AIDS Treatment News Issue #349, August 18, 2000
John S. James
"Infectious diseases are the leading case of death worldwide, and the third leading cause of death in the United States, following heart disease and strokes. Because many bacteria have learned to evade some or all of the 100 or so antibiotics developed in the last 60 years to fight them, deaths from infectious diseases like tuberculosis are once again on the rise. So concerned are leaders of the World Health Organization, American College of Physicians, the American Medical Association, and the U.S. Centers for Disease Control and Prevention that they recently named antibiotic resistance as one of the top public health concerns of this decade.
"On the occasion of the 40th anniversary of ICAAC, Global Resistance Day will address the impact of antimicrobial resistance worldwide, featuring internationally renowned scientists from Canada, the United States, Europe, Israel, China, and Venezuela. A preliminary program is available at http://www.asmusa.org/mtgsrc/ic40global.htm
"This special international program is being sponsored by the American Society for Microbiology, The Alliance for the Prudent Use of Antibiotics, Canadian Infectious Disease Society, European Society for Clinical Microbiology and Infectious Diseases, the Federation of European Societies for Chemotherapy and Infection, the International Society for Infectious Disease, International Society of Chemotherapy, and the Society for Healthcare Epidemiology of America." [Quoted from press release of the American Society for Microbiology.]
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Comment
Experts are worried that physicians are misusing antibiotics for minor conditions such as colds (which are usually caused by viruses, against which antibiotics have no effect), and for certain other illnesses where antibiotics are often overused. The problems of antibiotic misuse are increased by direct-to-consumer advertising by pharmaceutical companies, which try to get patients to ask their physicians for specific drugs--usually the newer, more expensive ones, which may not be most medically appropriate. Inappropriate use of antibiotics contributes to the development of resistant bacteria or other pathogens.
Our understanding is that antibiotics tend to be used more in the U.S. than in most other industrialized countries.
The AIDS community needs to be on top of this issue and exercise leadership, for two reasons. First, AIDS patients use more antibiotics than most, so physicians and the community need to be especially attentive about correct use. And second, we need to be informed to avoid any possible discounting of the lives of persons with HIV when treatment or policy decisions are made. We must insist on serving the public interest without sacrificing individuals--including those who are sometimes sacrificed at any available opportunity.
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