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Challenges of drug resistance in the developing world would not be resolved if people there only received antibiotics prescribed by medical doctors. Indeed, just because antibiotics in the developed countries are only available on prescription makes no difference to their wide-spread use and consequent wide-spread development of resistant bacteria. The calls for more judicious prescribing of antibiotics in developed countries fell on deaf ears; they are still being widely routinely prescribed for great variety of conditions.
Even more worrying is that in developed countries it is a standard practice to prescribe antibiotics together with antipyretics, especially paracetamol.
Researchers in the sixties and seventies intensively studied the effect of temperature on the growth dynamics of a variety of microorganisms (such as Escherichia coli, Golden staphylococcus, Streptococcus, Salmonella and Neisseria etc) and the effectiveness or otherwise of antibiotics and other antimicrobial agents (sulphadiazine).
Mackowiak (1981), in his article “Direct effects of hyperthermia on pathogenic microorganisms: teleologic implications with regard to fever” (Rev Infect Diseases; 3 (3): 508-520), reviewed studies on the relationship between body temperature and the resistance to infections, and, the effect of physiologic variation in temperature on both the immune response of higher animals and on pathogenic microorganisms themselves.
Mackowiak wrote (op.cit.) “Bacteria vary widely with respect to both the temperature at which they grow optimally and the temperature range over which they can reproduce successfully”. He continued that they can be divided into three arbitrary groups: psychrophiles, mesophyles, and thermophyles. Almost all of the bacteria that are pathogenic for human are mesophyles. For obvious reasons, i.e. their superior ability to adapt, they grow and reproduce within our physiological temperature range between 33-41 centigrades. As an example, Escherichia coli’s growth increases rapidly as one approaches the optimal temperature for growth of the bacterium from the low end of the range of temperature for viability and then decreases precipitiously as the temperature raises above the optimum for its growth. When cultures of E. coli were subjected to a temperature of 45 centigrades for 5 hours, bacterial cells became swollen and distorted when suspended in distilled eater and were easily destroyed by lysosome (from egg white).
The above findings apply to Streptococcus, Neisseria and others. Moreover , early researchers established that such microorganisms became increasingly susceptible to antibacterial effects of normal serum, antibiotics and detergents when temperature increases above 37 centigrades.
Similarly, the rate of RNA degradation in mesophilic bacteria increases linearly with temperature.
Mackowiak (1981) also quoted other studies which demonstrated the effects of sublethal hyperthermia on the metabolic activity of pathogenic bacteria by a general decrease in catabolic activity and a reduced production of selected end products associated with metabolism of glucose.
The clinical relevance of these early findings is highly significant and obvious. Administration of antibiotics and suppressing fever at the same time, the standard orthodox treatment of infectious diseases, is counterproductive, to say the least.
Even worse consequence of such unscientific approach is that it encourages the growth and general viability of the pathogens and their ability to develop resistance to antibiotics and other pharmaceuticals. This, coupled with another associated problem of the growth of toxigenic E. coli at the cost of beneficial gut biota, is in my considered opinion at the core of the wide-spread hospital infections, originating within each patient and not associated with some extraordinary ability of bacteria (such as toxigenic E. coli and Golden staph) to travel wide distances and jump continents.
The issue remains, however, that in many African countries antibiotics (and other drugs) are available from pharmacies without a prescription and, occasionally, without medical advice. Having come across antibiotic street traders and patients who have stocks of strong antibiotics ready to be taken for any ailment, it is of no surprise that Africa has high levels of resistance. It is therefore imperative that governments make the dispensing process more formal ensuring that antibiotics and antimalarials are not provided upon request.
Re: Challenges of drug resistance in the developing world
Dear editor,
Challenges of drug resistance in the developing world would not be resolved if people there only received antibiotics prescribed by medical doctors. Indeed, just because antibiotics in the developed countries are only available on prescription makes no difference to their wide-spread use and consequent wide-spread development of resistant bacteria. The calls for more judicious prescribing of antibiotics in developed countries fell on deaf ears; they are still being widely routinely prescribed for great variety of conditions.
Even more worrying is that in developed countries it is a standard practice to prescribe antibiotics together with antipyretics, especially paracetamol.
Researchers in the sixties and seventies intensively studied the effect of temperature on the growth dynamics of a variety of microorganisms (such as Escherichia coli, Golden staphylococcus, Streptococcus, Salmonella and Neisseria etc) and the effectiveness or otherwise of antibiotics and other antimicrobial agents (sulphadiazine).
Mackowiak (1981), in his article “Direct effects of hyperthermia on pathogenic microorganisms: teleologic implications with regard to fever” (Rev Infect Diseases; 3 (3): 508-520), reviewed studies on the relationship between body temperature and the resistance to infections, and, the effect of physiologic variation in temperature on both the immune response of higher animals and on pathogenic microorganisms themselves.
Mackowiak wrote (op.cit.) “Bacteria vary widely with respect to both the temperature at which they grow optimally and the temperature range over which they can reproduce successfully”. He continued that they can be divided into three arbitrary groups: psychrophiles, mesophyles, and thermophyles. Almost all of the bacteria that are pathogenic for human are mesophyles. For obvious reasons, i.e. their superior ability to adapt, they grow and reproduce within our physiological temperature range between 33-41 centigrades. As an example, Escherichia coli’s growth increases rapidly as one approaches the optimal temperature for growth of the bacterium from the low end of the range of temperature for viability and then decreases precipitiously as the temperature raises above the optimum for its growth. When cultures of E. coli were subjected to a temperature of 45 centigrades for 5 hours, bacterial cells became swollen and distorted when suspended in distilled eater and were easily destroyed by lysosome (from egg white).
The above findings apply to Streptococcus, Neisseria and others. Moreover , early researchers established that such microorganisms became increasingly susceptible to antibacterial effects of normal serum, antibiotics and detergents when temperature increases above 37 centigrades.
Similarly, the rate of RNA degradation in mesophilic bacteria increases linearly with temperature.
Mackowiak (1981) also quoted other studies which demonstrated the effects of sublethal hyperthermia on the metabolic activity of pathogenic bacteria by a general decrease in catabolic activity and a reduced production of selected end products associated with metabolism of glucose.
The clinical relevance of these early findings is highly significant and obvious. Administration of antibiotics and suppressing fever at the same time, the standard orthodox treatment of infectious diseases, is counterproductive, to say the least.
Even worse consequence of such unscientific approach is that it encourages the growth and general viability of the pathogens and their ability to develop resistance to antibiotics and other pharmaceuticals. This, coupled with another associated problem of the growth of toxigenic E. coli at the cost of beneficial gut biota, is in my considered opinion at the core of the wide-spread hospital infections, originating within each patient and not associated with some extraordinary ability of bacteria (such as toxigenic E. coli and Golden staph) to travel wide distances and jump continents.
Competing interests: No competing interests