Costanzo SD, Murby J, Bates J. Ecosystem response to antibiotics entering the aquatic environment. Marine Pollution Bulletin 51(1-4):218-223 (2005). Antibiotics in effluent from treatment plants could be detected up to a half kilometer from the point of entry. Bacteria in the water near the effluent discharge points tended to be antibiotic resistant.
PubMed Reference PMID:15757723
Dagan R, Barkai G, Leibovitz E, Dreifuss E, Greenberg D. Will reduction of antibiotic use reduce antibiotic resistance? The pneumococcus paradigm. Pediatric Infectious Disease Journal 25(10):981-986 (2006). Antibiotic abuse is the leading cause of antibiotic-resistant strains of pathogenic bacteria. However, not all antibiotics produce resistant strains equally. In the case of Streptococcus pneumococcus, the cause of pneumonia in young children, amoxicillin is the least resistance-promoting, while cephalosporins and azithromycin have a higher resistance-promoting potential. However, all antibiotics promote resistance to some degree.
PubMed Reference PMID:17006311
Lewis R. The Rise of Antibiotic-Resistant Infections. US Food and Drug Administration
Loganathan B, Phillips M, Mowery H, Jones-Lepp TL. Contamination profiles and mass loadings of macrolide antibiotics and illicit drugs from a small urban wastewater treatment plant. Chemosphere 75(1):70-77 (2009). A study of wastewater treatment effluents showed that a number of antibiotics and illegal drugs (methamphetamine and ecstasy) remain in the water after processing and thus enter the environment. The efficiency of removal varied between different antibiotics varied from virtually all with urobilin to only 47% with azithromycin. Only 54.5% of methamphetamine was removed.
PubMed Reference PMID:19121838
Nusslein K, Arnt L, Rennie J, Owens C, Tew GN. Broad-spectrum antibacterial activity by a novel abiogenic peptide mimic. Microbiology 152 (Pt. 7):1913-1918 (2006). As resistant strains of pathogens increase and antibiotic efficacy wanes, researchers have been searching for replacement therapies. One promising solution is a class of peptides known as antimicrobial peptides (AMP) which are found in both vertebrates and invertebrates as a part of the innate defense system. Modern technology has made it possible to design similar peptides with high specificity and therefore much less probability of creating resistance.
PubMed Reference PMID:16804167
Pallasch TJ. Antibiotic prophylaxis: problems in paradise. Dental Clinics of North America 47(7):665-679 (2003). The age of antibiotic prophylaxis may be receding into its twilight years because the assumption upon which it was based has not proved generally true. Although antibiotics treat infections, limited benefit has been demonstrated in preventing infections. These are two entirely different biologic entities, a distinction which appears to have gone unappreciated by many for more than 50 years. If the principles of antibiotic prophylaxis established more than 40 years ago had been assiduously followed, many of its abuses could have been avoided. This may not have stopped our legal colleagues, but it would have been worth an effort on behalf of our patients. It is likely that the massive overuse of antibiotics as litigation prevention has contributed to the global epidemic of antibiotic-resistant micro-organisms and an unknown number of serious adverse effects to the antibiotics themselves. Even with this abuse, much money has still flowed from defendant to plaintiff. Substantial data exist that antibiotics do not prevent bacteremias. The absolute risk rate for bacterial endocarditis after dental treatment even in at-risk patients is very low. Antibiotic prophylaxis for surgical infections requires specific dosing schedules (perioperative surgical prophylaxis) to be successful.
PubMed Reference PMID:14664458
Pallasch TJ. Antibiotic resistance. Dental Clinics of North America 47(4):623-639 (2003). Through billions of years of evolution, microbes have developed myriad defense mechanisms designed to ensure their survival. This protection is readily transferred to their fellow life forms via transposable elements. Despite very early warnings, humans have chosen to abuse the gift of antibiotics and have created a situation where all microorganisms are resistant to some antibiotics and some microorganisms are resistant to all antibiotics. When antibiotics are used, six events may occur with only one being beneficial: when the antibiotic aids the host defenses to gain control and eliminate the infection. Alternatively, the antibiotic may cause toxicity or allergy, initiate a superinfection with resistant bacteria, promote microbial chromosomal mutations to resistance, encourage resistance gene transfer to susceptible species, or promote the expression of dormant resistance genes.
PubMed Reference PMID:14664456
Salleh A. Antibiotics Flushed into Waterways. ABC News (Australia) March 17, 2005.
Sancho-Puchades M, Herraez-Vilas JM, Berini-Aytes L, Gay-Escoda C. Antibiotic prophylaxis to prevent local infection in Oral Surgery: use or abuse? Medicina Oral, Patología Oral y Cirugía Bucal 14(1)E28-E33 (2009). The use of antibiotics to prevent local infections in fit patients questionable. Many clinical trials have questioned the effectiveness of antibiotics in preventing wound infection. More effective are anti-infectious measures that minimize infection risk during the healing period of the wound.
PubMed Reference PMID:19114952
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