Sep 6, 2011

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

Parenting is never dull. One part of parenting that has stressed me out the most is rules I never thought Id have to make. Examples include Eric dont gargle with your Sprite! Apparently he liked the feel of the bubbles, so gargling with pop seemed reasonable to him. Eric dont spray that garden hose into that electrical outlet! Thankfully Eric wasnt hurt, but Im not sure if Doris has got over the shock of that one. Most recently it was Eric dont staple papers onto your dresser! Doris had refinished that dresser and wasnt happy about all the new little holes in it. I laughed at Doris a little after Eric had gone to bed. I told her he was just stressing the furniture as well as us. Doriss mom, Helga, works in a furniture plant. They have special hammers, chains and spikes they beat perfectly good wood furniture with to stress it. Stressing makes the furniture look older and more valuable.


Antibiotic resistance can be stressing as well. How do antibiotic resistant bacteria form in the first place? We create them by giving patients antibiotics. Where is the most likely place to get an antibiotic resistant infection? In the hospital. Lets look at these apparent contradictions and make some sense of them.


In August 2011 in the Archives of Pediatrics and Adolescent Medicine, Schneider-Lindner et. al., who are researchers from Canada, looked at a group of children in England. They found children who had the super bug MRSA were more likely to have had an antibiotic in the past 6 months. MRSA means Methicillin Resistant Staphylococcus Aureus. MRSA was apparently first seen in USA in 1960, but its first big outbreak in the US was in the 1980s. Usually we think of MRSA as an infection someone picks up in hospital. But the children in this study werent hospitalized, they lived in the community. The published paper was an observational study so it cant say that taking an antibiotic causes MRSA. But it is interesting that the children in Britian who took antibiotics were more likely to have MRSA.


First a little back ground on antibiotics. Sir Alexander Fleming discovered penicillin in 1928. He was doing research on bacteria and was already known as a good researcher, but a messy lab technician. Coming back to his lab after a few days off, he found some cultures of his bacteria that hed forgotten had been spoiled by mold. Instead of just throwing out all the culture plates, he noticed a zone around some of the mold was completely free of bacteria. The mold (later named Penicillium notatum) produced a substance (now called penicillin) that killed the bacteria. Penicillin was eventually isolated and made in large quantities. When it was given to people, certain infections were cured!


Penicillin was a miraculous discovery. Bacterial infections can kill people. Before antibiotics, strept throat, sexually transmitted diseases and child birth often killed people. As miraculous as antibiotics are, they arent perfect. Several decades after penicillin was discovered, doctors started noticing antibiotic resistance. Antibiotic resistance is when bacteria arent killed by a certain antibiotic anymore.


How do bacteria become resistant to an antibiotic? There are different ways but it often happens when the bacteria are exposed to a small dose of the antibiotic. This dose is either too small to kill them or given for too short a time to kill them. For example, lets say you go to the doctor and insist that she give you an antibiotic for your cough. Then, you only take 2 or 3 days worth of the antibiotics and save the rest for next time. This will kill off the most of the bacteria, but it will leave some alive. The ones that are left will have a natural immunity to the antibiotic. Those bacteria will reproduce and all their offspring will have a resistance to that antibiotic. Now that original antibiotic wont work anymore. You now have an antibiotic resistant infection!


In late August an article in the Winnipeg Free Press said, Hospitals Battle Superbug. The article went on to say that the Grace Hospital has had a VRE outbreak since March 9, 2011, St. Boniface Hospital has had a VRE Outbreak since Jan 24, 2011 and the Health Sciences Center (HSC) has had a VRE outbreak since February 2010. February 2010! The HSC has had a super bug for over 18 months!!!


VRE stands for Vancomycin Resistant Enterococcus. This bacteria can live in your gut. Why are resistant bacteria more common in hospitals? Well there are sicker people there who are more likely to have infections of all kinds. These bacteria can passed from patient to patient by people who dont wash their hands well enough. Often these poor hand washers are the health care professionals like me who work in the hospital.


So finish your antibiotics! Do not stop taking an antibiotic part way through the course of treatment without first discussing it with your doctor. Even if you feel better, use the entire prescription as directed to make sure that all of the bacteria are destroyed. Dead bacteria dont cause resistance. Dont forget to wash your hands. Hand washing is one of the best ways of preventing yourself and others from getting sick. And I promise I wont get too stressed if you ask me if I washed my hands when you see me at the pharmacy.


The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.


We now have most of the articles published in the Parkland Shopper on our Website


As always if you have any questions or concerns about these or other products, ask your pharmacist.


Winnipeg Free Press Article :


MRSA in Children in Britian:


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