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  1. Antibiotics: Are they the final answer?

    A case of pulmonary and intestinal tuberculosis was brought before me, whose tuberculosis in lungs had relapsed for the third time, and had developed resistance to normal TB medicines. Though he was under DOT for some time, when no improvement was registered in his case he was put on higher antibiotics. Even then there was no improvement in his condition. He had persistent cough, and very often his sputum was smeared with droplets of blood. This is usually a common case with every antibiotic treatment, when the prescribed doses have not been taken for a specified period. When any disease becomes resistant to any particular antibiotic, then other higher antibiotics are administered to procure a cure, but in the process normal functioning of vital organs are likely to be affected, sometimes it proves fatal. Still this practice is being applied again and again by doctors in hospitals, because there is no alternative either. Antibiotics are considered to be the only antidote. I have seen many such failed cases, one case was my mother.
    Every microorganism has an ability to withstand the effects of antibiotics; it is called a specific type of drug resistance. Horizontal gene transfer may be one of the reasons of antibiotic resistance, but it may also be due to the environmental pressure exerted on the antibiotic action on the pathogen. Once developed resistance, the microorganism transfers its trait to its offspring, and the result is the development of a fully resistant colony. It has been demonstrated by several studies that indiscriminate use of broad-spectrum antibiotics, for example second and third generation cephalosporins may trigger resistance to methicillin. Sometimes resistance may occur due to incorrect diagnosis, unnecessary prescriptions, improper use, non-compliance with the prescribed dose and finally administration of antibiotics to the livestock orally.
    Styphylococcus aureus is found in mucous membranes and skin of around one-third of population of the world, but it has developed resistance to major antibiotics. In 1947, it was detected that this bacterium has developed resistance to penicillin group of antibiotics. It had never occurred to the scientists before that penicillin could ever be resistant. In fact, until then penicillin was considered to be a great invention of mankind and cure for both gram-positive and gram-negative bacteria, except TB. Now the scientists took shelter of methicillin, but subsequently it has to be replaced by oxacillin, because the former was found to be toxic to kidneys and subsequent blood poisoning. Now around fifty percent of Styphylococcus aureus is resistant to pencillin, methicillin, tetracycline and erythromycin. Now, this has left vancomycin as the drug of choice. But again, it was first documented in 2002 in the United States that a strain of Aureus has manifested complete resistance to vancomycin.
    In 1990s, a completely new generation of antibiotics such as oxazolidones was introduced into the market. Oxazolidinone and linezolid were found equally effective as vancomycin in case of methicillin resistant S. Aureus (MRSA). However, in 2003, lenozolid-resistance against Aureus was reported. Now, MRSA is gradually appearing as fatal disease causing agent in the case of necrotizing pneumonia, severe sepsis and necrotizing fasciitis.
    Streptococcus pyogenes is amenable to many different kinds of antibiotics, but all infections are not, because of late some strains have become resistant to penicillin. Similarly Streptococcus pneumoniae is also gradually showing sign of resistance to penicillin group of medicines and other beta-lactams in the world. Resistance to penicillin was detected in 1967 in pneumonia originated from S.pneumoniae or in short Pneumococcus. Likewise Echerichia coli also appeared to be resistant to five variants of fluoroquinolone in 1993. And as we know of late Mycobacterium tuberculosis has also acquired resistance to isoniazid and rifampicine (rifampin). Salmonella, Campylobacter and Streptococci are again hostile to penicillin treatment. Enterococcus faecium is another superbug existing in many hospitals. In 1983 Enterococcus was noted to be penicillin resistant, in 1987 to vancomycin and linezolid in 1990s. Though Pseudomonas aeruginosa is considered to be a highly prevalent opportunistic pathogen, yet this pathogen is also displaying a sign of low susceptibility to multi-drug treatments due to either by mutation or by the horizontal gene transfer.
    Clostridium difficile is associated with the main causative factor of diarrhoea in hospitals world-wide, but this pathogen was also reported to be non-responsive to ciprofloxacin and levofloxacin in North America in 2005. Same is the case with Salmonella, E.coli and Acinetobacter baumannii. Salmonella and E.coli infections are mainly acquired through consumption of contaminated food items particularly, meat and highly resistant to most of the antibiotics, therefore bladder infection and urinary tract infections once acquired become recurrent. I have come across several such cases, in which antibiotics were found non-responsive. A.baumannii is responsible for blood-related infections, but once again it is resistant to several antibiotics. In developed countries at least some record is being maintained whenever there is a drug failure case in some or the other disease for future enlightenment, but in under-developed countries, who cares? There is neither the expertise nor the facilities to keep track of such failures. Thousands die without being diagnosed of the causative factor of death. The story is pathetic. Animals are also prone to MRSA; MRSA infection is being transmitted to animals by their owners and vice versa.
    The more the drugs are being pushed into the markets by the pharmaceutical companies as safe and effective, the more these drugs are being reported in course of time as resistant and ineffective. There is every possibility in future; no effective drug will be available for treatment of even simplest of the ailments if this process of emergence of resistance continues unabated.
    Different antibiotics are being administered to animals, such as cows, pigs, chickens, fish etc. in farms to keep them disease-free and fit for sale. Later these animals are marketed for human consumption, though the sellers are aware that these animals carry into their bodies at least a trace amount of antibiotics, but who will restrict such sale? The government agencies are not that effective to stop sell of these highly contaminated animals. When consumed, these drugs enter the human bodies and create resistant pathogens. Therefore, it is about time the government took serious concern on the issue related to feeding of antibiotics to animals. Just think for a moment, whether baby-food and health drinks served upon the infants and babies are safe? Are we sure that every health-drink industry follows minimum safety standard, when we know that on every cow antibiotics are randomly used? In every health drink or baby food the main protein constituent is the milk, so there is no rescue. Have we ever thought, in the name of health drinks are we not feeding our children with poisons? So is the case with the poultry industry, antibiotics are frequently used to keep the birds healthy, which are being passed into their meat and eggs. Every veggie, who refuses even eggs, but unknowingly consume with relish biscuits, pastries and cakes, so he is also not safe. In every biscuit preparation, the additional ingredient is milk, which we know is contaminated. I do not think, any biscuit manufacturer or baby-food producer maintains its own animal farm and ensures safety standard. Required ingredients are usually lifted from markets, and the companies simply produce the finished products and release them for sale.
    Have we ever thought why kidney, liver and skin ailments are so common in human population these days? Is any government serious to identify the causes, at least I am not sure. Unfortunately nobody feels concerned. How long will the food industries play second fiddle with the human-life, nobody knows? Human life is being gambled with impunity, and it is nobody’s concern! No rationality is applied in the use of antibiotics.
    It is true, survival rate has gone up, but with it simultaneously number of diseases has also multiplied. What is the utility of that life, which is dependent on drugs every day for its survival? Medicines are consumed in mouthfuls like food. Human life has now become synonymous with drugs, because we cannot contemplate to survive without drugs for a single day. It is difficult to find any man after thirty-five free from any disease. The major beneficiary at the cost of human life is either a pharmaceutical company or the food industry. What is the solution then?
    It is high time for us to restrict the use of antibiotics in our daily life, but how? Now, time is ripe for us to search for safe alternative remedies, which could be safely applied both on men and animals. Some herbs are highly effective, for example ginseng. It can be safely used as a restorative tonic in a convalescent patient. It is so effective; I used it for curing a couple of cases of incorrigible hiccups. There are other safe remedies, such as Hydrastis canadensis, Berberis vulgaris, Echinacea, Arjuna Janosia, Hymosa, Passiflora incarnata, Baptisia, Conium etc., and the list extends perpetually. The efficacies of these safe remedies have to be thoroughly researched. For example, who can deny the utility of Hydrastis and Conium in treatment of cancer; I used these remedies liberally on cancer patients. Berberis vulgaris is effective in treatment of kidney stones, Arjuna in heart, Hymosa in arthritis, Passiflora incarnata in insomnia, depression and asthma and Baptisia on typhoid. There is nothing like Echinacea in treatment of any kind of blood poisoning including septicaemia, skin ailments, non-specific diarrhoea, typhoid and gangrene. Even it is said, it is effective in retarding the effect of snake poison and rabies, though I have not yet found such cases so far to try out this remedy. When antibiotics fail to respond or develop poison in the system, Echinacea can be safely used to treat such cases. I also used this remedy in many cases of prolonged fever of unknown origin. Even I have found it highly effective in the last stage of cancer pain; perhaps it may retard the disease itself, but it is all subject to research. It is not a lone battle related to me only, because I know my limitation, but it is a battle of mankind. But in all cases self-medication is to be strictly prohibited, because in homeopathy every patient is an individual, therefore, it is always advisable to consult a practitioner of alternative medicines.
    Even it is not a case related to any particular country; antibiotics are taking its toll everywhere, be it a developed or an under-developed country.. The UNO should come forward. I tried to put up my logic before the UNO for trying out safe alternative remedies for eradication of tuberculosis in the world, but unfortunately I did not receive any reply. Hopefully I shall receive a reply, but when?
    Dr.P.K.Chhetri

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