Monday, January 18, 2010

Antibiotic Resistance and Obesity, Olivia Cvitanic

In class, we have talked a lot about drug resistant diseases and the effectiveness of antibiotics in our modern world. In this vein, many doctors worry about keeping antibiotics as a viable treatment option by prescribing it correctly in terms of type of antibiotics needed as well as the correct dose amount. Apparently, doctors are increasingly worried that their obese or very overweight patients are not being prescribed sufficient doses of antibiotics. According to Dr. Gurley, the author, antibiotics doses are not a “one size fits all” matter. In fact, obese people could become breeding grounds for heartier bacteria strains who are able to survive and reproduce because the antibiotic dose was not large enough to kill all of the bacteria. As obesity becomes a bigger problem in highly industrialized, developed nations where most of antibiotics are prescribed, the possibility that our antibiotics could be rendered less effective by not taking into account a person’s body weight is alarming and should be a subject of concern in the medical community. It would truly be a shame if humans were intelligent enough to develop antibiotics but more rapidly rendered them obsolete for failure to do some relatively simple math in prescribing them.

However many drug companies and doctors say it’s not that simple. The “kicker” according to Dr. Gurley is that changing the dose sizes and even pill sizes to appropriately accommodate people leaves drug companies a golden opportunity to “price-gouge” consumers. Should obese people be penalized financially for needing a larger dose of medicine? If so, then, Dr. Gurley argues, why not penalize people for their cardiac output or liver functions? I’m not sure how I feel about charging or not charging patients extra due to their weight, but I do think it’s an interesting point and a very serious point because if sick, obese people are not effectively treated then they could very well pass on drug resistant strains of antibiotics. If you are interested in the reading more, here’s the link:

http://sfgate.com/cgi-bin/blogs/gurley/detail?entry_id=55341

1 comment:

John Latto said...

Great article. Very interesting stuff.

There are also a couple of good points made in the public comments at the end of the article - about veterinarians already doing this, and about where the cost of a pill comes from (usually R&D rather than manufacturing so a cost per person regardless of dose does make some sense).