Paul Solman team up for a report.\u003c/em>\u003c/p>\n\u003cp>“We’re facing a crisis,” said Dr. Shira Doron, physician director of the antimicrobial stewardship program at Tufts. “What we need to be doing is treating until the person feels better and then stopping.”\u003c/p>\n\u003cp>This approach is not without its risks, Doron acknowledged: “Some of those people may have a recurrence of infection. But the number of antibiotic days that you’re saving the general population if you take that approach is so large and the impact is so large that it needs to be sort of the next phase of medicine.”\u003c/p>\n\u003cp>But carefully managing antibiotics courses is a tough ask for already overworked doctors. A multitude of factors pressure doctors to overprescribe antibiotics, added Dr. Helen Boucher, one of Doran’s colleagues.\u003c/p>\n\u003cp>“I think that especially in America, patients come in with an agenda,” Boucher said. “They expect an antibiotic. It takes longer to not give an antibiotic. We have shorter and shorter times per interaction with patients. When I started, it was 30 to 60 minutes, now it’s 15 to 30 minutes. It’s harder to have that conversation to explain that we’re going to do this test, see how you do, and then decide about an antibiotic and I’ll call you tomorrow. That’s a lot of work.”\u003c/p>\n\u003cp>Dr. Helen Boucher said patients should ask doctors for shorter courses of antibiotics. Patients should take to heart the lessons learned by antimicrobial stewards in hospitals and do their own part in preventing the overuse of antibiotics.\u003c/p>\n\u003cp>“We’ve learned for a very few infections, ear infections in two year olds, you need to treat for the whole course. But for many others, we’re learning that shorter is fine,” Boucher said. “So, I think if you’re a patient at a doctor you should ask, ‘Do I need to take it all or not?’ And oftentimes, the answer will be ‘No.'”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This column originally appeared on Miles O’Brien Productions.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Some health professionals are advocating for shorter antibiotics courses, going so far as to say maybe patients should stop taking antibiotics once they feel better.","status":"publish","parent":0,"modified":1514510963,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":1010},"headData":{"title":"The Never-Ending Debate Over Finishing Your Antibiotics | KQED","description":"Some health professionals are advocating for shorter antibiotics courses, going so far as to say maybe patients should stop taking antibiotics once they feel better.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"The Never-Ending Debate Over Finishing Your Antibiotics","datePublished":"2017-09-04T07:01:05.000Z","dateModified":"2017-12-29T01:29:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"435129 https://ww2.kqed.org/futureofyou/?p=435129","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/09/04/column-the-never-ending-debate-over-finishing-your-antibiotics/","disqusTitle":"The Never-Ending Debate Over Finishing Your Antibiotics","nprByline":"Fedor Kossakovski\u003c/br>PBS Newshour","path":"/futureofyou/435129/column-the-never-ending-debate-over-finishing-your-antibiotics","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>One of the most well-known concepts in medicine, to both doctors and patients, is that you must absolutely finish a course of antibiotics. The thinking goes that if you don’t eradicate every last bacterium causing your illness, the survivors can develop resistance and wreak further havoc.\u003c/p>\n\u003cp>This concern was voiced by the venerated Alexander Fleming himself — discoverer of penicillin, the first true antibiotic — which is part of why the idea is so enduring. Toward the end of his 1945 Nobel Prize acceptance speech, Fleming warned that “there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to nonlethal quantities of the drug make them resistant.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Overdosing antibiotics is a bigger threat than underdosing.\u003c/aside>\n\u003cp>This proclamation is only half true. If humanity truly wants to slow the spread of antibiotic resistance, we need to also look at the overprescription of antibiotics.\u003c/p>\n\u003cp>Recently, a group of British health professionals penned a compelling analysis in The BMJ, advocating for shorter antibiotics courses — even going so far as to say that maybe patients should stop taking antibiotics once they feel better.\u003c/p>\n\u003cp>That’s because Fleming only described one version of resistance: Where bad bugs get worse by surviving an “underdosing” of antibiotics. Researchers call that “target selection.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But there’s a flip side: Overusing antibiotics can cause usually nice bugs, with which we coexist, to gain resistance. The germs jump at the opportunity to take over ecological niches, like the gut of a patient on antibiotics. This form of resistance is called “collateral selection.”\u003c/p>\n\u003cp>The BMJ analysis, led by infectious disease specialist Martin Llewelyn, proposes that “most of the bacterial species now posing the greatest problems do not develop resistance through target selection” and that “collateral selection is the predominant driver of the important forms of antibiotic resistance affecting patients today.”\u003c/p>\n\u003cfigure id=\"attachment_435130\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-435130\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/08/infographic-800x800.png\" alt=\"\" width=\"800\" height=\"800\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-800x800.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-160x160.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-768x768.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-960x960.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-240x240.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-375x375.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-520x520.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-50x50.png 50w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-96x96.png 96w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-128x128.png 128w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic-150x150.png 150w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/infographic.png 1000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The different mechanisms by which bacteria acquire antibiotic resistance. \u003ccite>(Fedor Kossakovski)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In other words, overdosing antibiotics is a bigger threat than underdosing.\u003c/p>\n\u003cp>Yet many health practitioners and patients are so worried about breeding superbugs through underdosing that antibiotics courses are often unnecessarily long. The researchers’ analysis showed that shorter courses of several quinolone-class antibiotics are just as effective as the longer courses that are currently prescribed. But the team conceded that more research on the topic is needed.\u003c/p>\n\u003cp>“No such data exist for β-lactams, which are the main antibiotic class used,” Llewelyn and colleagues wrote. “Current international guidelines recommend 10-14 days’ treatment with β-lactams, based purely on absence of data for shorter courses.”\u003c/p>\n\u003cp>Many health professionals are so worried about underdosing that most antibiotics prescriptions for adults are not calibrated to account for differences in patients. For example, “under current practices, a 200-pound, 6-foot-2-inch man diagnosed with pneumonia would receive the same dose of antibiotics as a 124-pound, 5-foot woman with the same condition, despite their dramatically different body sizes.”\u003c/p>\n\u003cp>Though antibiotic resistance is a growing problem due to overuse of the drugs at home, the issue is already grave in hospitals where the concentration of antibiotics and at-risk people is high. That’s why hospital staffs around the world are on the front lines of developing more appropriate protocols for using antibiotics through a collective effort called “antimicrobial stewardship.”\u003c/p>\n\u003cp>During our recent reporting for the PBS NewsHour series “Stopping Superbugs,” science correspondent Miles O’Brien met some antimicrobial stewards at Tufts Medical Center in Boston.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/F42NPOnMIwQ'\n title='//www.youtube.com/embed/F42NPOnMIwQ'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cem>As the list of antibiotic resistant bacteria grows, so have the extraordinary efforts to prevent the spread of infection. Science correspondent Miles O’Brien and economics correspondent Paul Solman team up for a report.\u003c/em>\u003c/p>\n\u003cp>“We’re facing a crisis,” said Dr. Shira Doron, physician director of the antimicrobial stewardship program at Tufts. “What we need to be doing is treating until the person feels better and then stopping.”\u003c/p>\n\u003cp>This approach is not without its risks, Doron acknowledged: “Some of those people may have a recurrence of infection. But the number of antibiotic days that you’re saving the general population if you take that approach is so large and the impact is so large that it needs to be sort of the next phase of medicine.”\u003c/p>\n\u003cp>But carefully managing antibiotics courses is a tough ask for already overworked doctors. A multitude of factors pressure doctors to overprescribe antibiotics, added Dr. Helen Boucher, one of Doran’s colleagues.\u003c/p>\n\u003cp>“I think that especially in America, patients come in with an agenda,” Boucher said. “They expect an antibiotic. It takes longer to not give an antibiotic. We have shorter and shorter times per interaction with patients. When I started, it was 30 to 60 minutes, now it’s 15 to 30 minutes. It’s harder to have that conversation to explain that we’re going to do this test, see how you do, and then decide about an antibiotic and I’ll call you tomorrow. That’s a lot of work.”\u003c/p>\n\u003cp>Dr. Helen Boucher said patients should ask doctors for shorter courses of antibiotics. Patients should take to heart the lessons learned by antimicrobial stewards in hospitals and do their own part in preventing the overuse of antibiotics.\u003c/p>\n\u003cp>“We’ve learned for a very few infections, ear infections in two year olds, you need to treat for the whole course. But for many others, we’re learning that shorter is fine,” Boucher said. “So, I think if you’re a patient at a doctor you should ask, ‘Do I need to take it all or not?’ And oftentimes, the answer will be ‘No.'”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This column originally appeared on Miles O’Brien Productions.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435129/column-the-never-ending-debate-over-finishing-your-antibiotics","authors":["byline_futureofyou_435129"],"categories":["futureofyou_1"],"tags":["futureofyou_1184","futureofyou_697"],"featImg":"futureofyou_435131","label":"futureofyou"},"futureofyou_334042":{"type":"posts","id":"futureofyou_334042","meta":{"index":"posts_1591205157","site":"futureofyou","id":"334042","score":null,"sort":[1487105686000]},"guestAuthors":[],"slug":"maybe-you-shouldnt-take-all-your-antibiotics-after-all","title":"Maybe You Shouldn't Take All of Your Antibiotics, After All","publishDate":1487105686,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>You’ve heard it many times before from your doctor: If you’re taking antibiotics, don’t stop taking them until the pill vial is empty, even if you feel better.\u003c/p>\n\u003caside class=\"pullquote alignright\">'An argument can be made for stopping a course of antibiotics immediately after a bacterial infection has been ruled out … or when the signs and symptoms of a mild infection have disappeared.'\u003ccite>From a World Health Organization report\u003c/cite>\u003c/aside>\n\u003cp>The rationale behind this commandment has always been that stopping treatment too soon would fuel the development of antibiotic resistance—the ability of bugs to evade these drugs. Information campaigns aimed at getting the public to take antibiotics properly have been driving home this message for decades.\u003c/p>\n\u003cp>But the warning, a growing number of experts say, is misguided and may actually be exacerbating antibiotic resistance.\u003c/p>\n\u003cp>The reasoning is simple: Exposure to antibiotics is what drives bacteria to develop resistance. Taking drugs when you aren’t sick anymore simply gives the hordes of bacteria in and on your body more incentive to evolve to evade the drugs, so the next time you have an infection, they may not work.\u003c/p>\n\u003cp>The traditional reasoning from doctors “never made any sense. It doesn’t make any sense today,” Dr. Louis Rice, chairman of the department of medicine at the Warren Alpert Medical School at Brown University, told STAT.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some colleagues credit Rice with being the first person to declare the emperor was wearing no clothes, and it is true that he challenged the dogma in lectures at major meetings of infectious diseases physicians and researchers in 2007 and 2008. A number of researchers now share his skepticism of health guidance that has been previously universally accepted.\u003c/p>\n\u003cp>The question of whether this advice is still appropriate will be raised at a World Health Organization meeting next month in Geneva. A report prepared for that meeting—the agency’s expert committee on the selection and use of essential medicine—already notes that the recommendation isn’t backed by science.\u003c/p>\n\u003cp>In many cases “an argument can be made for stopping a course of antibiotics immediately after a bacterial infection has been ruled out … or when the signs and symptoms of a mild infection have disappeared,” suggests the report, which analyzed information campaigns designed to get the public on board with efforts to fight antibiotic resistance.\u003c/p>\n\u003cp>No one is doubting the lifesaving importance of antibiotics. They kill bacteria. But the more the bugs are exposed to the drugs, the more survival tricks the bacteria acquire. And the more resistant the bacteria become, the harder they are to treat.\u003c/p>\n\u003cp>The concern is that the growing number of bacteria that are resistant to multiple antibiotics will lead to more incurable infections that will threaten medicine’s ability to conduct routine procedures like hip replacements or open heart surgery without endangering lives.\u003c/p>\n\u003cp>So how did this faulty paradigm become entrenched in medical practice? The answer lies back in the 1940s, the dawn of antibiotic use.\u003c/p>\n\u003cp>At the time, resistance wasn’t a concern. After the first antibiotic, penicillin, was discovered, more and more gushed out of the pharmaceutical product pipeline.\u003c/p>\n\u003cp>Doctors were focused only on figuring out how to use the drugs effectively to save lives. An ethos emerged: Treat patients until they get better, and then for a little bit longer to be on the safe side. Around the same time, research on how to cure tuberculosis suggested that under-dosing patients was dangerous—the infection would come back.\u003c/p>\n\u003cp>The idea that stopping antibiotic treatment too quickly after symptoms went away might fuel resistance took hold.\u003c/p>\n\u003cp>“The problem is once it gets baked into culture, it’s really hard to excise it,” said Dr. Brad Spellberg, who is also an advocate for changing this advice. Spellberg is an infectious diseases specialist and chief medical officer at the Los Angeles County-University of Southern California Medical Center in Los Angeles.\u003c/p>\n\u003cp>We think of medicine as a science, guided by mountains of research. But doctors sometimes prescribe antibiotics based more on their experience and intuition than anything else. There are treatment guidelines for different infections, but some provide scant advice on how long to continue treatment, Rice acknowledged. And response to treatment will differ from patient to patient, depending on, among other things, how old they are, how strong their immune systems are, or how well they metabolize drugs.\u003c/p>\n\u003cp>There’s little incentive for pharmaceutical companies to conduct expensive studies aimed at finding the shortest duration of treatment for various conditions. But in the years since Rice first raised his concerns, the National Institutes of Health has been funding such research and almost invariably the ensuing studies have found that many infections can be cured more quickly than had been thought. Treatments that were once two weeks have been cut to one, 10 days have been reduced to seven and so on.\u003c/p>\n\u003cp>There have been occasional exceptions. Just before Christmas, scientists at the University of Pittsburgh reported that 10 days of treatment for otitis media—middle ear infections—was better than five days for children under 2 years of age.\u003c/p>\n\u003cp>It was a surprise, said Spellberg, who noted that studies looking at the same condition in children 2 and older show the shorter treatment works.\u003c/p>\n\u003cp>More of this work is needed, Rice said. “I’m not here saying that every infection can be treated for two days or three days. I’m just saying: Let’s figure it out.”\u003c/p>\n\u003cp>In the meantime, doctors and public health agencies are in a quandary. How do you put the new thinking into practice? And how do you advise the public? Doctors know full well some portion of people unilaterally decide to stop taking their antibiotics because they feel better. But that approach is not safe in all circumstances—for instance tuberculosis or bone infections. And it’s not an approach many physicians feel comfortable endorsing.\u003c/p>\n\u003cp>“This is a very tricky question. It’s not easy to make a blanket statement about this, and there isn’t a simple answer,” Dr. Lauri Hicks, director of the Centers for Disease Control and Prevention’s office of antibiotic stewardship, told STAT in an email.\u003c/p>\n\u003cp>“There are certain diagnoses for which shortening the course of antibiotic therapy is not recommended and/or potentially dangerous. … On the other hand, there are probably many situations for which antibiotic therapy is often prescribed for longer than necessary and the optimal duration is likely ‘until the patient gets better.’”\u003c/p>\n\u003cp>CDC’S Get Smart campaign, on appropriate antibiotic use, urges people never to skip doses or stop the drugs because they’re feeling better. But Hicks noted the CDC recently revised it to add “unless your healthcare professional tells you to do so” to that advice.\u003c/p>\n\u003cp>And that’s one way to deal with the situation, said Dr. James Johnson, a professor of infectious diseases medicine at the University of Minnesota and a specialist at the Minnesota VA Medical Center.\u003c/p>\n\u003cp>“In fact sometimes some of us give that instruction to patients. ‘Here, I’m going to prescribe you a week. My guess is you won’t need it more than, say, three days. If you’re all well in three days, stop then. If you’re not completely well, take it a little longer. But as soon as you feel fine, stop.’ And we can give them permission to do that.”\u003c/p>\n\u003cp>Spellberg is more comfortable with the idea of people checking back with their doctor before stopping their drugs — an approach that requires doctors to be willing to have that conversation. “You should call your doc and say ‘Hey, can I stop?’ … If your doctor won’t get on the phone with you for 20 seconds, you need to find another doctor.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/02/09/antibiotics-resistance-superbugs/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"You’ve heard it many times from your doctor: Even if you feel better, don’t stop taking your antibiotics until the pill vial is empty. But a growing number of experts say that advice is misguided.","status":"publish","parent":0,"modified":1487121873,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1374},"headData":{"title":"Maybe You Shouldn't Take All of Your Antibiotics, After All | KQED","description":"You’ve heard it many times from your doctor: Even if you feel better, don’t stop taking your antibiotics until the pill vial is empty. But a growing number of experts say that advice is misguided.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Maybe You Shouldn't Take All of Your Antibiotics, After All","datePublished":"2017-02-14T20:54:46.000Z","dateModified":"2017-02-15T01:24:33.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"334042 https://ww2.kqed.org/futureofyou/?p=334042","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/02/14/maybe-you-shouldnt-take-all-your-antibiotics-after-all/","disqusTitle":"Maybe You Shouldn't Take All of Your Antibiotics, After All","source":"KQED Future of You","nprByline":"Helen Branswell\u003cbr />\u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>","path":"/futureofyou/334042/maybe-you-shouldnt-take-all-your-antibiotics-after-all","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>You’ve heard it many times before from your doctor: If you’re taking antibiotics, don’t stop taking them until the pill vial is empty, even if you feel better.\u003c/p>\n\u003caside class=\"pullquote alignright\">'An argument can be made for stopping a course of antibiotics immediately after a bacterial infection has been ruled out … or when the signs and symptoms of a mild infection have disappeared.'\u003ccite>From a World Health Organization report\u003c/cite>\u003c/aside>\n\u003cp>The rationale behind this commandment has always been that stopping treatment too soon would fuel the development of antibiotic resistance—the ability of bugs to evade these drugs. Information campaigns aimed at getting the public to take antibiotics properly have been driving home this message for decades.\u003c/p>\n\u003cp>But the warning, a growing number of experts say, is misguided and may actually be exacerbating antibiotic resistance.\u003c/p>\n\u003cp>The reasoning is simple: Exposure to antibiotics is what drives bacteria to develop resistance. Taking drugs when you aren’t sick anymore simply gives the hordes of bacteria in and on your body more incentive to evolve to evade the drugs, so the next time you have an infection, they may not work.\u003c/p>\n\u003cp>The traditional reasoning from doctors “never made any sense. It doesn’t make any sense today,” Dr. Louis Rice, chairman of the department of medicine at the Warren Alpert Medical School at Brown University, told STAT.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some colleagues credit Rice with being the first person to declare the emperor was wearing no clothes, and it is true that he challenged the dogma in lectures at major meetings of infectious diseases physicians and researchers in 2007 and 2008. A number of researchers now share his skepticism of health guidance that has been previously universally accepted.\u003c/p>\n\u003cp>The question of whether this advice is still appropriate will be raised at a World Health Organization meeting next month in Geneva. A report prepared for that meeting—the agency’s expert committee on the selection and use of essential medicine—already notes that the recommendation isn’t backed by science.\u003c/p>\n\u003cp>In many cases “an argument can be made for stopping a course of antibiotics immediately after a bacterial infection has been ruled out … or when the signs and symptoms of a mild infection have disappeared,” suggests the report, which analyzed information campaigns designed to get the public on board with efforts to fight antibiotic resistance.\u003c/p>\n\u003cp>No one is doubting the lifesaving importance of antibiotics. They kill bacteria. But the more the bugs are exposed to the drugs, the more survival tricks the bacteria acquire. And the more resistant the bacteria become, the harder they are to treat.\u003c/p>\n\u003cp>The concern is that the growing number of bacteria that are resistant to multiple antibiotics will lead to more incurable infections that will threaten medicine’s ability to conduct routine procedures like hip replacements or open heart surgery without endangering lives.\u003c/p>\n\u003cp>So how did this faulty paradigm become entrenched in medical practice? The answer lies back in the 1940s, the dawn of antibiotic use.\u003c/p>\n\u003cp>At the time, resistance wasn’t a concern. After the first antibiotic, penicillin, was discovered, more and more gushed out of the pharmaceutical product pipeline.\u003c/p>\n\u003cp>Doctors were focused only on figuring out how to use the drugs effectively to save lives. An ethos emerged: Treat patients until they get better, and then for a little bit longer to be on the safe side. Around the same time, research on how to cure tuberculosis suggested that under-dosing patients was dangerous—the infection would come back.\u003c/p>\n\u003cp>The idea that stopping antibiotic treatment too quickly after symptoms went away might fuel resistance took hold.\u003c/p>\n\u003cp>“The problem is once it gets baked into culture, it’s really hard to excise it,” said Dr. Brad Spellberg, who is also an advocate for changing this advice. Spellberg is an infectious diseases specialist and chief medical officer at the Los Angeles County-University of Southern California Medical Center in Los Angeles.\u003c/p>\n\u003cp>We think of medicine as a science, guided by mountains of research. But doctors sometimes prescribe antibiotics based more on their experience and intuition than anything else. There are treatment guidelines for different infections, but some provide scant advice on how long to continue treatment, Rice acknowledged. And response to treatment will differ from patient to patient, depending on, among other things, how old they are, how strong their immune systems are, or how well they metabolize drugs.\u003c/p>\n\u003cp>There’s little incentive for pharmaceutical companies to conduct expensive studies aimed at finding the shortest duration of treatment for various conditions. But in the years since Rice first raised his concerns, the National Institutes of Health has been funding such research and almost invariably the ensuing studies have found that many infections can be cured more quickly than had been thought. Treatments that were once two weeks have been cut to one, 10 days have been reduced to seven and so on.\u003c/p>\n\u003cp>There have been occasional exceptions. Just before Christmas, scientists at the University of Pittsburgh reported that 10 days of treatment for otitis media—middle ear infections—was better than five days for children under 2 years of age.\u003c/p>\n\u003cp>It was a surprise, said Spellberg, who noted that studies looking at the same condition in children 2 and older show the shorter treatment works.\u003c/p>\n\u003cp>More of this work is needed, Rice said. “I’m not here saying that every infection can be treated for two days or three days. I’m just saying: Let’s figure it out.”\u003c/p>\n\u003cp>In the meantime, doctors and public health agencies are in a quandary. How do you put the new thinking into practice? And how do you advise the public? Doctors know full well some portion of people unilaterally decide to stop taking their antibiotics because they feel better. But that approach is not safe in all circumstances—for instance tuberculosis or bone infections. And it’s not an approach many physicians feel comfortable endorsing.\u003c/p>\n\u003cp>“This is a very tricky question. It’s not easy to make a blanket statement about this, and there isn’t a simple answer,” Dr. Lauri Hicks, director of the Centers for Disease Control and Prevention’s office of antibiotic stewardship, told STAT in an email.\u003c/p>\n\u003cp>“There are certain diagnoses for which shortening the course of antibiotic therapy is not recommended and/or potentially dangerous. … On the other hand, there are probably many situations for which antibiotic therapy is often prescribed for longer than necessary and the optimal duration is likely ‘until the patient gets better.’”\u003c/p>\n\u003cp>CDC’S Get Smart campaign, on appropriate antibiotic use, urges people never to skip doses or stop the drugs because they’re feeling better. But Hicks noted the CDC recently revised it to add “unless your healthcare professional tells you to do so” to that advice.\u003c/p>\n\u003cp>And that’s one way to deal with the situation, said Dr. James Johnson, a professor of infectious diseases medicine at the University of Minnesota and a specialist at the Minnesota VA Medical Center.\u003c/p>\n\u003cp>“In fact sometimes some of us give that instruction to patients. ‘Here, I’m going to prescribe you a week. My guess is you won’t need it more than, say, three days. If you’re all well in three days, stop then. If you’re not completely well, take it a little longer. But as soon as you feel fine, stop.’ And we can give them permission to do that.”\u003c/p>\n\u003cp>Spellberg is more comfortable with the idea of people checking back with their doctor before stopping their drugs — an approach that requires doctors to be willing to have that conversation. “You should call your doc and say ‘Hey, can I stop?’ … If your doctor won’t get on the phone with you for 20 seconds, you need to find another doctor.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/02/09/antibiotics-resistance-superbugs/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/334042/maybe-you-shouldnt-take-all-your-antibiotics-after-all","authors":["byline_futureofyou_334042"],"categories":["futureofyou_452","futureofyou_1","futureofyou_73"],"tags":["futureofyou_1184","futureofyou_697"],"featImg":"futureofyou_336943","label":"source_futureofyou_334042"},"futureofyou_302105":{"type":"posts","id":"futureofyou_302105","meta":{"index":"posts_1591205157","site":"futureofyou","id":"302105","score":null,"sort":[1482427800000]},"guestAuthors":[],"slug":"250-disposable-scopes-used-to-combat-drug-resistant-infection","title":"$250 Disposable Scopes Used to Combat Drug-Resistant Infection","publishDate":1482427800,"format":"aside","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>In response to a series of superbug outbreaks around the country, some doctors and hospitals are trying out disposable scopes to combat the spread of antibiotic-resistant bacteria.\u003c/p>\n\u003cp>U.S. regulators recently approved two new colonoscopes designed to be used just once and thrown away. They will sell for $250 or less apiece — compared to roughly $40,000 or more for a conventional scope that lasts several years but must be disinfected after each use. Other companies are promoting such devices — flexible, lighted tubes used to peer deep inside the body — for use in the lungs and kidneys.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s almost too good to be true with it being so cheap.'\u003c/aside>\n\u003cp>The new scopes are coming primarily from smaller companies looking to challenge a handful of dominant device makers. The upstarts are seizing on growing evidence that many reusable instruments cannot be cleaned reliably, even when manufacturer’s instructions are followed.\u003c/p>\n\u003cp>“If you can tell patients we have a disposable device so there’s really no chance of infection, that has to be very appealing,” said Chris Lavanchy, engineering director at the ECRI Institute, a nonprofit organization that tests medical devices. “This could allay public fears.”\u003c/p>\n\u003cp>Scopes include a wide array of devices used on millions of patients annually. As they snake through a patient’s throat, intestines and other cavities, they pick up mucus, blood and thousands of microbes. But the delicate devices can’t be sterilized like a scalpel because intense heat would destroy crucial components.\u003c/p>\n\u003cfigure id=\"attachment_305327\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\">\u003cimg class=\"size-full wp-image-305327\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\" alt=\"A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \" width=\"270\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270.jpg 270w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-240x360.jpg 240w\" sizes=\"(max-width: 270px) 100vw, 270px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \u003ccite>(Courtesy of Invendo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Instead, the scopes are brushed and washed with disinfectants in preparation for the next patient. Despite those efforts, contamination can persist and drug-resistant bacteria can result in patient infections that are difficult or even impossible to treat.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The threat has led to safety alerts from the Food and Drug Administration and a recent U.S. Senate investigation into repeated failures by manufacturers and hospitals to report outbreaks.\u003c/p>\n\u003cp>Overall, as many as 350 patients at 41 medical facilities worldwide were exposed to or infected by contaminated gastrointestinal scopes from 2010 to 2015, according to the FDA. And at least 35 patients at U.S. hospitals have died since 2013 after developing infections tied to tainted scopes, according to hospitals and public health officials.\u003c/p>\n\u003cp>For now, just a handful of medical centers are experimenting with the disposable colonoscopes. Some doctors remain skeptical about whether a cheaper scope will provide the high-quality images and versatility they need to diagnose and treat patients effectively. Many doctors count on the sophisticated cameras on existing scopes as well as multiple channels inside the device to accommodate surgical instruments.\u003c/p>\n\u003cp>Dr. Simon Lo, a nationally known gastroenterologist at Cedars-Sinai Medical Center in Los Angeles, said he shares those concerns. Nonetheless, he said he’s eager to try the disposable colonoscope from German device maker Invendo Medical in the coming months. The scope secured clearance from the U.S. Food and Drug Administration in August.\u003c/p>\n\u003cp>“I’m not totally sold this will be comparable to the [conventional] scopes other companies have spent decades perfecting. It’s almost too good to be true with it being so cheap,” Lo said. “But this is a fantastic possibility and at least gives us an alternative to the current scopes.”\u003c/p>\n\u003cp>Physician groups such as the American Society for Gastrointestinal Endoscopy maintain that the overall risk of infection is very low from these reusable devices. They say the benefits of screenings and many other procedures far outweigh any potential danger.\u003c/p>\n\u003cp>But some doctors say a simpler, single-use scope could be sufficient for many routine examinations. It could also be preferred for immunosuppressed patients who are more susceptible to infection and for patients who have already tested positive for antibiotic-resistant bacteria and would be likely to spread it.\u003c/p>\n\u003cp>“For those patients, it would be great to use this and throw it away,” Lo said.\u003c/p>\n\u003cp>His hospital, Cedars-Sinai, reported four infections last year from contaminated duodenoscopes, which are inserted down a patient’s throat and used to treat problems in the digestive tract such as cancers and blockages in the bile duct.\u003c/p>\n\u003cp>Colonoscopes, which look at the inner lining of the large intestine, haven’t been linked to the recent outbreaks, but concerns about cleaning and the spread of bacteria apply to all types of reusable scopes. Last year, the FDA warned about the risk to patients posed by bronchoscopes, used to examine problems in the airway and lungs.\u003c/p>\n\u003cp>In one study, researchers found that more than 75 percent of colonoscopes and gastroscopes were still contaminated after cleaning and disinfection in accordance with manufacturer guidelines.\u003c/p>\n\u003cp>Hospitals have experimented with a wide variety of new safety measures over the past two years. Some facilities started testing scopes for contamination after cleaning and holding them in quarantine for 48 hours to check them again for bacterial growth.\u003c/p>\n\u003cp>Those steps added layers to what was already a labor-intensive process. It costs about $75 or more to clean a scope each time.\u003c/p>\n\u003cp>“There is a lot of time and money tied up in that,” said John Cifarelli, chief commercial officer for Invendo. “The best solution is a device that doesn’t have to be cleaned.”\u003c/p>\n\u003cp>The leading scope makers haven’t shown much interest thus far in single-use devices, which could affect their longstanding dominance in the business.\u003c/p>\n\u003cp>Olympus Corp., which controls 85 percent of the U.S. market for gastrointestinal scopes, didn’t respond to a request for comment. The Tokyo-based company, linked to numerous infections in the U.S. and Europe, conducted a voluntary recall of its duodenoscopes this year and made repairs designed to reduce the contamination risk.\u003c/p>\n\u003cp>In a statement, another big manufacturer, Fujifilm, said it “has no plans at this time to market single-use disposable scopes, and cannot speak to the benefits or risks associated with such products.”\u003c/p>\n\u003cp>Israeli company GI-View received FDA clearance in August for its single-use colonoscope, called Aer-O-Scope, priced at about $200. The company’s chief executive, Tal Simchony, acknowledges that his smaller company faces an uphill battle against the industry giants. But he said he’s optimistic it can address the “ick” factor some patients feel with a reusable scope.\u003c/p>\n\u003cp>Other companies see opportunity, too. Boston Scientific, a bigger device maker, promotes a disposable ureteroscope to aid in treatment of kidney stones and other procedures. Ambu A/S, based in Denmark, has sold a single-use bronchoscope for about $300 in the U.S. for the past few years.\u003c/p>\n\u003cp>In Europe, two biomedical engineers are raising money to build a prototype and manufacture what could become a full line of disposable endoscopes. Francisco Soriano, one of the engineers in Barcelona, said he learned the business from repairing scopes with his father, who was a longtime Olympus technician.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We must reinvent the endoscope as we know it,” Soriano said. “Our vision is to eliminate cross-infection completely.”\u003c/p>\n\n","blocks":[],"excerpt":"Smaller companies looking to challenge a handful of dominant device makers are seizing on growing evidence that many reusable instruments cannot be cleaned reliably.","status":"publish","parent":0,"modified":1482348380,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1211},"headData":{"title":"$250 Disposable Scopes Used to Combat Drug-Resistant Infection | KQED","description":"Smaller companies looking to challenge a handful of dominant device makers are seizing on growing evidence that many reusable instruments cannot be cleaned reliably.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"$250 Disposable Scopes Used to Combat Drug-Resistant Infection","datePublished":"2016-12-22T17:30:00.000Z","dateModified":"2016-12-21T19:26:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"302105 http://ww2.kqed.org/futureofyou/?p=302105","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/12/22/250-disposable-scopes-used-to-combat-drug-resistant-infection/","disqusTitle":"$250 Disposable Scopes Used to Combat Drug-Resistant Infection","nprByline":"Chad Terhune\u003cbr />Kaiser Health News","path":"/futureofyou/302105/250-disposable-scopes-used-to-combat-drug-resistant-infection","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In response to a series of superbug outbreaks around the country, some doctors and hospitals are trying out disposable scopes to combat the spread of antibiotic-resistant bacteria.\u003c/p>\n\u003cp>U.S. regulators recently approved two new colonoscopes designed to be used just once and thrown away. They will sell for $250 or less apiece — compared to roughly $40,000 or more for a conventional scope that lasts several years but must be disinfected after each use. Other companies are promoting such devices — flexible, lighted tubes used to peer deep inside the body — for use in the lungs and kidneys.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s almost too good to be true with it being so cheap.'\u003c/aside>\n\u003cp>The new scopes are coming primarily from smaller companies looking to challenge a handful of dominant device makers. The upstarts are seizing on growing evidence that many reusable instruments cannot be cleaned reliably, even when manufacturer’s instructions are followed.\u003c/p>\n\u003cp>“If you can tell patients we have a disposable device so there’s really no chance of infection, that has to be very appealing,” said Chris Lavanchy, engineering director at the ECRI Institute, a nonprofit organization that tests medical devices. “This could allay public fears.”\u003c/p>\n\u003cp>Scopes include a wide array of devices used on millions of patients annually. As they snake through a patient’s throat, intestines and other cavities, they pick up mucus, blood and thousands of microbes. But the delicate devices can’t be sterilized like a scalpel because intense heat would destroy crucial components.\u003c/p>\n\u003cfigure id=\"attachment_305327\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\">\u003cimg class=\"size-full wp-image-305327\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\" alt=\"A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \" width=\"270\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270.jpg 270w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-240x360.jpg 240w\" sizes=\"(max-width: 270px) 100vw, 270px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \u003ccite>(Courtesy of Invendo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Instead, the scopes are brushed and washed with disinfectants in preparation for the next patient. Despite those efforts, contamination can persist and drug-resistant bacteria can result in patient infections that are difficult or even impossible to treat.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The threat has led to safety alerts from the Food and Drug Administration and a recent U.S. Senate investigation into repeated failures by manufacturers and hospitals to report outbreaks.\u003c/p>\n\u003cp>Overall, as many as 350 patients at 41 medical facilities worldwide were exposed to or infected by contaminated gastrointestinal scopes from 2010 to 2015, according to the FDA. And at least 35 patients at U.S. hospitals have died since 2013 after developing infections tied to tainted scopes, according to hospitals and public health officials.\u003c/p>\n\u003cp>For now, just a handful of medical centers are experimenting with the disposable colonoscopes. Some doctors remain skeptical about whether a cheaper scope will provide the high-quality images and versatility they need to diagnose and treat patients effectively. Many doctors count on the sophisticated cameras on existing scopes as well as multiple channels inside the device to accommodate surgical instruments.\u003c/p>\n\u003cp>Dr. Simon Lo, a nationally known gastroenterologist at Cedars-Sinai Medical Center in Los Angeles, said he shares those concerns. Nonetheless, he said he’s eager to try the disposable colonoscope from German device maker Invendo Medical in the coming months. The scope secured clearance from the U.S. Food and Drug Administration in August.\u003c/p>\n\u003cp>“I’m not totally sold this will be comparable to the [conventional] scopes other companies have spent decades perfecting. It’s almost too good to be true with it being so cheap,” Lo said. “But this is a fantastic possibility and at least gives us an alternative to the current scopes.”\u003c/p>\n\u003cp>Physician groups such as the American Society for Gastrointestinal Endoscopy maintain that the overall risk of infection is very low from these reusable devices. They say the benefits of screenings and many other procedures far outweigh any potential danger.\u003c/p>\n\u003cp>But some doctors say a simpler, single-use scope could be sufficient for many routine examinations. It could also be preferred for immunosuppressed patients who are more susceptible to infection and for patients who have already tested positive for antibiotic-resistant bacteria and would be likely to spread it.\u003c/p>\n\u003cp>“For those patients, it would be great to use this and throw it away,” Lo said.\u003c/p>\n\u003cp>His hospital, Cedars-Sinai, reported four infections last year from contaminated duodenoscopes, which are inserted down a patient’s throat and used to treat problems in the digestive tract such as cancers and blockages in the bile duct.\u003c/p>\n\u003cp>Colonoscopes, which look at the inner lining of the large intestine, haven’t been linked to the recent outbreaks, but concerns about cleaning and the spread of bacteria apply to all types of reusable scopes. Last year, the FDA warned about the risk to patients posed by bronchoscopes, used to examine problems in the airway and lungs.\u003c/p>\n\u003cp>In one study, researchers found that more than 75 percent of colonoscopes and gastroscopes were still contaminated after cleaning and disinfection in accordance with manufacturer guidelines.\u003c/p>\n\u003cp>Hospitals have experimented with a wide variety of new safety measures over the past two years. Some facilities started testing scopes for contamination after cleaning and holding them in quarantine for 48 hours to check them again for bacterial growth.\u003c/p>\n\u003cp>Those steps added layers to what was already a labor-intensive process. It costs about $75 or more to clean a scope each time.\u003c/p>\n\u003cp>“There is a lot of time and money tied up in that,” said John Cifarelli, chief commercial officer for Invendo. “The best solution is a device that doesn’t have to be cleaned.”\u003c/p>\n\u003cp>The leading scope makers haven’t shown much interest thus far in single-use devices, which could affect their longstanding dominance in the business.\u003c/p>\n\u003cp>Olympus Corp., which controls 85 percent of the U.S. market for gastrointestinal scopes, didn’t respond to a request for comment. The Tokyo-based company, linked to numerous infections in the U.S. and Europe, conducted a voluntary recall of its duodenoscopes this year and made repairs designed to reduce the contamination risk.\u003c/p>\n\u003cp>In a statement, another big manufacturer, Fujifilm, said it “has no plans at this time to market single-use disposable scopes, and cannot speak to the benefits or risks associated with such products.”\u003c/p>\n\u003cp>Israeli company GI-View received FDA clearance in August for its single-use colonoscope, called Aer-O-Scope, priced at about $200. The company’s chief executive, Tal Simchony, acknowledges that his smaller company faces an uphill battle against the industry giants. But he said he’s optimistic it can address the “ick” factor some patients feel with a reusable scope.\u003c/p>\n\u003cp>Other companies see opportunity, too. Boston Scientific, a bigger device maker, promotes a disposable ureteroscope to aid in treatment of kidney stones and other procedures. Ambu A/S, based in Denmark, has sold a single-use bronchoscope for about $300 in the U.S. for the past few years.\u003c/p>\n\u003cp>In Europe, two biomedical engineers are raising money to build a prototype and manufacture what could become a full line of disposable endoscopes. Francisco Soriano, one of the engineers in Barcelona, said he learned the business from repairing scopes with his father, who was a longtime Olympus technician.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We must reinvent the endoscope as we know it,” Soriano said. “Our vision is to eliminate cross-infection completely.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/302105/250-disposable-scopes-used-to-combat-drug-resistant-infection","authors":["byline_futureofyou_302105"],"categories":["futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_697","futureofyou_1151"],"featImg":"futureofyou_305359","label":"futureofyou"},"futureofyou_250228":{"type":"posts","id":"futureofyou_250228","meta":{"index":"posts_1591205157","site":"futureofyou","id":"250228","score":null,"sort":[1474660592000]},"guestAuthors":[],"slug":"u-n-takes-historic-action-against-antibiotic-resistance","title":"U.N. Takes 'Historic' Action Against Antibiotic Resistance","publishDate":1474660592,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Historic. A possible turning point.\u003c/p>\n\u003cp>These are the words health researchers are using to describe a declaration passed Wednesday by the U.N. General Assembly aiming to slow down the spread of superbugs — bacteria that have become resistant to antibiotics.\u003c/p>\n\u003cp>\"I think the declaration will have very strong implications,\" says the \u003ca href=\"http://www.who.int/en/\">World Health Organization's\u003c/a> Dr. Keiji Fukuda. \"What it will convey is that there's recognition that we have a big problem and there's a commitment to do something about it.\"\u003c/p>\n\u003cp>Every year, more than 2 million Americans get sick with antibiotic-resistant infections, and tens of thousands die as a result, \u003ca href=\"http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf\">says\u003c/a> the Centers for Disease Control and Prevention. Common diseases, like urinary tract infections and pneumonia, are becoming harder and harder to treat. And new superbugs are \u003ca href=\"http://www.npr.org/sections/health-shots/2016/05/26/479639936/germ-resistant-to-antibiotic-of-last-resort-appears-in-u-s\">cropping up\u003c/a> — even here in the U.S. — that are resistant to last-resort drugs.\u003c/p>\n\u003cp>Doctors have been warning about this problem for decades. But in the past year or so, another group of researchers has started taking interest in superbugs: economists. And they quickly realized the problem goes way beyond health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Antibiotic resistance has immense economic consequences and immense implications for food,\" Fukuda says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There's recognition that we have a big problem and there's a commitment to do something about it.'\u003ccite>Dr. Keiji Fukuda, World Health Organization\u003c/cite>\u003c/aside>\n\u003cp>A recent \u003ca href=\"http://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf\">report\u003c/a> from the U.K. government found that antibiotic-resistant bacteria could cost the world $100 trillion by 2050 if nothing is done about it. The World Bank \u003ca href=\"http://www.worldbank.org/en/news/press-release/2016/09/18/by-2050-drug-resistant-infections-could-cause-global-economic-damage-on-par-with-2008-financial-crisis\">predicts\u003c/a> drug-resistant infections could damage the economy as much as — or even more than — the 2008 financial crisis. And annual global GDP could drop by 1 to 4 percent, the agency says.\u003c/p>\n\u003cp>On top of that, farmers around the world have come to rely on antibiotics to raise animals. The drugs make pigs, cows and chickens grow fatter more quickly — and keeps them healthy in densely packed quarters.\u003c/p>\n\u003cp>\"If we lose that ability we begin to perhaps lose the ability to have adequate food supplies in the world,\" Fukuda says.\u003c/p>\n\u003cp>And that's why world leaders are now getting involved. The U.N.'s declaration requires countries to come up with a two-year a plan to protect the potency of antibiotics. Countries need to create ways to monitor the use of antibiotics in medicine and agriculture, start curbing that use and begin developing new antibiotics that work.\u003c/p>\n\u003cfigure id=\"attachment_250257\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-250257\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Staph.-aureus-800x541.jpg\" alt=\"Staphylococcus Aureus in biofilm, magnified.\" width=\"800\" height=\"541\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-800x541.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-400x270.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-768x519.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-960x649.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Staphylococcus Aureus in biofilm, magnified. \u003ccite>(Janice Carr/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After two years, the U.N.'s secretary-general will assess each country's plan and check to make sure each is making progress.\u003c/p>\n\u003cp>\"I think this is the first realistic chance, in our lifetime, to turn this around,\" Fukuda says.\u003c/p>\n\u003cp>And there's precedent for this optimism.\u003c/p>\n\u003cp>Back in 2001, the U.N. made a \u003ca href=\"http://www.un.org/ga/aids/coverage/FinalDeclarationHIVAIDS.html\">similar declaration\u003c/a> about the HIV pandemic. And that declaration had a big impact on curbing the spread of HIV around the world, says \u003ca href=\"http://www.cddep.org/profile/ramanan_laxminarayan#sthash.UiH1YYRk.dpbs\">Ramanan Laxminarayan\u003c/a>, who directs the Center for Disease Dynamics, Economics & Policy in Washington, D.C.\u003c/p>\n\u003cp>\u003cem>\"\u003c/em>The declaration made countries take responsibility for the HIV burden,\" he says. People were willing to start talking about and change their attitudes on stigma. And last but not least, the declaration made sure that lots of money went towards both treatment and prevention.\"\u003c/p>\n\u003cp>He says there are a few weaknesses in the U.N.'s new plan on antibiotic-resistant bacteria. For example, there are no hardcore targets for reducing antibiotic use by a certain amount in two years.\u003c/p>\n\u003cp>But he thinks the declaration could have the same impact on fighting antibiotic-resistant bacteria as the previous one had on fighting HIV. Since 2004, there \u003ca href=\"http://www.npr.org/sections/goatsandsoda/2016/09/15/493760787/why-the-u-s-is-pledging-4-3-billion-to-the-global-fund\">has been\u003c/a> a 45 percent drop in AIDS-related deaths in countries supported by global HIV campaigns.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Am I optimistic? I certainly am,\" he says. \"In fact, we don't have a choice. We have to do better than we're doing right now because tens of thousands of people are now dying around the world, particularly newborns. And this is surely getting worse year by year.\"\u003c/p>\n\n","blocks":[],"excerpt":"An unprecedented U.N. declaration requires countries to come up with a two-year plan to protect the potency of antibiotics.","status":"publish","parent":0,"modified":1474904794,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":685},"headData":{"title":"U.N. Takes 'Historic' Action Against Antibiotic Resistance | KQED","description":"An unprecedented U.N. declaration requires countries to come up with a two-year plan to protect the potency of antibiotics.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"U.N. Takes 'Historic' Action Against Antibiotic Resistance","datePublished":"2016-09-23T19:56:32.000Z","dateModified":"2016-09-26T15:46:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"250228 http://ww2.kqed.org/futureofyou/?p=250228","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/09/23/u-n-takes-historic-action-against-antibiotic-resistance/","disqusTitle":"U.N. Takes 'Historic' Action Against Antibiotic Resistance","nprByline":"Michaeleen Doucleff \u003c/Br> NPR","path":"/futureofyou/250228/u-n-takes-historic-action-against-antibiotic-resistance","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Historic. A possible turning point.\u003c/p>\n\u003cp>These are the words health researchers are using to describe a declaration passed Wednesday by the U.N. General Assembly aiming to slow down the spread of superbugs — bacteria that have become resistant to antibiotics.\u003c/p>\n\u003cp>\"I think the declaration will have very strong implications,\" says the \u003ca href=\"http://www.who.int/en/\">World Health Organization's\u003c/a> Dr. Keiji Fukuda. \"What it will convey is that there's recognition that we have a big problem and there's a commitment to do something about it.\"\u003c/p>\n\u003cp>Every year, more than 2 million Americans get sick with antibiotic-resistant infections, and tens of thousands die as a result, \u003ca href=\"http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf\">says\u003c/a> the Centers for Disease Control and Prevention. Common diseases, like urinary tract infections and pneumonia, are becoming harder and harder to treat. And new superbugs are \u003ca href=\"http://www.npr.org/sections/health-shots/2016/05/26/479639936/germ-resistant-to-antibiotic-of-last-resort-appears-in-u-s\">cropping up\u003c/a> — even here in the U.S. — that are resistant to last-resort drugs.\u003c/p>\n\u003cp>Doctors have been warning about this problem for decades. But in the past year or so, another group of researchers has started taking interest in superbugs: economists. And they quickly realized the problem goes way beyond health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Antibiotic resistance has immense economic consequences and immense implications for food,\" Fukuda says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There's recognition that we have a big problem and there's a commitment to do something about it.'\u003ccite>Dr. Keiji Fukuda, World Health Organization\u003c/cite>\u003c/aside>\n\u003cp>A recent \u003ca href=\"http://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf\">report\u003c/a> from the U.K. government found that antibiotic-resistant bacteria could cost the world $100 trillion by 2050 if nothing is done about it. The World Bank \u003ca href=\"http://www.worldbank.org/en/news/press-release/2016/09/18/by-2050-drug-resistant-infections-could-cause-global-economic-damage-on-par-with-2008-financial-crisis\">predicts\u003c/a> drug-resistant infections could damage the economy as much as — or even more than — the 2008 financial crisis. And annual global GDP could drop by 1 to 4 percent, the agency says.\u003c/p>\n\u003cp>On top of that, farmers around the world have come to rely on antibiotics to raise animals. The drugs make pigs, cows and chickens grow fatter more quickly — and keeps them healthy in densely packed quarters.\u003c/p>\n\u003cp>\"If we lose that ability we begin to perhaps lose the ability to have adequate food supplies in the world,\" Fukuda says.\u003c/p>\n\u003cp>And that's why world leaders are now getting involved. The U.N.'s declaration requires countries to come up with a two-year a plan to protect the potency of antibiotics. Countries need to create ways to monitor the use of antibiotics in medicine and agriculture, start curbing that use and begin developing new antibiotics that work.\u003c/p>\n\u003cfigure id=\"attachment_250257\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-250257\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Staph.-aureus-800x541.jpg\" alt=\"Staphylococcus Aureus in biofilm, magnified.\" width=\"800\" height=\"541\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-800x541.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-400x270.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-768x519.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-960x649.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Staphylococcus Aureus in biofilm, magnified. \u003ccite>(Janice Carr/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After two years, the U.N.'s secretary-general will assess each country's plan and check to make sure each is making progress.\u003c/p>\n\u003cp>\"I think this is the first realistic chance, in our lifetime, to turn this around,\" Fukuda says.\u003c/p>\n\u003cp>And there's precedent for this optimism.\u003c/p>\n\u003cp>Back in 2001, the U.N. made a \u003ca href=\"http://www.un.org/ga/aids/coverage/FinalDeclarationHIVAIDS.html\">similar declaration\u003c/a> about the HIV pandemic. And that declaration had a big impact on curbing the spread of HIV around the world, says \u003ca href=\"http://www.cddep.org/profile/ramanan_laxminarayan#sthash.UiH1YYRk.dpbs\">Ramanan Laxminarayan\u003c/a>, who directs the Center for Disease Dynamics, Economics & Policy in Washington, D.C.\u003c/p>\n\u003cp>\u003cem>\"\u003c/em>The declaration made countries take responsibility for the HIV burden,\" he says. People were willing to start talking about and change their attitudes on stigma. And last but not least, the declaration made sure that lots of money went towards both treatment and prevention.\"\u003c/p>\n\u003cp>He says there are a few weaknesses in the U.N.'s new plan on antibiotic-resistant bacteria. For example, there are no hardcore targets for reducing antibiotic use by a certain amount in two years.\u003c/p>\n\u003cp>But he thinks the declaration could have the same impact on fighting antibiotic-resistant bacteria as the previous one had on fighting HIV. Since 2004, there \u003ca href=\"http://www.npr.org/sections/goatsandsoda/2016/09/15/493760787/why-the-u-s-is-pledging-4-3-billion-to-the-global-fund\">has been\u003c/a> a 45 percent drop in AIDS-related deaths in countries supported by global HIV campaigns.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Am I optimistic? I certainly am,\" he says. \"In fact, we don't have a choice. We have to do better than we're doing right now because tens of thousands of people are now dying around the world, particularly newborns. And this is surely getting worse year by year.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/250228/u-n-takes-historic-action-against-antibiotic-resistance","authors":["byline_futureofyou_250228"],"categories":["futureofyou_452","futureofyou_1"],"tags":["futureofyou_697","futureofyou_651","futureofyou_125","futureofyou_1058","futureofyou_1059"],"featImg":"futureofyou_250255","label":"futureofyou"},"futureofyou_96746":{"type":"posts","id":"futureofyou_96746","meta":{"index":"posts_1591205157","site":"futureofyou","id":"96746","score":null,"sort":[1452641682000]},"guestAuthors":[],"slug":"more-hospitals-are-ditching-antibiotics-in-the-meat-they-serve","title":"More Hospitals Are Ditching Antibiotics In The Meat They Serve","publishDate":1452641682,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Every year some 2 million Americans get infections from antibiotic-resistant bacteria, and 23,000 of them die from these superbugs.\u003c/p>\n\u003cp>Superbugs are mostly a hospital problem: They're where these pathogens are often born and spread, and where the infected come for help. But hospitals are not where the majority of antibiotics sold in the U.S. are used.\u003c/p>\n\u003cp>Food and Drug Administration \u003ca href=\"http://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/UCM476258.pdf\" target=\"_blank\">data show\u003c/a> that 62 percent of antibiotics important for human health are sold to food animal producers and used on farms. And in December, the agency \u003ca href=\"http://www.npr.org/sections/thesalt/2015/12/11/459274335/antibiotic-use-on-farms-is-up-despite-promises-to-kick-the-drugs\" target=\"_blank\">noted\u003c/a> that antibiotics for use on the farm increased in 2014, including antibiotics important in human medicine.\u003c/p>\n\u003caside class=\"pullquote alignright\">Various studies ... have found resistant bacteria on samples of beef, pork, turkey and chicken from supermarkets.\u003c/aside>\n\u003cp>Concern about the livestock industry's overuse of antibiotics has led a number of health care institutions to start choosing meat from animals raised without antibiotics whenever they can. According to \u003ca href=\"https://practicegreenhealth.org/\" target=\"_blank\">Practice Greenhealth\u003c/a>, a nonprofit that's helping the health care industry on this issue, more than 400 U.S. hospitals are working toward a goal of making 20 percent of their meat purchases \"antibiotic-free.\" And around a dozen hospitals have already switched the majority of their chicken purchases to antibiotic-free.\u003c/p>\n\u003cp>\"Health care is really voicing their demand for [antibiotic-free meat] products,\" says Hillary Bisnett, a food expert for Practice Greenhealth and \u003ca href=\"https://noharm.org/\" target=\"_blank\">Health Care Without Harm\u003c/a>. \"Hospitals understand antibiotic resistance, and they're being asked to steward their own use of antibiotics. So it's very easy for them to say, 'Livestock producers need to be doing their part, too.' \"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Is meat from animals raised without antibiotics really better? Public health groups who follow this issue, like the Pew Charitable Trusts, say it can be safer. Of greatest concern is that when chicken, hog or cattle farmers use drugs to promote growth or prevent disease in their animals, they'll overuse the drugs and create resistant bacteria, like Salmonella and Campylobacter, that could make people sick.\u003c/p>\n\u003cp>Various studies, including \u003ca href=\"http://cid.oxfordjournals.org/content/early/2015/07/09/cid.civ428.full\" target=\"_blank\">ones\u003c/a> by George Washington University microbiologist Lance Price and advocacy groups like \u003ca href=\"http://www.consumerreports.org/cro/2012/06/antibiotics-are-widely-used-by-u-s-meat-industry/index.htm\" target=\"_blank\">Consumer Reports\u003c/a> and the \u003ca href=\"http://www.ewg.org/meateatersguide/superbugs/\" target=\"_blank\">Environmental Working Group\u003c/a>, have found resistant bacteria on samples of beef, pork, turkey and chicken from supermarkets. If meat contaminated this way isn't cooked properly, the resistant bacteria can infect humans. And if the pathogens are resistant to antibiotics designed to kill them, then doctors may have few tools to treat the infections.\u003c/p>\n\u003cp>Among the hospitals that have made antibiotic-free meat a priority for their food services is \u003ca href=\"http://www.hackensackumc.org/\" target=\"_blank\">Hackensack University Medical Center\u003c/a> in New Jersey. But according to Kyle Tafuri, senior sustainability adviser at the hospital, it wasn't easy to figure out how to switch 100 percent of their chicken purchases to antibiotic-free.\u003c/p>\n\u003cfigure id=\"attachment_96749\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/chicken.jpg\" rel=\"attachment wp-att-96749\">\u003cimg class=\"size-large wp-image-96749\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/chicken-1180x1065.jpg\" alt=\"Perdue's Harvestland brand, antibiotic-free chicken, served at Overlake Medical Center in Bellevue, Washington.\" width=\"640\" height=\"578\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-1180x1065.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-400x361.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-665x600.jpg 665w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-768x693.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-960x866.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken.jpg 1200w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Perdue's Harvestland brand, antibiotic-free chicken, served at Overlake Medical Center in Bellevue, Washington. \u003ccite>(Overlake Medical Center)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At first, the hospital's distributor said it didn't have enough antibiotic-free chicken to sell the hospital. But over the course of a few years, and after several meetings with the distributor and a group purchasing organization, they were able to find away to make it work.\u003c/p>\n\u003cp>Eventually, Tafuri says, the supplier, Perdue, agreed to specially ship the chicken up to the distributor's warehouse just for the hospital. \"It took a lot of work to make this happen and a lot of pushing, but hospitals should be inclined to push the industry to make a change,\" he says.\u003c/p>\n\u003cp>His hospital pays 30 percent more for Perdue's antibiotic-free chicken under its Harvestland brand, but Tafuri says it's worth it to his institution to be able to offer a \"higher quality and healthier product.\" He's now working on sourcing more antibiotic-free pork and beef, but he says they're dramatically more expensive, and more difficult to source.\u003c/p>\n\u003cp>\u003ca href=\"https://www.linkedin.com/in/chris-linaman-1734b946\" target=\"_blank\">Chris Linamen\u003c/a>, executive chef at \u003ca href=\"http://www.overlakehospital.org/\" target=\"_blank\">Overlake Medical Center\u003c/a> in Bellevue, Wash., says he's managed to find antibiotic-free sources for 79 percent of his total meat purchases.\u003c/p>\n\u003cp>\"The biggest challenge is budget,\" says Linamen. He's also struggled to find antibiotic-free sources for specific items, like chicken strips, sausage patties, duck and lamb.\u003c/p>\n\u003cp>Part of what explains Linamen and Tafuri's success in getting more antibiotic-free meat on the plates they serve is the fact that neither of their institutions is locked into a contract with a big food service management company, like Aramark, Sodexo or Compass, says Bisnett of Practice Greenhealth. Many other hospitals tell her they would like to source more antibiotic-free meat but can't, because their contracts do not allow them to.\u003c/p>\n\u003cp>The biggest food-service management companies have very limited supply of these items. And the hospitals \"don't have flexibility in changing vendors or supply,\" says Bisnett.\u003c/p>\n\u003cp>\"That's why it's really important that the food service sector get more involved with this issue, too, since one third of hospitals in the U.S. have food service managed by Sodexo, Compass or Aramark,\" she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Hospitals are far from the only big buyers to get interested in sourcing antibiotic-free meat and apply pressure to biggest meat producers, like Perdue, Tyson, JBS and Smithfield, to make more of it available. Several restaurant and retail chains in 2015 committed to sourcing more antibiotic-free meat, including \u003ca href=\"http://www.npr.org/sections/thesalt/2015/03/04/390701295/mcdonalds-says-it-wont-be-serving-chicken-raised-on-antibiotics\" target=\"_blank\">McDonalds\u003c/a>, \u003ca href=\"http://www.npr.org/sections/thesalt/2015/10/20/450314991/subway-joins-the-fast-food-antibiotic-free-meat-club\" target=\"_blank\">Subway\u003c/a>, Panera, CostCo and Chick-fil-A. Some have committed to sourcing antibiotic-free poultry, while others have also given suppliers of beef and pork a mandatory timetable to go antibiotic-free as well.\u003c/p>\n\n","blocks":[],"excerpt":"Concern about the livestock industry’s overuse of antibiotics has led a number of institutions to seek meat from animals raised without antibiotics. ","status":"publish","parent":0,"modified":1452641843,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":923},"headData":{"title":"More Hospitals Are Ditching Antibiotics In The Meat They Serve | KQED","description":"Concern about the livestock industry’s overuse of antibiotics has led a number of institutions to seek meat from animals raised without antibiotics. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"More Hospitals Are Ditching Antibiotics In The Meat They Serve","datePublished":"2016-01-12T23:34:42.000Z","dateModified":"2016-01-12T23:37:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"96746 http://ww2.kqed.org/futureofyou/?p=96746","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/01/12/more-hospitals-are-ditching-antibiotics-in-the-meat-they-serve/","disqusTitle":"More Hospitals Are Ditching Antibiotics In The Meat They Serve","source":"Food Technology","nprByline":"Eliza Barclay\u003cbr>NPR","path":"/futureofyou/96746/more-hospitals-are-ditching-antibiotics-in-the-meat-they-serve","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Every year some 2 million Americans get infections from antibiotic-resistant bacteria, and 23,000 of them die from these superbugs.\u003c/p>\n\u003cp>Superbugs are mostly a hospital problem: They're where these pathogens are often born and spread, and where the infected come for help. But hospitals are not where the majority of antibiotics sold in the U.S. are used.\u003c/p>\n\u003cp>Food and Drug Administration \u003ca href=\"http://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/UCM476258.pdf\" target=\"_blank\">data show\u003c/a> that 62 percent of antibiotics important for human health are sold to food animal producers and used on farms. And in December, the agency \u003ca href=\"http://www.npr.org/sections/thesalt/2015/12/11/459274335/antibiotic-use-on-farms-is-up-despite-promises-to-kick-the-drugs\" target=\"_blank\">noted\u003c/a> that antibiotics for use on the farm increased in 2014, including antibiotics important in human medicine.\u003c/p>\n\u003caside class=\"pullquote alignright\">Various studies ... have found resistant bacteria on samples of beef, pork, turkey and chicken from supermarkets.\u003c/aside>\n\u003cp>Concern about the livestock industry's overuse of antibiotics has led a number of health care institutions to start choosing meat from animals raised without antibiotics whenever they can. According to \u003ca href=\"https://practicegreenhealth.org/\" target=\"_blank\">Practice Greenhealth\u003c/a>, a nonprofit that's helping the health care industry on this issue, more than 400 U.S. hospitals are working toward a goal of making 20 percent of their meat purchases \"antibiotic-free.\" And around a dozen hospitals have already switched the majority of their chicken purchases to antibiotic-free.\u003c/p>\n\u003cp>\"Health care is really voicing their demand for [antibiotic-free meat] products,\" says Hillary Bisnett, a food expert for Practice Greenhealth and \u003ca href=\"https://noharm.org/\" target=\"_blank\">Health Care Without Harm\u003c/a>. \"Hospitals understand antibiotic resistance, and they're being asked to steward their own use of antibiotics. So it's very easy for them to say, 'Livestock producers need to be doing their part, too.' \"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Is meat from animals raised without antibiotics really better? Public health groups who follow this issue, like the Pew Charitable Trusts, say it can be safer. Of greatest concern is that when chicken, hog or cattle farmers use drugs to promote growth or prevent disease in their animals, they'll overuse the drugs and create resistant bacteria, like Salmonella and Campylobacter, that could make people sick.\u003c/p>\n\u003cp>Various studies, including \u003ca href=\"http://cid.oxfordjournals.org/content/early/2015/07/09/cid.civ428.full\" target=\"_blank\">ones\u003c/a> by George Washington University microbiologist Lance Price and advocacy groups like \u003ca href=\"http://www.consumerreports.org/cro/2012/06/antibiotics-are-widely-used-by-u-s-meat-industry/index.htm\" target=\"_blank\">Consumer Reports\u003c/a> and the \u003ca href=\"http://www.ewg.org/meateatersguide/superbugs/\" target=\"_blank\">Environmental Working Group\u003c/a>, have found resistant bacteria on samples of beef, pork, turkey and chicken from supermarkets. If meat contaminated this way isn't cooked properly, the resistant bacteria can infect humans. And if the pathogens are resistant to antibiotics designed to kill them, then doctors may have few tools to treat the infections.\u003c/p>\n\u003cp>Among the hospitals that have made antibiotic-free meat a priority for their food services is \u003ca href=\"http://www.hackensackumc.org/\" target=\"_blank\">Hackensack University Medical Center\u003c/a> in New Jersey. But according to Kyle Tafuri, senior sustainability adviser at the hospital, it wasn't easy to figure out how to switch 100 percent of their chicken purchases to antibiotic-free.\u003c/p>\n\u003cfigure id=\"attachment_96749\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/chicken.jpg\" rel=\"attachment wp-att-96749\">\u003cimg class=\"size-large wp-image-96749\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/chicken-1180x1065.jpg\" alt=\"Perdue's Harvestland brand, antibiotic-free chicken, served at Overlake Medical Center in Bellevue, Washington.\" width=\"640\" height=\"578\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-1180x1065.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-400x361.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-665x600.jpg 665w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-768x693.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken-960x866.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/chicken.jpg 1200w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Perdue's Harvestland brand, antibiotic-free chicken, served at Overlake Medical Center in Bellevue, Washington. \u003ccite>(Overlake Medical Center)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At first, the hospital's distributor said it didn't have enough antibiotic-free chicken to sell the hospital. But over the course of a few years, and after several meetings with the distributor and a group purchasing organization, they were able to find away to make it work.\u003c/p>\n\u003cp>Eventually, Tafuri says, the supplier, Perdue, agreed to specially ship the chicken up to the distributor's warehouse just for the hospital. \"It took a lot of work to make this happen and a lot of pushing, but hospitals should be inclined to push the industry to make a change,\" he says.\u003c/p>\n\u003cp>His hospital pays 30 percent more for Perdue's antibiotic-free chicken under its Harvestland brand, but Tafuri says it's worth it to his institution to be able to offer a \"higher quality and healthier product.\" He's now working on sourcing more antibiotic-free pork and beef, but he says they're dramatically more expensive, and more difficult to source.\u003c/p>\n\u003cp>\u003ca href=\"https://www.linkedin.com/in/chris-linaman-1734b946\" target=\"_blank\">Chris Linamen\u003c/a>, executive chef at \u003ca href=\"http://www.overlakehospital.org/\" target=\"_blank\">Overlake Medical Center\u003c/a> in Bellevue, Wash., says he's managed to find antibiotic-free sources for 79 percent of his total meat purchases.\u003c/p>\n\u003cp>\"The biggest challenge is budget,\" says Linamen. He's also struggled to find antibiotic-free sources for specific items, like chicken strips, sausage patties, duck and lamb.\u003c/p>\n\u003cp>Part of what explains Linamen and Tafuri's success in getting more antibiotic-free meat on the plates they serve is the fact that neither of their institutions is locked into a contract with a big food service management company, like Aramark, Sodexo or Compass, says Bisnett of Practice Greenhealth. Many other hospitals tell her they would like to source more antibiotic-free meat but can't, because their contracts do not allow them to.\u003c/p>\n\u003cp>The biggest food-service management companies have very limited supply of these items. And the hospitals \"don't have flexibility in changing vendors or supply,\" says Bisnett.\u003c/p>\n\u003cp>\"That's why it's really important that the food service sector get more involved with this issue, too, since one third of hospitals in the U.S. have food service managed by Sodexo, Compass or Aramark,\" she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Hospitals are far from the only big buyers to get interested in sourcing antibiotic-free meat and apply pressure to biggest meat producers, like Perdue, Tyson, JBS and Smithfield, to make more of it available. Several restaurant and retail chains in 2015 committed to sourcing more antibiotic-free meat, including \u003ca href=\"http://www.npr.org/sections/thesalt/2015/03/04/390701295/mcdonalds-says-it-wont-be-serving-chicken-raised-on-antibiotics\" target=\"_blank\">McDonalds\u003c/a>, \u003ca href=\"http://www.npr.org/sections/thesalt/2015/10/20/450314991/subway-joins-the-fast-food-antibiotic-free-meat-club\" target=\"_blank\">Subway\u003c/a>, Panera, CostCo and Chick-fil-A. Some have committed to sourcing antibiotic-free poultry, while others have also given suppliers of beef and pork a mandatory timetable to go antibiotic-free as well.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/96746/more-hospitals-are-ditching-antibiotics-in-the-meat-they-serve","authors":["byline_futureofyou_96746"],"categories":["futureofyou_1"],"tags":["futureofyou_697","futureofyou_80","futureofyou_698","futureofyou_699"],"featImg":"futureofyou_96747","label":"source_futureofyou_96746"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. 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