Drug Company CEO Blames Drug Industry For Increased Drug Resistance

BarbaraHudson writes Times Live is reporting that while doctors have usually been blamed for bacterial resistance because of over-prescribing, Karl Rotthier, chief executive of the Dutch DSM Sinochem Pharmaceuticals, claims lax procedures at drugs companies are the real cause. "Most antibiotics are now produced in China and India and I do not think it is unjust to say that the environmental conditions have been quite different in these regions. Poor controls mean that antibiotics are leaking out and getting into drinking water. They are in the fish and cattle that we eat, and global travel and exports mean bacteria are traveling. That is making a greater contribution to the growth of antibiotic resistance than over-prescribing", Rothier said. "We cannot have companies discharging untreated waste water into our environment, contributing to illness and, worse, antibacterial resistance. We cannot accept that rivers in India show higher concentrations of active antibiotic than the blood of someone undergoing treatment."

Comments

Holy Carp!

[disposable60]

We cannot accept that rivers in India show higher concentrations of active antibiotic than the blood of someone undergoing treatment.

Re:Holy Carp!

[jae471]

More on this: http://www.nature.com/news/201...

Re:Holy Carp!

[ColdWetDog]

Remember that in the early days of penicillin, when manufacturing meant making a couple of grams of the stuff, it was 'recycled' from patient's urine, purified and used again. Many drugs are passed unchanged through the kidney. Many more have only modest changes that might still be biologically active. Standard sewage treatment plants have a relatively haphazard approach to breaking down complex organic molecules of all sorts. If the primary bacteria and flocculation (precipitation) don't get the compound it goes into the drink (so to speak).

UV radiation is pretty good at breaking down things, and even atmospheric radiation (without adding additional UV lights) works to some extent but it is slow and the UV does not penetrate any great deal into the water column. So you either need active UV filtering (something the EPA is pushing) or some other active means of removing organochemicals. Add industrial level effluents and you've got a problem. All of this requires money, time, rule of law and civil commitment. Which means it doesn't always happen - either in China or India or anywhere.

Re:Holy Carp!

[Guppy]

So it's the water coming out of the plant that (sometimes) reaches that level. The actual river has orders of magnitude more flow than that.

So he may have a valid point, but this is obvious FUD.

So in other words, the river itself might have a few tenths or hundredths of a percent of a concentration below the therapeutic MIC (potentially of multiple different antibiotics, depending on what factories happen to be located on that river).

Your interpretation of this is doesn't-matter, therefore FUD. My interpretation of this is enough to exert influence on relative competitiveness within a microbial community, and exert selection for antibiotic resistance.

Long before you reach lethal anti-microbial concentrations, you get subtle changes in growth rate and microbial gene expression. In agriculture, farms routinely use antibiotics at just a few percent of therapeutic dosing, and that is already enough to cause massive changes in the microbial community (with the side-effect of improving the growth rate of the host animal). You don't need to directly kill the microbes themselves, you just need enough to skew the balance of power between the various micro-organisms that are busy competing with each other.

The concentrations in the river may be a fraction below even that, but even slight pressures are enough to alter the course of evolution, when administered over a long enough time period. And "long enough" in this situation is in the context of an organism with 20-minute generation times.

Those wacky subcontractors

[Anonymous Coward]

So, lemme get this straight.

A drug company CEO is blaming manufacturing companies in third world countries (which the big drug companies use to cut costs) for having shoddy practices. This hand wringing goes so far as "I wish they'd clean up their act." But then stops, of course, because it's not OUR fault - it's those people over in India and China that are to blame.

It's not like we hire them (or, in some cases, employ them as wholly owned subsidiaries), so we're in an excellent position to dictate policy (and ENFORCE policy) for them. Nope. It's all their fault. Nothing to do with us at all.

This is Apple putting the blame on Foxconn for unconscionable conditions in their manufacturing plants. Or western garment companies who contract their manufacturing to Bangladesh shaking their heads at Tazreen.

Shame on those other people in countries we choose to do work in because of lax regulation and cheap unskilled labor for having poor regulation and lacking skilled quality control people! It's all their fault.

A drug company CEO taking this position, but not accepting any blame, disgusts me.

But I thought...

[Overzeetop]

Corporations said they would always act in the best interest because they're held accountable by stockholders and consumers? Is he saying that unregulated corporations are doing things which may be harming the population in general because of a short-term profit motive? Say it isn't so!

The problem isnt the manufacturers

[Anonymous Coward]

Two thirds of all antibiotics go to perfectly healthy farm animals. Not to cure them of anything, but to make them fatter for market, and make more money for Agrobusiness.

Get rid of that, and you will reduce the evolution and spread of antibiotic resistant bacteria by 2/3.

It could be worse

[The Grim Reefer]

"We cannot have companies discharging untreated waste water into our environment, contributing to illness and, worse, antibacterial resistance. We cannot accept that rivers in India show higher concentrations of active antibiotic than the blood of someone undergoing treatment."

I'm just happy that Monsanto is not one of these drug companies. They'd probably sue everyone on the planet for drinking water that may contain their product and not paying for the privilege of consuming their pollutants.

Re:More people should be serious about this

[slew]

It's not like drug-resistant bacteria are going to rise up and kill us all at once some day in a weird, snotty epidemic...

Actually, it may be like that... tuberculosis and pneumonia are quite capable in ravaging through our population if unchecked.

In the years right before the wide availability of antibiotics in the US (1930's), just these two bacterial infections were responsible about 20% of all deaths in the US (not including other bacterial infections). If you've seen someone suffering TB, perhaps it might be considered your weird snotty epidemic...

Also, those mushroom-based antibiotics aren't the ones of last resort. The nasty antibiotics with all the nasty side-effects are the modern ones (that are basically injectable pesticides that doctors often hold back as last resort). If we don't clean up our act we might be going back to something more akin to a pre-anti-biotic Victorian era with people dying of consumption (not some quaint 60's ampicillin pill-poping rehash).

Sidenote

[eskayp]

Graphics in linked articles show the effluent of Indian wastewater treatment plants. Few public wastewater facilities can, or were designed to, remove antibiotics from our waste. They are designed for household waste, not industrial waste. Most antibiotics and other drugs pass straight through a typical wastewater plant unharmed. In the USA, Industrial PreTreatment is required for businesses that would otherwise discharge toxic or damaging substances to a public treatment plant. Usually the offending business builds, runs, and pays for pretreatment. Unless, of course, the "good ol' boy" system can unload the cost onto local residents.
America and India have the same problem; India just has more metric tons of it and far less regulation.
FYI: licensed wastewater operator (retired).

Re:Hypocrisy

[Razed By TV]

Besides, how many people just throw old pills in the *garbage* ? I'm pretty sure that's the main reason for drug resistance.

It's funny, because this illustrates the bigger problem of people not being aware that when they stop taking antibiotics early, they potentially breed resistant bacteria if their illness relapses. *Noone* should have any antibiotics left to throw the garbage, with the rare exception of someone having an allergic reaction to them.

My one coworker ceased her antibiotics when she felt better, relapsed, and had to get stronger antibiotics. In the meantime, she infected two of her family members with the more resilient bacteria, one of whom had to be hospitalized.