Common Antibiotic May Be the Answer to Many Multidrug-Resistant Bacterial Infections
Long ignored as a treatment option for certain serious bacterial infections, azithromycin proves strikingly effective in new lab and animal tests

Contrary to current medical dogma, researchers at University of California, San Diego School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences report that the common antibiotic azithromycin kills many multidrug-resistant bacteria very effectively — when tested under conditions that closely resemble the human body and its natural antimicrobial factors. The researchers believe the finding, published June 10 by EBioMedicine, could prompt an immediate review of the current standard of care for patients with certain so-called “superbug” infections.

Azithromycin is the most often prescribed antibiotic in the United States, where short courses can cure common bacterial infections such as strep throat and sinusitis. But azithromycin, also sold commercially as Zithromax Z-Pak, is never given to patients with some of the most nefarious multidrug-resistant bacterial infections. That’s because years of testing in standard laboratory media — the nutrient broth that helps bacteria grow — concluded that azithromycin doesn’t kill these types of bacteria.

“Unquestioning adherence to a single standardized lab practice may be keeping doctors from considering potentially life-saving antibiotics — therapies that are proven safe and readily available in any hospital or pharmacy,” said senior author Victor Nizet, MD, professor of pediatrics and pharmacy. “While bacterial agars and testing media are useful in providing consistency for hospital laboratories around the world, the actual infection is taking place in the blood and tissues of the patient, and we know the action and potency of drugs can change quite dramatically in different surroundings.”

The bacteria at the center of this study are Gram-negative rods, so-called due to their cell wall structure (they appear “negative” in a classic typing test known as the Gram stain) and their shape. Nizet’s team studied extremely antibiotic-resistant strains of three medically important Gram-negative rods: Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. These opportunistic pathogens rarely infect healthy people but instead strike debilitated patients in hospitals, such as those with weakened immune systems, or following trauma or surgery, sometimes with deadly consequences. The Centers for Disease Control and World Health Organization have warned that resistance is rapidly spreading in these species, and no new antibiotic candidates are on the horizon.

In this study, Nizet’s team found that simply growing these Gram-negative rod bacteria in mammalian tissue culture media — the same stuff used to sustain human cells in the lab — instead of standard bacteriologic media made a huge difference in their sensitivity to azithromycin. Even more striking, the drug-resistant superbugs were completely wiped out when azithromycin was paired with the antibiotic colistin or with antimicrobial peptides produced naturally by the human body during infection.

To test these promising laboratory results in a live infection system, Nizet and team moved the experiment into a mouse model of multidrug-resistant A. baumannii pneumonia. They treated the mice with a single injected dose of azithromycin at a concentration that mimics the amount typically given by IV to human patients. Twenty-four hours after infection, azithromycin-treated mice had 99 percent fewer bacteria in their lungs than untreated mice. Similarly, in mouse models of multidrug-resistant P. aeruginosa and K. pneumoniae infections, a single dose of azithromycin reduced bacterial counts by more than 10-fold.

According to the authors, the study suggests that the general effectiveness of antibiotics in the decades since the discovery of penicillin has led to complacency in our approach to antibiotic evaluation. In the current era of ever-increasing antibiotic resistance, they recommend a more holistic approach that considers both the bug and the patient’s immune system.

“If something this simple could be overlooked for so many years, what else might we be missing?” Nizet said.

Pictured: Multi-drug resistant Gram-negative rod bacteria Acinetobacter baumannii being killed by the common antibiotic azithromycin (green) in the presence of a human antimicrobial peptide naturally present at infection sites.

“Scientists have a responsibility to monitor and reduce our use of antibiotics. With the growth and fast advancement of synthetic biology, it is timely for us to consider other options and to teach the next generation of researchers by example how to truly value antibiotics by using them more responsibly.”

Laura Bowater argues that scientists should act as researchers, educators, and stewards of antibiotics and antibiotic resistance. 

Image credit: Biology. CC0 via Pixabay.

How Existing Drugs Could Fight Resistant Bugs

“Medical experts have been powerless to stop the rise of antibiotic-resistant bacteria and are increasingly desperate to develop novel drugs. But a new study finds that smarter use of current antibiotics could offer a solution. Researchers were able to keep resistant bacteria from thriving by alternating antibiotics to specifically exploit the vulnerabilities that come along with resistance—a strategy that could extend the lifespan of existing drugs to continue fighting even the most persistent pathogens.”

Stupid computer and your non-ability to not freeze every 5 mins. Sheesh, me thinks its time for a replacement..wah more money that should severely not be spent D:
Not to mention I am getting sick. Thankyou antibiotics for obliterating my immune system - it seems the only logical thing to do is go out tomorrow night and drown the rest in alcoholic beverages. Woot woot :)

God Bless Antibiotics and 90s Rap

Yes I know they are overprescribed. But not in this case. The little guy was terribly sick and now he’s almost his old self. There’s still a wet cough that makes me very uneasy, but I think he’s on the mend.

My relief is spilling over at work. Yesterday felt much more comfortable and happy in front of the students. One mentioned “Me & My Bitch” (B.I.G.? Tupac?) and my response was, “Actually it’s ‘My Bitch and I.’"

One test showed that a sugared up antibiotic could eliminate 99.9 percent of persisters in two hours, while a regular antibiotic did nothing. Doctors believe that this discovery will help treat urinary tract infections, staph infections, and strep throat

Oh. my. dead. God. Strep throat? I’m firing my doctor. I am firing my fucking doctor. You can tell I’m serious because I swore and stuff.

Note that that while human antibiotic use has leveled off at below 8 billion pounds annually, livestock farms have been sucking in more and more of the drugs each year—and consumption reached a record nearly 29.9 billion pounds in 2011. To put it another way, the livestock industry is now consuming nearly four-fifths of the antibiotics used in the US, and its appetite for them is growing.

@dextervancity showing us his #chopculture, and enjoying his new favourite #PawshChop flavor - Cheese Burgeroo! He’s a #Yaletown #bachelor – a #chihauha #dachshund mix - and a true #chiweenie! This treat has #kangaroo with #dairyfree #probiotics! Which is a tasty and healthy treat after being on #antiobiotics or to reward your pet with something special! Biologically appropriate, #raw compatible, and a good source of #biotin, #calcium and #digestiveenzymes. Doesn’t your pet deserve the very best? #dogsofinstigram #dogsofvancouver #dogsofyaletown #petstore #dogtreats
Dispute over a Lyme disease treatment draws in some state legislatures.

Advocates of long-term antibiotics to treat Lyme disease claim doctors are hesitant to prescribe for fear of professional sanctions. Now, lawmakers in some states are taking up the cause.

The dispute over lyme disease continues, but it looks like state legislatures are trying to make a difference!

McDonald’s Moving to Limit Antibiotic Use in Chickens

The use of a class of antibiotics important in human medicine by farmers raising animals for food increased 16 percent from 2009 to 2012. If you were a fast food executive, would you sell chicken raised with antibiotics used to treat human?

McDonald’s said on Wednesday that it would begin using chickens that are not raised with antibiotics used to treat humans, a move likely to put pressure on competitors of the fast-food chain, which now sells more chicken than beef.

The decision by McDonald’s, which is also one of the largest buyers of chicken in the United States, is likely to have a major impact on how poultry is raised and on the kinds of chicken restaurants serve.

The shift toward offering chicken that is largely antibiotic-free is to occur over two years, the company said. McDonald’s also announced that this year it would give customers the choice of low-fat and chocolate milk from cows not treated with the artificial growth hormone rBST.

McDonald’s announcement coincided with Steve Easterbrook’s first week as its chief executive. But the struggling company declined to provide access to Mr. Easterbrook, who succeeded Don Thompson as chief, or to other executives to speak about the new policy, citing the “quiet period” required by federal regulation before the release of its financial performance report next week.

The Centers for Disease Control and Prevention has been increasingly vocal about its concerns about the use of antibiotics in animal husbandry as more bacteria and pathogens have shown resistance to such drugs. It estimated in 2013 that at least two million Americans fall sick each year because of antibiotic-resistant infections and at least 23,000 die from them.

The use of a class of antibiotics important in human medicine by farmers raising animals for food increased 16 percent from 2009 to 2012, according to a report by the Food and Drug Administration — although the agency found that sales of the drugs for that purpose had declined somewhat during that period. The government’s concern has caught the attention of consumers, and food companies and restaurants are increasingly using “antibiotic-free” labels as a marketing tool that sometimes allows them to command a higher price.

“The last time McDonald’s did something like this, five other fast-food companies made similar announcements within six months,” said Steven Roach, food safety program director for Food Animal Concerns Trust, one of the advocacy groups involved in the coalition Keep Antibiotics Working. “I would expect we’re going to see a similar pattern this time around.”

Wendy’s and Burger King said their policies prohibited the use of antibiotics to promote growth. McDonald’s said its suppliers could still use ionophores, additives used to increase feed efficiency and body weight gain in animals, which are less controversial.

The National Chicken Council said in a statement that a “vast majority” of antibiotics used for disease prevention in the industry were never given to humans. “Chicken producers have a vested interest in protecting the effectiveness of antibiotics for the welfare of their animals,” the council, a trade group, said. “As such, we’ve proactively and voluntarily taken steps toward finding alternative ways to control disease while reducing antibiotic use.”

Ariane Daguin, the founder and chief executive of D’Artagnan, which sells high-end meat, poultry, game and truffles, said that the move by McDonald’s was significant but that “the devil is in the details.”

“To stop using only those antibiotics that ‘are important to human medicine’ does not mean much,” Ms. Daguin said. “It is important to understand what antibiotic-free really means and the need to eliminate all antibiotics to prevent antibiotic-resistant bacteria.”

In January, the International Production & Processing Expo, billed as “the world’s largest annual poultry, feed and meat technology exposition,” devoted a panel to antibiotic-free poultry production. An industry consultant who participated said that antibiotic-free chicken was no longer a niche business.

“I think in a few years, one-third of chicken and turkey will be antibiotic-free,” the consultant, Richard Kottmeyer, managing director of Strategic, an agricultural consulting firm, said, according to a report on “The problem then is the other 66 percent of consumers will be resenting the fact that their chicken isn’t antibiotic-free.”

Last September, Perdue became the first major United States poultry company to say it was no longer using antibiotics in its hatcheries, one of the last parts of its production process where the drugs were still in use. A month later, Tyson Foods made a similar announcement, although unlike Perdue, Tyson still uses antibiotics for disease prevention.

And a year ago, Chick-fil-A, the fast-growing fast-food chicken business, said it was no longer using chicken treated with antibiotics. Panera has used meat raised without antibiotics for more than a decade.

McDonald’s is somewhat late to the game, in part because its size makes it difficult to establish supply chains that can fulfill the demand in its 14,000 United States restaurants. It took the company two years, for example, to establish enough contracts to supply it with cucumbers when it added them to its menu several years ago. The company first announced a policy limiting its chicken suppliers’ use of antibiotics in 2003, but it had done little to update it over the years, Mr. Roach said.

McDonald’s latest move coincides with its “Your Questions, Our Food” marketing campaign, in which it answers questions such as whether the eggs it uses are freshly cracked and how it cooks its beef patties. Mr. Easterbrook, the new chief, used a similar program to help turn around the McDonald’s business in Britain.

He is meeting this week with McDonald’s franchisees and suppliers to present what he has called the Turnaround Agenda. One of the seven “Big Actions” he plans is to “win” with the company’s food by, among other things, improving taste and giving consumers food they can “feel good about” eating, like chicken raised without antibiotics.

While scores of advocates applauded Wednesday’s announcement, they were already preparing for another battle with the company over the use of antibiotics in beef production. Last year, McDonald’s pledged to begin buying “verified sustainable” beef by 2016, but Representative Louise M. Slaughter, a Democrat from upstate New York who has long taken an interest in food and agricultural issues, sent the company a letter in January, saying she was “disappointed” in the criteria for determining what beef would qualify.

Those standards were developed by the Global Roundtable on Sustainable Beef, a business group of which McDonald’s is a member, and were condemned as “fundamentally flawed” and “toothless” by advocacy groups in favor of eliminating antibiotic use in beef. “The failure to include meaningful restrictions on antibiotic use in the agreed-upon standards calls into question McDonald’s commitment to ending the misuse of antibiotics and could contradict its own policy,” Ms. Slaughter wrote.
The Fat Drug -- and an open letter to Millennials 15 years from now

How humankind unwittingly joined an experiment on antibiotics and weight gain. / and / In the meantime, we are faced with the legacy of these drugs — the possibility that they have affected our size and shape, and made us different people.


Dear #Millennials, please remember these good-ideas-gone-horribly-wrong when you’re in mid-life (42-62 years old). Your generational archetype (Hero) is the one that ushered in Vaccines For All (wheee!!!) and “all together now, ‘antiobiotics are good’ ” chants to the masses the last time your archetype (the GI generation, born 1901-1924) was in midlife. 

See, the thing for your generation to understand about itself is your Achilles’ heel: your hubris. Your generation is upbeat, trusting of institutions, increasingly powerful as it ages, and focused on a few grand solutions rather than scattered countless gambles (that’s the GenX role) or moralistic, values-driven contemplation (Boomers’ role).

But, in your collaboration and agreement, in your assumption that because you all find X or Y or Z the Thing To Do, what you forget to do is assess, to look at repercussions, to look at the effect and the effect of the effect. That’s what your junion generation (the Homelanders) will do for you in their young adulthood to your mid-life years. Heed them. And more so, remember in your feelings of glory and power, that the things that seem so grand today will – like clockwork – become the profound problems that create the crisis situation for society and the next round of Millennial-like kids and young adults 80 years hence. 

You’ll do great work; that is certain. Just remember that when your elder cautious GenXers and your younger sensitive Homelanders say, “um, maybe this could be tweaked just a bit,” to listen. And heed.