Antimicrobial Resistance (AMR)

By Vincent Man

Antibiotics, also known as antibacterials, are types of medications that are used to treat infections by killing or inhibiting the growth of bacteria. For the most part, our immune system is highly competent of destroying the bacteria and naturally fighting off the infection on its own. However in some cases, when there is all too much, then there is a need for the use of antibiotics.

Although antibiotics play a fundamental role in treating infections, it must be used correctly and appropriately. Over the past decades, the widespread use of antibiotics has posed a threat to the health and safety of the community. Antimicrobial resistance (AMR) is the resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive. Every now and then, people become sick with a sore throat, cold, fever, or a cough. They typically purchase some OTC (over the counter) medications from the Pharmacy in hopes of a speedy and successful treatment. When OTC medications fail, patients ultimately believe they need antibiotics. Many patients pressure their doctors to write prescriptions for antibiotics when the reality is, the patient do not have an infection but a virus. For example, a disease caused by bacteria is strep throat and an ailment caused by a virus is the flu. In fact, most infections present in the upper respiratory tract are generally caused by viruses. As mentioned, antibiotics target only microorganisms such as bacteria, fungi and parasites, but are ineffective against viruses. If given antibiotics to treat a virus, it is not only futile but can also be detrimental such that when an infection arises in the future, our body will not respond as effectively due to AMR. Once these infections become acquired, there are only a handful of last-line antibiotics capable of undertaking these superbugs, increasing the chances of death. Better yet, let it alone for the immune system to combat these viruses.

Bacteria, unlike humans, evolve and replicate themselves exponentially in their lysogenic cycle to produce the millions that dwell inside our bodies. These bacteria and other microbes that cause infections are remarkably resilient and have developed ways to resist antibiotics and other antibacterial drugs. Antibiotic overuse is one of the factors that have contributed towards the growing number of bacterial infections, which are becoming resistant to antibacterial medications. According to the ECDC (European Centre for Disease Prevention and Control), antibiotic resistance continues to be an increasing public health threat worldwide. In a statement issued in 2012, the ECDC reported that an estimated 25,000 people die each year in the European Union from antibiotic-resistant bacterial infections. In addition to the misuse of antibiotics, antibiotic-resistant bacterial infections can also be caused by a patient’s incompletion of the medication course used to prevent the infection from coming back. If a course is not completed, there is a higher risk the bacteria may become resistant to future treatments- because the ones that survive have had exposure to the antibiotic and may therefore have built up a resistance to it.

A solution to this public health concern is to better educate our patients and more importantly our health care professionals regarding the use of antibiotics. Rather than succumbing to the use of antibiotics, health care professionals should act logically and prescribe medications in interest of the long-term care for the patient. In recent years, programs such as the Antimicrobial Stewardship was created to slow the spread of antimicrobial resistance. The program aims to make rational approaches to the use of antimicrobial agents in order to accomplish optimal success. Actions must be taken now to prevent antibiotic resistance from proliferating. As bacteria become resistant to antibiotics, it is possible for previously treated infections to resurface and become ever more so lethal.

About the Author: Vincent is a 3rd year intended molecular toxicology major and planning on applying for Pharmacy School. Vincent is also doing research on protein crystallography at Lawrence Berkeley National Laboratory. He is part of the Pre-Pharmacy Club (PILLS) on campus as well as the pharmacy facilitator for the Pre-Health Decal. Some of his hobbies include playing basketball, tennis, puzzle-solving, and biking.

The Mediterranean Diet

by Nisha Sarla Chandra

A new study published in the New England journal of medicine in early February 2013 definitively shows the effect that diet can have on one’s cardiovascular health. The 5-year long study, which took place in Spain, used participants who were at high risk for heart disease. Each of the 7,447 people had at least one risk factor, such as smoking, being overweight, or having diabetes. They were then separated into three groups; one group was assigned a low-fat diet and the two others followed different variations of a traditional Mediterranean diet.

The Mediterranean diet is one that has been followed by the people of the region for hundreds of years. The diet has moderate amounts of fat in the form of olive oil and nuts. It also involves multiple servings of fish each week, lots of fresh fruit and vegetables, and a daily glass of wine. Those who adhere to the Mediterranean diet stay clear of red meat, dairy, and store-bought bakery goods. Researchers in the past have noticed a slightly lower incidence in heart disease for people who live in the Mediterranean. However, without definitive proof, it was hard to ascribe this lower prevalence to diet, rather than other factors like genetics or lifestyle. In fact, many leading experts in cardiovascular health have long recommended either low-fat diets or veganism to those with heart issues.

But it seems that a low-fat diet is not the solution. The group assigned to a low-fat diet had a hard time sticking to it, despite intensive nutritional counselling. As a result, the study ended up comparing the Mediterranean diet with a modern, moderate-fat diet. The end result was astonishing – a 30% decrease in heart attacks, strokes, and deaths from heart disease in those following the Mediterranean diet. In fact, the study was supposed to run for a longer period of time, but researchers could not in good conscious allow a study to go on that showed such a large health disparity between groups.

Of course, as with any study, there are detractors. But the majority of experts are impressed with the parameters researchers used and the ensuing results. The study only explored the effects on the diet on those with risk factors for heart disease, but it is expected to have preventative benefits for those at low risk.

Adderall Abuse

By Karen Louie

What is supposed to be a prescription drug for individuals with attention deficit hyperactive disorder (ADHD) is now being touted as the miracle that college students have been looking for. Adderall – it’s the small capsule that’s making big news across the nation as finals approach.

For non-ADHD students who are using Adderall, the common effect seems to be prolonged periods of concentration. Superficially, it seems like a win-win. Students are cranking out those papers and don’t seem to experience any side effects -- sounds too good to be true. Let’s get real. The moment an individual without ADHD ingests an Adderall capsule, the chemistry of the brain is being manipulated. The amygdala, the regulating sector of your emotions, can be altered leading to heightened aggression, depression, and generally feelings of being on edge.

It is becoming more apparent to public health officials that Adderall abuse is now a social norm. No longer is there a taboo of discussing illicit usage in public. Walking around campus, you can hear conversations of extraordinary late-night cramming sessions thanks to Adderall. The risks are forgotten or unconcerned as the usage of this drug becomes standard among the college population.

In the spirit of finals week, here is a brief, informative Adderall study guide:

1.)Adderall is a mixture of different ingredients, one being amphetamine salts. Another amphetamine drug? Speed.

2.)It’s listed as a Schedule II drug by the FDA, meaning it has a high potential for abuse and said abuse can lead to severe dependence.

3.)Possible psychotic effects of Adderall abuse: bipolar disorder, insomnia, Tourette’s

4.)Possible physical effects of Adderall abuse: unintentional weight loss, impotence, digestive issues, hives, strokes

The academic pressure is high here in Berkeley. We are prompted to evolve into the leaders of tomorrow, innovators, and cancer-curers. With academic pressure and competition high, it is understandable why so many students succumb to using illicit resources to aid our studies. However, It is important to look at our experience here at Cal, or any university and college, with perspective. Do not gamble away your mental and physical well-being just for an A on that exam.

For more information:
1.) http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm111441.htm
2.) http://www.cdc.gov/media/pressrel/2010/r100603.htm