Sunday, February 28, 2010

Beating infections by using . . . LESS drugs???

It seems that Norway has developed a new and interesting technique to cut down on hospital infections - minimize the use of antibiotics, so that bacteria can't develop a resistance to them. The Miami Herald reports:

Aker University Hospital is a dingy place to heal. The floors are streaked and scratched. A light layer of dust coats the blood pressure monitors. A faint stench of urine and bleach wafts from a pile of soiled bedsheets dropped in a corner.

Look closer, however, at a microscopic level, and this place is pristine. There is no sign of a dangerous and contagious staph infection that killed tens of thousands of patients in the most sophisticated hospitals of Europe, North America and Asia last year, soaring virtually unchecked.

The reason: Norwegians stopped taking so many drugs.

Twenty-five years ago, Norwegians were also losing their lives to this bacteria. But Norway's public health system fought back with an aggressive program that made it the most infection-free country in the world. A key part of that program was cutting back severely on the use of antibiotics.

Now a spate of new studies from around the world prove that Norway's model can be replicated with extraordinary success, and public health experts are saying these deaths -- 19,000 in the U.S. each year alone, more than from AIDS -- are unnecessary.

``It's a very sad situation that in some places so many are dying from this, because we have shown here in Norway that Methicillin-resistant Staphylococcus aureus [MRSA] can be controlled, and with not too much effort,'' said Jan Hendrik-Binder, Oslo's MRSA medical advisor. ``But you have to take it seriously, you have to give it attention and you must not give up.''

The World Health Organization says antibiotic resistance is one of the leading public health threats on the planet. A six-month investigation by The Associated Press found overuse and misuse of medicines has led to mutations in once curable diseases like tuberculosis and malaria, making them harder and in some cases impossible to treat.

Now, in Norway's simple solution, there's a glimmer of hope.

Dr. John Birger Haug shuffles down Aker's scuffed corridors, patting the pocket of his baggy white scrubs. ``My bible,'' the infectious disease specialist says, pulling out a little red Antibiotic Guide that details this country's impressive MRSA solution.

It's what's missing from this book -- an array of antibiotics -- that makes it so remarkable.

``There are times I must show these golden rules to our doctors and tell them they cannot prescribe something, but our patients do not suffer more and our nation, as a result, is mostly infection free,'' he says.

. . .

Around the world, various medical providers have successfully adapted Norway's program with encouraging results. A medical center in Billings, Mont., cut MRSA infections by 89 percent by increasing screening, isolating patients and making all staff -- not just doctors -- responsible for increasing hygiene.

In 2001, the CDC approached a Veterans Affairs hospital in Pittsburgh about conducting a small test program. It started in one unit, and within four years, the entire hospital was screening everyone who came through the door for MRSA. The result: an 80 percent decrease in MRSA infections.

The program has now been expanded to all 153 VA hospitals, resulting in a 50 percent drop in MRSA bloodstream infections, said Dr. Robert Muder, chief of infectious diseases at the VA Pittsburgh Healthcare System.

There's more at the link.

Hmm . . . no - or virtually no - deaths from MRSA infections in Norway, as opposed to 19,000 in the USA every year? I wonder how much Norway's saving by not having to provide all those antibiotics, too?

I've had a post-surgery MRSA infection, and it was no fun at all. It took three weeks to clear it up with some very strong antibiotics (which made me feel even more grim than the pain from the surgery), and I had recurrent skin infections for a couple of years afterwards.

If something as simple as the Norwegian approach can be so effective, I have to ask: why is it not being more widely implemented here? Is it that our medical system is simply too oriented towards 'give them a pill' or 'give them an injection' as a solution to every problem?



Andrew C said...

You can't sue the hospital for prescribing antibiotics to other people. You can sue the hospital for not providing antibiotics to you if you end up having a bad outcome. So, antibiotics for everyone!

reflectoscope said...

I think Andrew C got it.

As an aside, whoever prepared that article is using a software setup similar to Win7: Notice how the quote marks are messed up. It appears that either Windows likes to forget which keyboard map it should be using.


Jon said...

I'm not buying it. My evil heart tells me that this is cover for the lack of money and the failure of Socialized medicine. It, also, tells me that there is a tremendous amount of waste involved with regulations and tort taxes.

Bacteria can evolve to become resistant to antibiotics, but the same can be true for natural defenses. There's a balance to be found, but arbitrarily removing antibiotics, and allowing filth isn't a solution. Ultimately, someone becomes the guinea pig and the conditions that result from failures are terrible to behold, or endure.

Betty said...

I have not gotten the flu since middle school, and I do attribute it to a strong immune system. I let my body fight illnesses instead of jumping all over medications at the first sign of sickness. (That doesn't mean I would let myself go unmedicated if I ever got severely ill.) I do believe people weaken themselves by being overly-reliant on medications.

Anonymous said...

Why so much drug use in the US of A?
Follow the money.

You either have Big Pharma pimping their products to the hospitals and doctors
You have the slap-happy shysters.

Pick your poison.
B Woodman

Barry Obama said...

A lot of lawyers have to die before anything like this could be tried in the US.