Kyle Colby Policy Paper

Kyle Eagen, Colby Rohde
Antibiotic Resistance and How the Spread of It Could Be Stopped
Background:
Antibiotic resistance has been a growing plague on society for the past 60 years. The first penicillin-resistant strains were found almost immediately in the 1940’s when penicillin was introduced [1]. It is a problem that won’t Avoid Contractions be solved by a single solution and one which has multiple factors that cause it. A few of these factors include over prescription of antibiotics and the misuse of such antibiotics by the patient/public I feel like there is a better way to word this [1]. We will be focusing on the excessive prescription of antibiotics and how we should be steering away from the use of antibiotics in general. If antibiotics continue to be misused at the rate maintained today we will soon be unable to combat infections with antibiotics. If there is not a change in the policies regarding the prescription of antibiotics before an infection or if antibiotics continue to be misused by the public then we will most likely end up with a multitude of bacterial infections that we can’t kill. One majorI'd omit major example is staphylococcus aureus hmmmmm she may kill you for this one…first Staphylococcus needs to be capitalized and the entire name needs to be italicized which kills roughly 19,000 more people then HIV/AIDS a year [3]. Also the research and production of possible anti bacterial weapons that are not antibiotics and will hopefully not produce resistances. This sentence seems out of place, it just needs better wording. Antibiotics are a dying breed that is slowly losing the fight, what is needed are the next generation of weapons in our fight against bacterial infections.
Policy:
Our policy would be a three part program on a national basis:
Step 1: Control the allotment of antibiotics used as a precautionary measure instead of treating an already symptomatic infection
- Restrict the prescription power of family physicians, if a person is in need of stronger antibiotics send them to the hospital for treatment
- Also follow up appointments set up at a local clinic to check for proper usage of antibiotics prescribed
- These would be monitored on a regional level and then relayed to a national board in Congress or even just run by the FDA
- Funding provided through the healthcare budget, supplemented through Congress grants to regional operations
Step 2: Moving away from the use of antibiotics entirely, more effort put into other research
- Using antimicrobial peptides found in plants and animals, these have been altered to increase damage against bacteria, they are designed to penetrate the plasma membranes and kill the cell. Does not target a single piece, aims at cell membrane in general [3]
- Bacterial infections communicate using a quorum; they do this to establish density and when a quorum is established begin the making of proteins known as virulence factors or a biofilm called aggregates that can resist antibiotics 1,000 times more effectively. There also exist mutant bacteria that either transmit and don’t receive or receive and don’t transmit signals, these grow at a much larger rate due to less energy use in communication. If left or encouraged to multiply they are capable of halting communications and ending the formation of a quorum [2].
- An FDA approved drug found to kill e coli bacteria through the disruption of conjugation, or the sharing of DNA between bacteria. This was done by substituting a phosphate ion in place of the phosphate rich DNA strands [5].
Conclusion:
- How would the regulation of antibiotics and the check up appointments to ensure correct usage of antibiotics be enforced realistically? Well there is already an international committee called the Alliance for the Prudent Use of Antibiotics. It would be a similar organization just on a smaller scale; enforcement is always the tougher of the two, requiring actual legislative codes to establish it.
- Well aren’t there potential drawbacks to the use of non-antibiotics to fight infections? Yes there is always some risk in dealing with your personal health. That is why there are laws out there designed to make sure that any kind of product like this is designed to have its potential benefits make it worth any possible risks.
The point of this policy is to minimize the continuing adverse effects we are creating through the misuse of antibiotics. We need to collectively work to reduce the abuse of antibiotics in a precautionary manner and take better steps in insured the correct use of prescribed antibiotics. Also we need to look to other sources of protection from and eradication of bacterial infections. Antibiotics are slowly going to lose the capability of fighting and do we want to be left defenseless? I'm not really sure you want these last two points to be bulleted, I guess if that's how the example was its fine. But it disrupts the flow a little bit.

References:
1. Antibiotics have been around for years, so why is it only recently that antibiotic-resistant bacteria have become the focus of attention and alarm? Also, why are resistant strains especially likely to arise if a patient doesn't complete a course of antibiotic therapy? It seems counterintuitive, 2009. Replied to by: Levy, Stuart B., Bittner, Marvin J., Salyers, Abigail. http://www.scientificamerican.com/article.cfm?id=antibiotics-have-been-aro
2. Quiet Bacteria and Antibiotic Resistance, May 2009. Wenner, Melinda. http://www.scientificamerican.com/article.cfm?id=bacteria-antibiotic-resistance
3. Synthetic Peptide May Succeed Where Antibiotics Have Met with Resistance, July 2009. Graham, Sarah. http://www.scientificamerican.com/article.cfm?id=synthetic-peptide-may-suc
4. Comprehensive Strategy to Prevent Nosocomial Spread of Methicillin-Resistant Staphylococcus aureus in a Highly Endemic Setting, 2004. Viktorija Tomic, MD; Petra Svetina Sorli, MD; Darinka Trinkaus, MD; Jurij Sorli, MD, PhD; Andreas F. Widmer, MD, MS; Andrej Trampuz, MD. http://archinte.ama-assn.org/cgi/content/full/164/18/2038?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Prevent+Nosocomial&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
5. New Way To Stop Antibiotic Resistant Bacteria Found, July 2009. Paddock, Catharine. http://www.medicalnewstoday.com/articles/76498.php#**bold text**

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