Health Sciences Institute e-Alert
 
March 30, 2004
 
 
Dear Reader,
 
Every day, school is in session inside our bodies. And the
students and teachers are one and the same: bacteria.
 
Bacteria are highly adaptive because they actually "teach"
one another to resist antibiotics. When one bacterium
develops resistance to an antibiotic, it can share that
resistance with similar and even unrelated strains. They do
this by passing DNA-containing organisms called plasmids,
from one to another. The result: Due to the excessive use of
antibiotics, virtually all of the bacterial infections known
to scientists are becoming resistant to even the most
powerful antibiotics.
 
Fortunately, awareness of this overuse has led to a general
rethinking about how best to utilize antibiotics. Now a new
test has been developed that may provide doctors with the
information they need to avoid prescribing antibiotics
unnecessarily.
 
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Sorting the Bs from the Vs
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Antibiotics can only control bacteria - not viruses. But
because many viral and bacterial infections have similar
symptoms, doctors often prescribe antibiotics to treat
viruses on the chance that they might be bacteria. So it's
no mystery why many unneeded prescriptions are filled for
respiratory infections and colds that are viral infections.
 
Currently there are tests that can determine the exact
nature of an infection, but they tend to either take too
long to show results or are too expensive to be practical.
But a new test may change all that. This test quickly
measures levels of procalcitonin, a blood protein that rises
sharply in the presence of a bacterial infection.
Procalcitonin levels rise only slightly in response to viral
infections.
 
As reported in The Lancet medical journal last month,
researchers at the University Hospital in Basel,
Switzerland, devised a trial to examine the procalcitonin
test. More than 240 subjects who were admitted to the
hospital with lower respiratory tract infections were
assigned either standard care, or care based on the results
of a procalcitonin test.
 
In the procalcitonin group, 43 percent showed levels high
enough to prescribe antibiotics. In the standard care group,
patients were diagnosed using x-rays and other tests to
determine infection type. In this group, 83 percent received
antibiotics.
 
Favorable outcomes for patients in both groups were about
equal, and none of the patients in the procalcitonin group
experienced any adverse effects due to a lack of
antibiotics. Follow-up tests to verify infection types
confirmed that approximately 20 percent of the patients in
both groups had bacterial infections.
 
One of the authors of the study observed that while
antibiotics were over-prescribed in the procalcitonin
group, "The test halves antibiotic use, without altering the
clinical outcome."
 
Future: "quick and easy dipstick test"
 
What the immediate future holds in store for the
procalcitonin test remains to be seen. More research and
development is required in order to transform it into what
one antibiotic resistance expert calls a  "quick and easy
dipstick test" that could reveal bacterial infection right
away.
 
So it may be awhile yet before your doctor has a
procalcitonin test ready to use in his office. In the
meantime, doctors and patients alike need to be more careful
about resorting to antibiotics to treat every sniffle,
earache and cough. And the growing crisis of antibiotic
resistance is only part of the reason to be wary.
 
Just last month, in the e-Alert "Protection Jumps The Rails"
(2/19/04), I told you about a large University of Washington
study that revealed how excessive antibiotic use may be
associated with an elevated risk of breast cancer. In that
study, the women who had the highest rates of cumulative
days of antibiotic use over 17 years had a sharply increased
risk of death due to breast cancer.
 
And in a recent "Baseline of Health" newsletter, HSI
Panelist Jon Barron shared details about a 2003 study of the
effects of antibiotic use in young children. The Henry Ford
Hospital (Detroit) researchers followed 448 children from
birth to seven years. Nearly half of the children received
antibiotic treatments (mostly penicillin) within the first
six months of life, and among these children the risk of developing asthma was two and a half times greater than the risk to children who received no antibiotics within the first six months. Risk of developing allergies was also significantly increased in the antibiotic group.
 

Without question, antibiotics are important, life-saving
tools. But the overuse of these drugs has to be curtailed or the antibiotic resistance crisis will turn into a disaster. So the next time your doctor suggests writing an antibiotic prescription, ask specific questions about why it's necessary and what other options might be workable.
 
For instance, in many cases a natural antibiotic could be just as effective as a pharmaceutical variety. In the e- Alert I mentioned above I reviewed four natural antibiotics recommended by HSI Panelist Allan Spreen, M.D.: vitamin C, grapefruit seed extract, olive leaf extract and colloidal silver. (You can find that e-Alert on our web site at www.hsibaltimore.com with a search of the e-Alert archives.)
 
And I've made a special note to follow the progress of the procalcitonin test, which could emerge as the most important means of cutting back antibiotic use. As that develops I'll keep you posted.
 
 
Sources:
"Effect of Procalcitonin-Guided Treatment on Antibiotic Use and Outcome in Lower Respiratory Tract Infections: Cluster- Randomised, Single-Blinded Intervention Trial" The Lancet, Vol. 363, 2004, thelancet.com

"Test May Lower Antibiotic Use" Helen R. Pilcher, Nature Science Update, 2/20/04, nature.com

"New Test May Determine Antibiotic Need" Associated Press, 2/18/04, msnbc.com

"Antibiotic Use in Relation to the Risk of Breast Cancer" Journal of the American Medical Association, Vol. 291, 2004, ama-assn.org

"Asthma and Antibiotics" Jon Barron, Baseline of Health, 10/13/04, jonbarron.org

"Questions and Answers About the Prostate-Specific Antigen (PSA) Test" National Cancer Institute, cis.nci.nih.gov
 
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