How Norway Fought Staph Infections

eldavojohn writes "Studies are showing that Norway's dirtiest hospitals are actually cleaner than most other countries', and the reason for this is that Norwegians stopped taking antibiotics. A number of factors like paid sick leave and now restrictions on advertising for drugs make Norway an anomaly when it comes to diseases like Methicillin-resistant Staphylococcus aureus (MRSA). A Norwegian doctor explains, 'We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better.' Norway is the most MRSA free country in the world. In a country like Japan, where 17,000 die from MRSA every year, 'doctors overprescribe antibiotics because they are given financial incentives to push drugs on patients.'"

Comments

Stop with the drugs already

[Anonymous Coward]

Endure non-life-threatening illnesses without drugs, it helps you build an immune system. Taking drugs means your body never learns to fend for itself, like a spoiled brat.

Re:Stop with the drugs already

[dexmachina]

Er, preventative medicine is entirely different from treatment medicine. Vaccinations and antibiotics are entirely different compounds. The article is about letting certain illnesses run their course naturally, not saying, "Well, screw it let's just not bother with the whole medicine thing." Unless of course you'd like to see a resurgence in polio.

It appears that years of media scaremongering and anti-vaccine lobbies have gotten through the youth crowd quite effectively.

Re:Stop with the drugs already

[Anonymous Coward]

Not all non-life-threating illnesses help build your immune system. I'm sick and tired of this idea that the immune system is like a muscle that you can build up over time or weaken by taking antibiotics. This is a failure on the public's part for understanding how the immune system actually works.

MRSA would have exsited with or without antibiotics. It is all just a matter of time. Things evolve, get use to that fact. So do immune systems. If I could point to a large contribution to the flood of antibotics, it would be peoples lack of understanding of how medicine works. People walk into a doctor's office and say, "fix me, fix him, fix her, fix us..." They want instant results, not results that take 24, 48, or 72-hours to take effect. Doctors, as much as they would love to tell you, can't say you're over reacting go home and call me in a week. That's an awsome way to get sued in the US. The moment that people come to the understanding that the only medication that develers instant results is used in leatal injections, will be the opprtunity to educate people to just, "take it easy, stay home, get rest, drink plenty of fluids, and go to the hospital or follow up with your doctor if your symtomps presist or get worst."

People and the "instant get better" thought process are the real problem of over medication. If no one shows up to the hospital, how do we over medicate? MRSA is just another evolving part of nature, nothing can be done about that. And I dare say that antibiotics do not work the way that you so claim them to work. I would like to see the person who has acquired immunity to something that is treated with antibiotics like Gengreen.

Re:Stop with the drugs already

[Galactic Dominator]

MRSA would have exsited with or without antibiotics.

Do you even know what MRSA means?

Re:Stop with the drugs already

[sjames]

No doubt, it's part of the incredible healthcare costs in the U.S.

Compared to when I was growing up, it seems that people go to the doctor for even the most trivial complaint these days. The fevers I had as a child that got "we'll give it a day or two and see how it is" are now treated like some sort of emergency. Cuts and scrapes that used to mean some iodine and a band aid are treated as if they were an emergency.

I haven't had medical treatment of any sort in over 20 years. It's not that I'm some sort of superman, just that I don't buy in to the hype.

Re:Stop with the drugs already

[Bert64]

Also with your father being a doctor, he has incentive to give you medical advice which is in your best interest, rather than the advice which makes him the most money (as mentioned in the article)...

Re:Stop with the drugs already

[crmarvin42]

Please do explain to me what you mean by "anti-vaccine lobbies." A lobby or lobbyist is a representative of a monied interest. What monied interest out there profits from NOT selling something? Because the anti-vaccine idea is all about not purchasing vaccines. Please tell me who these lobbyists are.

I'm not the OP, but I can probably answer that question for you. There are several "Anti-vaccine" groups that have a lot of money and could be considered "Lobbyists".

1. The well meaning, but ultimately wrong, "Vaccines cause Autism" group. I don't know that they actually have a formal lobbying group, but they are numerous, vocal, and have several politicians at least paying lip service to them.

2. The "Anti-modern Medicine" folk. They are a sub set of the "Anti-modern Science" population that don't trust what they don't understand and have made an emotional (thus irrefutable) decision to go back to old style medicine. That old medicines either didn't work, or worked becuase of chemical compounds that are the basis of many "Modern" drugs is a fact lost on them based on the origin of their decision (Emotion vs. Reason).

There is a lot of overlap between the groups, and collectively there is a lot of money involved. Many of those that vocally espouse either view point are not actually believers, but cynical con-men who are selling all of their dupes vials of distilled water and passing it off as a better "Safer" alternative.

I'm not saying I disagree that the case for Swine-Flu was overblown. I go the vaccine, but only because I have a 4month old at home, who's immune system isn't developed enough to handle any flu (I got the seasonal flu vaccine as well). However, before this year I'd never gotten a flu vaccine, and I've seen some pretty convincing explanations on why we shouldn't bother giving it to the elderly, the group that everyone says needs it most (Hint: rates of flu fatalities in the elderly have not changed since before the existance of the flu vaccine).

More on what the OP said. Vaccines and antibiotics are different. Vaccines exercise the immune system while minimizing the risk of severe problems, whereas antibiotics fight infection on behalf of the immune system potentially reducing the immune systems effectiveness on repeat challenge in the future. I've been of the opinion that antibiotics are abused by human medicine, and the cause of MSRA like "Super-Bugs" and not any of the usual scape goats. However, I have to admit that I'm involved in animal agriculture and understand why and when antibiotics are fed to animals, one of the popular whipping boys in the EU and increasingly in the US.

[Soapbox]That direct administration of antibiotics in a reckless manner to humans cuts out several degrees of separation between potential antibiotic resistance gene appearance, and the human population seems to be lost on anyone involved in policy. That the complete ban of antibiotic use in animal agriculture in the EU almost a decade ago hasn't resulted in any changes in the prevalence of antibiotic resistance gene prevalance or rate of spread in either the livestock or human populations is very telling, but being ignored for the most part by the legislator both in the EU (who'd have to admit they were wrong in order to reverse there knee-jerk decision) and to a lesser extent the US (who are simply ignoring the science so that they can jump on the bandwaggon being driven by the EU). Hopefully they'll see this as further confirmation that HUMAN use of antibiotics like candy is the primary problem and legislate accordingly, but I doubt it.[/soapbox]

Re:Stop with the drugs already

[Delkster]

People with breathing issues should be cautious.

Actually, that might be a good enough reason for other people to get vaccinated as well. Even if it's mostly people with risk factors that develop serious cases, having more people vaccinated reduces the spread of the flu in general, and that will mean fewer people with risk factors will catch it as well. The group of people who are at risk is not isolated from the rest of the population so their risk is not independent of how the flu spreads in the population in general. The normally healthy person might have a rather mild case himself but someone with higher risk could still contract the virus from him, and that's all the more likely if more people around them are infected. Also, just not being in contact when you have the flu is not enough due to the incubation period.

That's one reason I'll probably take the vaccine when its available to me sometime soon. Also, even though the first wave of the flu has been quite mild -- more or less on par with any yearly flu -- we don't know exactly yet what the second wave is going to be like. Other major flu pandemics have also had second or third waves, and those might be more devastating than the first one.

Don't get me wrong. I've been mostly just annoyed by what has sometimes approached hysteria around H1N1. I'm the last one to advocate panicking or useless measures whose only purpose is to create a false sense of security, or convince the public that something is being done. I do believe, however, that vaccinations against H1N1 are likely to actually save lives, perhaps someone else's even if I'm not at much risk myself.

As for antibiotics, TFA is probably spot on.

Re:Stop with the drugs already

[crmarvin42]

While your understanding is partially correct, you conclusion (which is common) is fundamentally flawed.

Modeling shows that use of antibiotics in livestock at worst will decrease the amount of time it takes for a resistance gene to appear by 2 to 5 years (they will appear anyway, it's just a matter of time). Whether the appearance is either as a result of a novel mutation or of selective pressure in favor of a previously existing gene is immaterial (although the later is more likely). Once the gene appears and enters the human population (transfer to the human population is slow are rare, because the species that can set up permanent or semi-permanent populations within the intestines of human and swine are surprisingly different) the rate of transfer between humans is no different than if the gene originated in humans. It's not the existence of MRSA that is the problem per se, but the occurrence of MRSA in immune compromised populations like the elderly, who spend a lot of time in hospitals where MRSA is almost ubiquitous. MRSA poses little risk to a healthy adult.

It is the excessive use of antibiotics by human medical professionals that have turned hospitals into islands of MRSA. And it is the usual lack of generally good hygiene that results in MRSA spread between individuals outside of the hospital. The best suggestions I've seen for guidelines are to ban the use of New classes of antibiotics in animals until we start finding bacterial strains that are resistant in humans. By that point the horse will already be out of the barn and use in animals will cause no further risk to humans. However, the last draft I saw of the regulations proposed by the FDA was to let antibiotics be used in animals UNTIL the appearance of resistant bacteria, and then a complete ban (around 2004). I don't know if the FDA's guidelines have been revised, but I do know that there are several Democratic Representatives that keep trying to slip an EU style ban into unrelated bills as a rider.

Eliminating the use of antibiotics in livestock for which resistance genes are already common is pointless. The genes are already in the human population and a ban does nothing to stop their existence or spread. All you do in that case is increase the production costs of animal agriculture by increasing weaning mortality, days-to-market, feed costs, management costs, etc. This has been shown to be true in the EU. No reductions have been see in resistance gene prevalence in livestock, their handlers, or the general population as a result of the ban, and despite 2-3 years with similar performance to that pre-ban, all of the production criteria I mentioned have experienced a decrease since then. A lot of money is being spent trying to find alternative to antibiotics, but nothing has come close to matching it and that money could be better spent on finding new antibiotics or in some other area of research.

The People Problem

[LtCol Burrito]

While the doctors writing out scrips for antibiotics does play a role, one of the major factors should be patient education. A lot of people think that antibiotics should be used for minor complaints, such as colds. In addition, one major cause of superbugs is the failure of patients to complete a course of antibiotics. They feel better, so they simply stop taking the medications.

Re:The People Problem

[Anonymous Coward]

And why do you think they act like that ? I don't know about the US but here TV ads for antibiotics where everywhere a couple years ago, pretty much telling you to take some even when you weren't sick because hey ANTIBIOTICS ARE GOOD FOR YOU. The whole idea of allowing medical companies to run ads and pay doctors to promote their stuff is a recipe for disaster.

Re:The People Problem

[trollebolle]

Norway's answer to the people problem is to ban ads for medicine that are regulated in any way, like antibiotics. Medicine must be prescribed by a doctor (you can't by antibiotics in a convenience store), and the doctor don't get patients that want a certain medicine after watching a TV ad. Advertisement for medicine is considered to be too dangerous to be allowed, as the decision regarding medical treatment should be left to the doctor, not the pharmaceutical companies through aggressive marketing.

Tip for USA

[spectrokid]

In Scandinavia, most doctors are government employees. They have no incentive for prescribing anything and can freely tell their patients to bugger if they ask for useless drugs. Yes, there are disadvantages to "communist" healthcare, but this story shows there are also some clear advantages. A Belgian Doctor once told me he believed antibiotics should be given as a prevention to all kindergarten kids. A Danish study showed you can cut sick days in kindergartens by half by forcing all children to wash their hands twice a day.

Re:The plural of anecdote is not data...

[Mr. Freeman]

Of course, it could be random coincidence or that you just happen to have a stronger immune system than the average person, but I guess your nonsense rationale sounds better. Also, remind me never to have dinner with you. You might enjoy the taste of your own shit, but I don't.