RE: The Informed Patient: The Battle Against Superbugs Needs SomeRecruits: Patients

["Ted Rockwell" <tedrock@CPCUG.ORG>]

Until the discovery of sulpha, penicillin and the "wonder drugs," low-dose,

full-body (or partial-body) x-rays were used to treat low-grade infections.

Particularly in the kind of cases now leading to amputation, it was about

90% successful, with few amputations, in contrast to current treatment that

now often leads to amputation ("to be sure we got it all"), and death in a

high percentage of the cases.  They knew, nearly a century ago, that the

x-rays were not powerful enough to kill the infection, and assumed

(correctly) that they were stimulating the immune system.



I recently talked with two friends who had legs amputated, because in the

current radiophobic climate, few doctors would resort to this well-proven

technique.  It is NOT conservative to always assume that tiny amounts of

radiation are harmful.  "When all else fails, consult the data."



Ted Rockwell



-----Original Message-----

From: jws@SMTP00.InfoAve.Net [mailto:jws@SMTP00.InfoAve.Net]On Behalf Of

John Simpson

Sent: Sunday, September 29, 2002 2:54 PM

To: LIST: ;

Subject: The Informed Patient: The Battle Against Superbugs Needs

SomeRecruits: Patients





The Informed Patient: The Battle Against Superbugs Needs Some Recruits:

Patients

Wall Street Journal; New York, N.Y.; Sep 26, 2002; By Laura Landro;



Edition: Eastern edition

Start Page: D6

ISSN: 00999660

Abstract:

At the heart of the problem is the overuse of antibiotics, which has

accelerated the spread of antibiotic resistance; the more antibiotics we

take unnecessarily, the more bacteria keep evolving to outwit the drugs.

Richard Besser, medical director for the CDC's National Campaign for

Appropriate Antibiotic Use, says doctors have started to cut the number of

unnecessary prescriptions they write, especially for kids. But tens of

millions are still written each year for viral infections such as colds or

flu against which they aren't effective. The CDC is trying to wean both

doctors and patients away from the habit, and starting in November will

provide states with free TV, radio and print ads aimed at cutting demand

for unnecessary prescriptions.



Catheters are among the most dangerous sources of infection, and the CDC

urges doctors to remove the tubes from patients as soon as possible. But

insura! nce companies sometimes won't pay for another hospital day once a

catheter comes out. As a result, doctors sometimes leave catheters in

longer than necessary just to keep a patient in the hospital for more

observation. The problem of overextended use of catheters is "tougher to

solve," Dr. [Steven Solomon] admits. The CDC is looking for a state to act

as a test bed for reforms that would encourage earlier catheter removal.



Full Text:

Copyright Dow Jones & Company Inc Sep 26, 2002

AS IF THE STATISTICS on medical mistakes weren't enough to scare you away

from the hospital, recent reports about the dangers of dying from a

bacterial infection once you're admitted may do the job. But there are

steps you can take to protect yourself from increasingly virulent hospital

bugs.

Over t! he past decade, scientists have been fighting a losing battle

against such bacteria as the deadly Staphylococcus aureus, which are ever

more resistant to even powerful antibiotics like vancomycin. According to

the Centers for Disease Control and Prevention, more than 70% of the

bacteria that cause hospital-acquired infections are resistant to at least

one of the drugs commonly used to treat them. Two million people a year get

an infection in a hospital; 90,000 of those die and the rest face longer

hospital stays and treatment with drugs that are less effective and more

toxic.

At the heart of the problem is the overuse of antibiotics, which has

accelerated the spread of antibiotic resistance; the more antibiotics we

take unnecessarily, the more bacteria keep evolving to outwit the drugs.

Richard Besser, medical director for the CDC's National Campaign for

Appropriate Antibiotic Use, says doctors have started to cut the number of

unnecessary prescriptions they write, e! specially for kids. But tens of

millions are still written each year for viral infections such as colds or

flu against which they aren't effective. The CDC is trying to wean both

doctors and patients away from the habit, and starting in November will

provide states with free TV, radio and print ads aimed at cutting demand

for unnecessary prescriptions.

Another culprit is poor hand-washing in the hospital: doctors, nurses and

other staffers spread bacteria onto bed railings, stethoscopes, and tubing,

where it finds its way into catheters, wounds or incisions. Keep your eye

on sanitation in the hospital, and don't be afraid to ask anyone who comes

near if they have washed their hands. The National Patient Safety

Foundation (www.npsf.org) recently issued guidelines for patients on

preventing infections in the hospital, such as keeping the skin around a

catheter dressing clean and dry, and washing your own hands, especially

after you've gone to the bathroom. (New studies! suggest that cleaning

hands with an alcohol-based solution is more effective than antiseptic

soap.)

Statistics show there was actually a decline during the 1990s in infection

rates in intensive-care units that followed strict hygiene rules. But

hygiene alone isn't enough to solve the problem. Even if every hospital

were as clean as a whistle, there is evidence that bacteria may be winning

the war. Some new drugs are coming to market, but none has yet been proven

effective over time. What's more, studies show that once drug-resistant

infections take hold in a hospital, they can spread to the community at

large. For a compelling -- if terrifying -- account of the rise of

antibiotic resistance, read a new book by Michael Schnayerson and Mark

Plotkin, "The Killers Within: The Deadly Rise of Drug-Resistant Bacteria"

(Little, Brown).

"The threat of a superbug that can't be treated has been hanging over

everyone's head for a long time, and we are headed in that dir! ection, "

acknowledges Steven Solomon, who runs the CDC's health-care

quality-promotion group. But he maintains "panic in the streets is not

necessary. The vast majority of hospitals do extremely well in preventing

infections, and we know a lot more about how to prevent them than we did in

the past." Dr. Solomon urges consumers to take an active role if they are

hospitalized.

Before signing off on your surgical procedure, ask about the hospital's

infection-control program. Hospitals should adhere to the CDC's own

guidelines (www.cdc.gov/drugresistance), which include a 12-step prevention

and treatment program for hospitalized adults. The agency soon will issue

more specific guidelines to protect vulnerable populations, such as

kidney-dialysis, geriatric, surgical, pediatric and obstetrics patients.

Catheters are among the most dangerous sources of infection, and the CDC

urges doctors to remove the tubes from patients as soon as possible. But

insurance compani! es sometimes won't pay for another hospital day once a

catheter comes out. As a result, doctors sometimes leave catheters in

longer than necessary just to keep a patient in the hospital for more

observation. The problem of overextended use of catheters is "tougher to

solve," Dr. Solomon admits. The CDC is looking for a state to act as a test

bed for reforms that would encourage earlier catheter removal.

To help reduce the need for antibiotics, ask your doctor about being

vaccinated against diseases that cause respiratory infections, such as the

flu. If you do need an antibiotic, make sure you use the entire

prescription. But just as important -- next time you have a runny nose or a

head cold, don't demand an antibiotic you don't need. And as recent studies

have shown, stop overusing antibacterial products in your own home. "The

idea that people can sterilize their environment is wrong and just

contributes to the problem," says Dr. Besser.

---











************************************************************************

You are currently subscribed to the Radsafe mailing list. To unsubscribe,

send an e-mail to Majordomo@list.vanderbilt.edu  Put the text "unsubscribe

radsafe" (no quote marks) in the body of the e-mail, with no subject line.

You can view the Radsafe archives at http://www.vanderbilt.edu/radsafe/