Rebuttal Rewrite

The discovery and development of antibiotics improved people’s lives, providing treatments that were more effective than their predecessors. What was once a potentially deadly infection could now be treated with amazing efficacy. Arsenic, a deadly poison in a high dose, was once the only method of treating infection. In small doses arsenic would attack the unwanted bacteria, but this was a precarious scenario. Too much arsenic would have an adverse effect, potentially killing the consumer. Enter the “Age of Antibiotics,” states Gerard D. Write in his book, The Origins of Antibiotic Resistance and we see drastic improvements in the field beginning in the 1940’s. However, resistance was inevitable from the start.

We need to figure out a way to combat resistance. In the article, “What’s old is new: Reconfiguring known antibiotics to fight drug resistance,” from the journal Nature Medicine, Shraddha Chakradhar proposes that the way to do that might be by changing current antibiotics. Chakradhar states, “Turning to pre-existing drugs to make antibiotics more effective against drug-resistant strains of well-known pathogens is especially appealing given that no new class of antibiotics has been approved for nearly 30 years.” This argument does not address why no new class of antibiotics have been approved and therefore leaves us wondering, is it perhaps policy that needs to change. Moreover, she states that “drug companies and the US government have invested more than $1 billion combined toward the development of new antibiotics, just within the past decade,” which again screams at a potential flaw in how we go about approving these new antibiotics. According to the UK’s Chief Medical Officer, Sally Davies, there is a, “‘ticking time-bomb’. She says this is because of an overuse of antibiotics and the lack of new drugs coming on stream – no new class of antibiotics has been discovered since 1987,” taken from the Cancer Nursing Practice Journal, written by Nick Triggle.

The approach of “reconfiguring” existing antibiotics does nothing to address the problem with over-prescription. Over-prescription and misuse is negating any efforts to create stronger more effective drugs. Linda Bren quotes Stuart Levy, M.D., president of the Alliance for the Prudent Use of Antibiotics. “”The number of bacteria resistant to many different antibiotics has increased, in many cases, tenfold or more. Even new drugs that have been approved are confronting resistance, fortunately in small amounts, but we must be careful how they’re used. If used for extended periods of time, they too risk becoming ineffective early on,”” in her article, “Overprescription of Antibiotics Has Led to Resistant Bacteria.” Dr. Levy warns us that if we continue to overprescribe, even new drugs will become ineffective.

 

Bren, L. (2006). Overprescription of Antibiotics Has Led to Resistant Bacteria. In A. Hiber (Ed.), At Issue. Are Americans Overmedicated? Detroit, MI: Greenhaven Press. (Reprinted from FDA Consumer, 2003, September) Retrieved from http://link.galegroup.com/apps/doc/EJ3010471213/OVIC?u=rowan&sid=OVIC&xid=04a2ea06

Triggle, N. (2013). Overprescription of antibiotics is a ‘ticking time-bomb’: Chief medical officer points out that cancer patients are at increased risk of infections. nick triggle reports. Cancer Nursing Practice, 12(3), 6-7. doi:10.7748/cnp2013.04.12.3.6.p10926

Coates, A. R. M. (2012;2014;). Antibiotic resistance (1. Aufl. ed.). Heidelberg;New York;: Springer. https://link-springer-com.ezproxy.rowan.edu/book/10.1007%2F978-3-642-28951-4

Chakradhar, S. (2016). What’s old is new: Reconfiguring known antibiotics to fight drug resistance. Nature Medicine, 22(11), 1197-1199. doi: http://dx.doi.org/10.1038/nm1116-1197

Shlaes, D. M. (2010). Antibiotics: The perfect storm (1st;1; ed.). New York;Dordrecht;: Springer. doi:10.1007/978-90-481-9057-7 https://link.springer.com/book/10.1007%2F978-90-481-9057-7

Brian N Tse, Amesh A Adalja, Christopher Houchens, Joseph Larsen, Thomas V Inglesby, Richard Hatchett; Challenges and Opportunities of Nontraditional Approaches to Treating Bacterial Infections, Clinical Infectious Diseases, Volume 65, Issue 3, 1 August 2017, Pages 495–500, https://doi.org/10.1093/cid/cix320

 

Research—Marvel

Let’s Resist Resistance

Current hygiene practices increase our contraction of infectious disease. We have all seen the signs on the bathroom door or next to the sink that reads “employees must wash hands.” This signifies that OSHA (Occupational Safety and Health Administration) recognizes the importance of washing our hands after using the restroom. If this sign is abided by, customers are put at ease when eating at their favorite restaurant or buying muffins from their local baker. Customers can be rest assured that they are not going to contract some vile food borne illness that will knock them out of commission for days. We forget about the dish rag that has been used all day to wipe the counters, or the bench seats at the diner that haven’t been cleaned properly. There is a growing need to address the way we clean and the products we use to clean. This extends to the antibiotics we take to “clean” our bodies and the antibiotics we use to treat the animals we eat.

The invention of penicillin awarded Alexander Fleming the Nobel Prize in 1945. Fleming warned during his acceptance speech that the overuse of antibiotics would lead to a decline in their effectiveness. This overuse happens when bacteria evolve to have stronger defenses against certain antibiotics. The overuse is dangerous because as we take more antibiotics, bacteria are getting stronger and more likely to have a defense against the very thing meant to kill them. Today we are seeing an increased awareness to antibiotic resistant strains of bacteria. Immuno-compromised persons are at an increased risk due to their susceptibility to bacterial infection. This population consists of elderly and children as well as any persons with an existing condition that would weaken their bodies ability to fight infection. Compounding these issues is improper hygiene amongst people that service these immuno-compromised people.

According to The American Journal of Infection Control we should be taking a “risk-based approach” to hygiene. Knowing which cleaning products to use and when to use them is crucial to appropriate hygiene. Author, Sally F. Bloomfield says in an article titled, A Risk Assessment Approach to use of Antimicrobials in the Home to Prevent Spread of Infection” that “detergent-based cleaning can be used to break the chain of infection, in some cases an antimicrobial agent is required.” At one time, using an antimicrobial agent in the home was unnecessary but with a growing immune-compromised population that is receiving similar care in home as they once saw in a hospital it is becoming more crucial. This crucial step breaks the chain of the bacteria and allows for the person in contact with a once contaminated surface to now be safe from any bacterial infection. In addition to this step being crucial for the reduction of an infection, it also limits the use of antibiotics to treat an infection. By limiting the use of the antibiotics, we see a reduction in the risk for antibiotic resistant strains of bacteria.

Along with direct use of antibiotics in humans for treatment, the United States meat industry began using antibiotics both as a tool to keep animals from getting sick and as a tool to aid in weight gain. This practice is adding to the inappropriate hygiene practices. Maryn Mckenna writes in an article titled Drugs: gut response?, that “By saturating the environment with antibiotic residues, Blaser argues, we have effectively recreated that weight-gain programme in humans — and the result has been the seemingly unstoppable increase in obesity, especially in children.” This article is from the International Journal of Science. Mckenna is reviewing an article written by Martin J. Blaser on how the overuse of antibiotics is “Fueling our modern plagues”. Essentially, we are contaminating our food now with a product that was meant to treat infection. In doing so we are seeing a similar response in humans that these farmers see in their animals such as weight gain. Weight gain has many health repercussions on its own and now add to that the use of the antibiotics affecting efficiency when a person is ill. On top of the now sometimes inefficient antibiotics, Blaser discusses the idea that the overuse of antibiotics is destroying healthy benign bacteria that are necessary for normal, healthy, human function.

It appears that we are at a boiling point. With things like resistant bacteria and a growing immune-compromised population it is crucial that we begin to make strides in practicing appropriate hygiene. We can’t let that sign in the bathroom fool us. Just washing our hands is not enough. Appropriate hygiene goes beyond hand-washing.

Overuse and misuse of antibiotics leads to an increased occurrence of antibiotic resistant bacteria. We have an infestation of some mutant bug, a spider-cockroach hybrid that isn’t afraid to charge at us when we try to kill it. So, we call a professional to exterminate the hybrid monster bugs. The exterminator uses a substance that kills 95% of the spider-cockroach mutants but leaves 5% not killed. Now imagine, not only are these hybrid bugs not dead but they are now stronger. They have been exposed to the substance that killed the other 95% and have evolved to defend against that lethal substance. In addition, they are multiplying and passing their enhanced defense against the killing substance to their young. Antibiotics are designed to treat bacterial infection. Not unlike the substance used by the exterminator. They attack bacteria within the body by either killing the bacteria or stopping the bacteria from multiplying. Antibiotics are meant to be used as a last line of defense. The human body can usually stop an excess of harmful bacteria from multiplying without the use of antibiotic; however, there are instances when the bacteria becomes too great for a healthy immune system. This is when antibiotics are effective.

Antibiotics are only effective when prescriptions are followed through. A doctor will prescribe a specific number of pills to rid the body of the infection. If we fail to follow though and take all the pills, then the above analogy proves true. We will have exposed some bacteria to the drug meant to destroy them but not enough to kill them. Now exposed, those bacteria grow stronger. They will no longer be killed by the antibiotic first prescribed. Thus, this misuse of antibiotics increases the likelihood of an antibiotic resistant bacteria.

The use of antibiotics in animal agriculture is also contributing to resistant bacteria. Most of the meat found at the local grocer is contaminated with antibiotics. The farmers we buy our meat from are using these antibiotics to increase their profits. Antibiotics contribute to weight gain of their livestock, giving them more inventory, and keep their livestock healthier, giving them more inventory. The situation: animals take antibiotics, whether needed or not, increasing the likelihood of developing resistant bacteria, we eat the animals containing resistant bacteria resulting in the introduction of that resistant bacteria to our system. The microbial ecosystem of the animals we eat is interwoven in such a way that it is unable to be separated from our own. This makes this passing of resistant bacteria impossible to negate unless we were to not feed livestock antibiotics.

The discovery and development of antibiotics improved people’s lives, providing treatments that were more effective than their predecessors. What was once a potentially deadly infection can now be treated with amazing efficacy. Arsenic, a deadly poison in a high dose, was once the only method of treating infection. In small doses arsenic would attack the unwanted bacteria, but this was a precarious scenario. Too much arsenic would have an adverse effect, potentially killing the consumer. Enter the “Age of Antibiotics,” states Gerard D. Write in his book, The Origins of Antibiotic Resistance and we see drastic improvements in the field beginning in the 1940’s. However, resistance was inevitable from the start.

We need to figure out a way to combat resistance. In the article, What’s old is new: Reconfiguring known antibiotics to fight drug resistance,” from the journal Nature Medicine, Shraddha Chakradhar proposes that the way to do that might be by changing current antibiotics. Chakradhar states, “Turning to pre-existing drugs to make antibiotics more effective against drug-resistant strains of well-known pathogens is especially appealing given that no new class of antibiotics has been approved for nearly 30 years.” This argument does not address why no new class of antibiotics have been approved and therefore leaves us wondering, is it perhaps policy that needs to change? Moreover, she states that “drug companies and the US government have invested more than $1 billion combined toward the development of new antibiotics, just within the past decade,” which again screams at a potential flaw in how we go about approving these new antibiotics. According to the UK’s Chief Medical Officer, Sally Davies, there is a, “‘ticking time-bomb’. She says this is because of an overuse of antibiotics and the lack of new drugs coming on stream—no new class of antibiotics has been discovered since 1987,” from the Cancer Nursing Practice Journal, written by Nick Triggle.

The approach of “reconfiguring” existing antibiotics does nothing to address the problem with over-prescription. Over-prescription and misuse are negating any efforts to create stronger more effective drugs. Linda Bren quotes Stuart Levy, M.D., president of the Alliance for the Prudent Use of Antibiotics. “”The number of bacteria resistant to many different antibiotics has increased, in many cases, tenfold or more. Even new drugs that have been approved are confronting resistance, fortunately in small amounts, but we must be careful how they’re used. If used for extended periods of time, they too risk becoming ineffective early on,“” in her article, Overprescription of Antibiotics Has Led to Resistant Bacteria, Dr. Levy warns us that if we continue to overprescribe, even new drugs will become ineffective.

References

Aiello, A. E., & Larson, E. (2003). Antibacterial cleaning and hygiene products as an emerging risk factor for antibiotic resistance in the community. The Lancet Infectious Diseases, 3(8), 501-506. doi:http://dx.doi.org/10.1016/S1473-3099(03)00723-0

Bloomfield, Sally F., PhD, BPharm, & Scott, Elizabeth A., PhD, MPhil. (2013). A risk assessment approach to use of antimicrobials in the home to prevent spread of infection.AJIC: American Journal of Infection Control, 41(5), S87-S93. doi:10.1016/j.ajic.2013.01.001

Bren, L. (2006). Overprescription of Antibiotics Has Led to Resistant Bacteria. In A. Hiber (Ed.), At Issue. Are Americans Overmedicated? Detroit, MI: Greenhaven Press. (Reprinted from FDA Consumer, 2003, September) Retrieved from http://link.galegroup.com/apps/doc/EJ3010471213/OVIC?u=rowan&sid=OVIC&xid=04a2ea06

Brian N Tse, Amesh A Adalja, Christopher Houchens, Joseph Larsen, Thomas V Inglesby, Richard Hatchett; Challenges and Opportunities of Nontraditional Approaches to Treating Bacterial Infections, Clinical Infectious Diseases, Volume 65, Issue 3, 1 August 2017, Pages 495–500, https://doi.org/10.1093/cid/cix320

Chakradhar, S. (2016). What’s old is new: Reconfiguring known antibiotics to fight drug resistance. Nature Medicine, 22(11), 1197-1199. doi: http://dx.doi.org/10.1038/nm1116-1197

Coates, A. R. M. (2012;2014;). Antibiotic resistance (1. Aufl. ed.). Heidelberg;New York;: Springer. https://link-springer-com.ezproxy.rowan.edu/book/10.1007%2F978-3-642-28951-4

Davies, J., & Davies, D. (2010). Origins and evolution of antibiotic resistance. Microbiology and Molecular Biology Reviews, 74(3), 417-433. doi:10.1128/MMBR.00016-10

McKenna, Maryn, (2014) Drugs:Gut Response. Nature Publishing group, a division of Macmillan Publishers Limited. All Rights Reserved. Nature volume508, pages182–183. Retrieved from https://www.nature.com/articles/508182a

Nordqvist, Christian. “Antibiotics: Uses, Resistance, and Side Effects.” Medical News Today, MediLexicon International, 25 July 2018, www.medicalnewstoday.com/articles/10278.php

Shlaes, D. M. (2010). Antibiotics: The perfect storm (1st;1; ed.). New York;Dordrecht;: Springer. doi:10.1007/978-90-481-9057-7 https://link.springer.com/book/10.1007%2F978-90-481-9057-7

Triggle, N. (2013). Overprescription of antibiotics is a ‘ticking time-bomb’: Chief medical officer points out that cancer patients are at increased risk of infections. nick triggle reports. Cancer Nursing Practice, 12(3), 6-7. doi:10.7748/cnp2013.04.12.3.6.p10926

Twomey, Carolyn (2006). Hand Hygiene. Infection Control Today. Retrieved from https://www.infectioncontroltoday.com/hand-hygiene/hand-hygiene-0?nck=1.

Witte, W. (1998). Medical consequences of antibiotic use in agriculture. Science, 279(5353), 996-997.

 

 

Definition Rewrite-Marvel

Current hygiene practices increase our contraction of infectious disease. We have all seen the signs on the bathroom door or next to the sink that reads “employees must wash hands.” This signifies that OSHA (Occupational Safety and Health Administration) recognizes the importance of washing our hands after using the restroom. If this sign is abided by, customers are put at ease when eating at their favorite restaurant or buying muffins from their local baker. Customers can be rest assured that they are not going to contract some vile food bourn illness that will knock them out of commission for days. We forget about the dish rag that has been used all day to wipe the counters, or the bench seats at the diner that haven’t been cleaned properly.

There is a growing need to address the way we clean and the products we use to clean. This extends to the antibiotics we take to “clean” our bodies and the antibiotics we use to treat the animals we eat.The invention of penicillin awarded Alexander Fleming the Nobel Prize. Fleming warned during his acceptance speech that the overuse of antibiotics would lead to a decline in their effectiveness. This overuse happens when bacteria evolve to have stronger defenses against certain antibiotics. The overuse is dangerous because as we take more antibiotics, bacteria are getting stronger and more likely to have a defense against the very thing meant to kill them.

Today we are seeing an increased awareness to antibiotic resistant strains of bacteria. Immuno-compromised persons are at an increased risk due to their susceptibility to bacterial infection. This population consists of elderly and children as well as any people with existing conditions that would weaken their bodies ability to fight infection. Compounding these issues are those of improper hygiene among people that service these immune-compromised people.According to The American Journal of Infection Control we should be taking a “risk-based approach” to hygiene. Knowing which cleaning products to use and when to use them is crucial to appropriate hygiene. Author, Sally F. Bloomfield says, “detergent-based cleaning can be used to break the chain of infection, in some cases an antimicrobial agent is required,” in an article titled, “A Risk Assessment Approach to use of Antimicrobials in the Home to Prevent Spread of Infection.”

At one time the idea of using an antimicrobial agent in the home was unnecessary but with a growing immune-compromised populations that is receiving similar care in home as they once saw in a hospital it is becoming more crucial. This crucial step breaks the chain of the bacteria and allows for the person in contact with a once infected surface to know be safe from any bacterial infection. In addition to this step being crucial for the reduction of an infection, it also limits the use of antibiotics to treat an infection. By limiting the use of the antibiotics, we see a reduction in the risk for antibiotic resistant strains of bacteria.

Along with direct use of antibiotics in humans for treatment, the United States meat industry began using antibiotics both as a tool to keep animals from getting sick and as a tool to aid in weight gain. This practice is adding to the inappropriate hygiene practices. Maryn Mckenna writes in an article titled Drugs: gut response?, that “By saturating the environment with antibiotic residues, Blaser argues, we have effectively recreated that weight-gain programme in humans — and the result has been the seemingly unstoppable increase in obesity, especially in children.” This article is from the International Journal of Science. Mckenna is reviewing an article written by Martin J. Blaser on how the overuse of antibiotics is “Fueling our modern plagues”.

Essentially, we are contaminating our food now with a product that was meant to treat infection. In doing so we are seeing a similar response in humans that these farmers see in their animals such as weight gain. Weight gain has many health repercussions on its own and now add to that the use of the antibiotics effecting efficiency when a person is ill. On top of the now sometimes inefficient antibiotics, Blaser discusses the idea that the overuse of antibiotics is destroying healthy benign bacteria that are necessary for normal, healthy, human function.

It appears that we are at a boiling point. With things like resistant bacteria and a growing immune-compromised population it is crucial that we begin to make strides in practicing appropriate hygiene. Don’t let that sign in the bathroom fool you. Just washing your hands is not enough. Appropriate hygiene goes beyond hand-washing.

https://www.sciencedirect.com/science/article/pii/S0196655313000217

https://www.nature.com/articles/508182a

https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/diagnosis-treatment/drc-20378852

Bibliography-Marvel

  1. Bloomfield, Sally F., PhD, BPharm, & Scott, Elizabeth A., PhD, MPhil. (2013). A risk assessment approach to use of antimicrobials in the home to prevent spread of infection.AJIC: American Journal of Infection Control, 41(5), S87-S93. doi:10.1016/j.ajic.2013.01.001

Background: The article provides information regarding efficacy of hand washing vs. using hand sanitizers. Four different hand sanitizers were evaluated on their antimicrobial efficacy on various bacteria.

How I Used it: This article provided background knowledge on hand-sanitizers and how they differ from one another. The comparison of hand sanitizers vs. hand washing was useful when determining best practices for hand hygiene.

  1. McKenna, Maryn, (2014) Drugs:Gut Response. Nature Publishing group, a division of Macmillan Publishers Limited. All Rights Reserved. Naturevolume508, pages182–183. Retrieved from https://www.nature.com/articles/508182a

Background: This article discusses antibiotic resistant bacteria. The article provides background information for the creation of the first antibiotic as well as a warning from the creator of penicillin in regard to resistance becoming an issue.

How I Used it: I cited directly from the warning given by Alexander Flemming about resistant bacteria. I also used the background information to provide information about how poor health practiced are contributing to resistant bacteria.

  1. Bloomfield, Sally F., PhD, BPharm, & Scott, Elizabeth A., PhD, MPhil. (2013). A risk assessment approach to use of antimicrobials in the home to prevent spread of infection. AJIC: American Journal of Infection Control, 41(5), S87-S93. doi:10.1016/j.ajic.2013.01.001 https://www.sciencedirect.com/science/article/pii/S0196655313000217

Background: This article describes best practice for home hygiene, including appropriate products to use and when to use them.  Also discusses the importance of home hygiene in preventing illness.

How I Used it: This article was used to help define appropriate home hygiene and describe some best practice solutions for preventing illness. Also aided in an describing the relationship between hygiene and resistant bacteria and how one influences the other.

  1. T. (2006). Hand Hygiene. Infection Control Today. Retrieved from https://www.infectioncontroltoday.com/hand-hygiene/hand-hygiene-0?nck=1.

Background: This article provides information about hand washing in hospitals. The article also discusses implications of antimicrobials found in home cleaning products and the effect they have on resistant bacteria. Provides facts about the number of antimicrobials found in cleaning products now vs. years past.

How I Used it: I used this article to identify problems with antimicrobials in household cleaning products and describe why these should be avoided. This supported an argument about appropriate hygiene reducing the likely hood of creating resistant bacteria.

  1. Aiello, A. E., & Larson, E. (2003). Antibacterial cleaning and hygiene products as an emerging risk factor for antibiotic resistance in the community. The Lancet Infectious Diseases, 3(8), 501-506. doi:http://dx.doi.org/10.1016/S1473-3099(03)00723-0

Background: This article emphasizes the issues surrounding a cleaning product called triclosan. The article demonstrates a need for further research into household cleaning products containing the chemical triclosan.

How I Used it: I used this article as a source for background information on hygiene products containing triclosan and the effects this chemical has on household cleaning products efficacy. In addition this source as a view of overall household hygiene as well as additional information on antibiotic resistant bacteria.

  1. Davies, J., & Davies, D. (2010). Origins and evolution of antibiotic resistance. Microbiology and Molecular Biology Reviews, 74(3), 417-433. doi:10.1128/MMBR.00016-10

Background: This article shows the increase in antibiotic resistance and that there is a need for continued research into alternative treatment measures.

How I Used it: I used this article as a source for alternative approaches to reducing antibiotic resistance and as another example for why we need additional research on the topic.

  1. Nordqvist, Christian. “Antibiotics: Uses, Resistance, and Side Effects.” Medical News Today, MediLexicon International, 25 July 2018, medicalnewstoday.com/articles/10278.php.

Background: This article provides basic information on how antibiotics work, when and why they are used.

How I used it: I used this article to gain basic information on how antibiotics work, why they are used, and when it is appropriate to use them. I used the information gained to explain these concepts.

  1. Witte, W. (1998). Medical consequences of antibiotic use in agriculture. Science, 279(5353), 996-997.

Background: This article provides information on how the use of antibiotics in agriculture affects people in terms of antibiotic resistance and other medical issues.

How I used it: I used this article for an argument regarding the misuse of antibiotics in agriculture. The information found in this article shows that there is a consequence to antibiotic use in agriculture which aided in my position that we are overusing antibiotics.

  1. Bren, L. (2006). Overprescription of Antibiotics Has Led to Resistant Bacteria. In A. Hiber (Ed.), At Issue. Are Americans Overmedicated? Detroit, MI: Greenhaven Press. (Reprinted from FDA Consumer, 2003, September) Retrieved from http://link.galegroup.com/apps/doc/EJ3010471213/OVIC?u=rowan&sid=OVIC&xid=04a2ea06

Background: This article discusses antibiotic resistance and the history of occurrences. Antibiotic development has become stagnant. Also discussed in ways to preserve the effectiveness of existing antibiotics.

How I used it: Directly quoted this argument as a source for expert opinion on the dangers of overusing antibiotics. Analyzed claims and gained factual information about development of antibiotics necessary for providing a compelling argument against the manipulation of current antibiotics.

  1. Triggle, N. (2013). Overprescription of antibiotics is a ‘ticking time-bomb’: Chief medical officer points out that cancer patients are at increased risk of infections. nick triggle reports. Cancer Nursing Practice, 12(3), 6-7. doi:10.7748/cnp2013.04.12.3.6.p10926

Background: Journal article discussing the current state of danger in overusing antibiotics. Article quotes Chief Medical Officer in the UK and her warning that it is a “ticking time bomb.” Also discussed is the increased susceptibility cancer patients have to antibiotic resistant bacteria.

How I used it: Directly quotes Sally Davies, the chief medical officer in the UK. I used her quote as a warning and an example of why we need to address policy rather then drugs in regards to reducing or slowing down the rate at which antibiotic resistant bacteria are forming.

  1. Coates, A. R. M. (2012;2014;). Antibiotic resistance (1. Aufl. ed.). Heidelberg;New York;: Springer. https://link-springer-com.ezproxy.rowan.edu/book/10.1007%2F978-3-642-28951-4

Background: Book source providing an in depth look at antibiotic resistance, the history of resistance, various functions of antibiotics etc. Antibiotic resistance is nothing new.

How I used it: Quoted directly a passage pertaining to history of antibiotics and they existence of resistance since their invention. This added to the argument that we need to address misuse of antibiotics.

  1. Chakradhar, S. (2016). What’s old is new: Reconfiguring known antibiotics to fight drug resistance. Nature Medicine, 22(11), 1197-1199. doi: http://dx.doi.org/10.1038/nm1116-1197

Background: Article proposes that the answer to antibiotic resistance is by “reconfiguring” existing antibiotics. Specifically discussed is the use of a potentiator to add to the efficacy of existing antibiotics.

How I used it: This article was used as the counter argument for my Rebuttal section of the essay. I argue that it is necessary we address policy and misuse of antibiotics rather than spending money and time on new antibiotics that if misused will still lead to resistance.

  1. Shlaes, D. M. (2010). Antibiotics: The perfect storm (1st;1; ed.). New York;Dordrecht;: Springer. doi:10.1007/978-90-481-9057-7 https://link.springer.com/book/10.1007%2F978-90-481-9057-7

Background: This book discusses antibiotic history as well as development and proposals for solving resistance problems. One section “the Miracle” provides a detailed history of treatments for bacterial infection, including arsenic and heavy metal compounds.

How I used it: I used it to emphasize the importance of the discovery of antibiotics to set a tone for why it is equally important to address resistance.

  1. Brian N Tse, Amesh A Adalja, Christopher Houchens, Joseph Larsen, Thomas V Inglesby, Richard Hatchett; Challenges and Opportunities of Nontraditional Approaches to Treating Bacterial Infections, Clinical Infectious Diseases, Volume 65, Issue 3, 1 August 2017, Pages 495–500, https://doi.org/10.1093/cid/cix320

Background: Discusses different approaches to fighting bacterial infections. Provides a detailed analysis of advantages vs disadvantages of various “nontraditional approaches. “

How I used it:  I used this as a source for identifying different approaches to antibiotic resistance and how these approaches varied in efficacy.

Rebuttal-Marvel

Rebuttal

The discovery and development of antibiotics improved people’s lives, providing treatments that were more effective than their predecessors. What was once a potentially deadly infection could now be treated with amazing efficacy. Arsenic, a deadly poison in a high dose, was once the only method of treating infection. In small doses arsenic would attack the unwanted bacteria, but this was a precarious scenario. Too much arsenic would have an adverse effect, potentially killing the consumer. Enter the “Age of Antibiotics” as said by Gerard D. Write in his book, The Origins of Antibiotic Resistance and we see drastic improvements in the field beginning in the 1940’s. However, resistance was inevitable from the start.

We need to figure out a way to combat resistance. In the article, What’s old is new: Reconfiguring known antibiotics to fight drug resistance, from the journal Nature Medicine, Shraddha Chakradhar proposes that the way to do that might be by changing current antibiotics. Chakradhar states, “Turning to pre-existing drugs to make antibiotics more effective against drug-resistant strains of well-known pathogens is especially appealing given that no new class of antibiotics has been approved for nearly 30 years.” This argument does not address why no new class of antibiotics have been approved and therefore leaves us wondering, is it perhaps policy that needs to change. Moreover, she states that “drug companies and the US government have invested more than $1 billion combined toward the development of new antibiotics, just within the past decade,” which again screams at a potential flaw in how we go about approving these new antibiotics. According to the UK’s Chief Medical Officer, Sally Davies, there is a, “‘ticking time-bomb’. She says this is because of an overuse of antibiotics and the lack of new drugs coming on stream – no new class of antibiotics has been discovered since 1987,” taken from the Cancer Nursing Practice Journal, written by Nick Triggle.

The approach of “reconfiguring” existing antibiotics does nothing to address the problem with over prescription. Over prescription and misuse is negating any efforts to create stronger more effective drugs. Linda Bren quotes Stuart Levy, M.D., president of the Alliance for the Prudent Use of Antibiotics. “”The number of bacteria resistant to many different antibiotics has increased, in many cases, tenfold or more. Even new drugs that have been approved are confronting resistance, fortunately in small amounts, but we must be careful how they’re used. If used for extended periods of time, they too risk becoming ineffective early on,”” in her article, Overprescription of Antibiotics Has Led to Resistant Bacteria. Dr. Levy warns us that if we continue to overprescribe, even new drugs will become ineffective.

 

Bren, L. (2006). Overprescription of Antibiotics Has Led to Resistant Bacteria. In A. Hiber (Ed.), At Issue. Are Americans Overmedicated? Detroit, MI: Greenhaven Press. (Reprinted from FDA Consumer, 2003, September) Retrieved from http://link.galegroup.com/apps/doc/EJ3010471213/OVIC?u=rowan&sid=OVIC&xid=04a2ea06

Triggle, N. (2013). Overprescription of antibiotics is a ‘ticking time-bomb’: Chief medical officer points out that cancer patients are at increased risk of infections. nick triggle reports. Cancer Nursing Practice, 12(3), 6-7. doi:10.7748/cnp2013.04.12.3.6.p10926

Coates, A. R. M. (2012;2014;). Antibiotic resistance (1. Aufl. ed.). Heidelberg;New York;: Springer. https://link-springer-com.ezproxy.rowan.edu/book/10.1007%2F978-3-642-28951-4

Chakradhar, S. (2016). What’s old is new: Reconfiguring known antibiotics to fight drug resistance. Nature Medicine, 22(11), 1197-1199. doi: http://dx.doi.org/10.1038/nm1116-1197

Shlaes, D. M. (2010). Antibiotics: The perfect storm (1st;1; ed.). New York;Dordrecht;: Springer. doi:10.1007/978-90-481-9057-7 https://link.springer.com/book/10.1007%2F978-90-481-9057-7

Brian N Tse, Amesh A Adalja, Christopher Houchens, Joseph Larsen, Thomas V Inglesby, Richard Hatchett; Challenges and Opportunities of Nontraditional Approaches to Treating Bacterial Infections, Clinical Infectious Diseases, Volume 65, Issue 3, 1 August 2017, Pages 495–500, https://doi.org/10.1093/cid/cix320

 

Reflective- Marvel

Core Value 1. My work demonstrates that I used a variety of social and interactive practices that involve recursive stages of exploration, discovery, conceptualization, and development.

During the semester long pursuit to improve upon my own writing skills I regularly looked to my peers writing for inspiration. Professor Hodges gives effective and unique feedback. There were times I was stuck on a particular assignment and I looked to feedback Mr. Hodges had left on other students. Many time I found an approach that I had not thought of and that got me moving in the right direction. Participating in daily class activities also allowed me to exercise the social and interactive practices that are so crucial to growing as a writer.  During one particular class, Mr. Hodges used my example from the Visual Rhetoric assignment as an in class exercise on what was expected from that assignment. This was instrumental in my understanding of the two fold purpose to this assignment. I had addressed the visual aspect, at least to some degree, but I failed to acknowledge what the images were saying.

Core Value 2. My work demonstrates that I read critically, and that I placed texts into conversation with one another to create meaning by synthesizing ideas from various discourse communities. 

Understanding language is hard. There is a level of interpretation that happens when we read that can sometimes mold ideas to how we want to see them. No one escapes bias. However, I do believe we can try to achieve a level of objectiveness to which we can begin to synthesis information more effectively. This course has awakened in me the critical analyzer and it goes beyond just work for this course. I heard an ad on the radio the other day on NPR, it said, “there are over a million bubbles in a glass of champagne.” Normally, I would have just accepted this as fact, however, I thought to myself, what If the champagne had been sitting out for a while and was flat. I don’t believe that there would be over a million bubbles in that glass. I attribute this to a semester of reading and analyzing many different kinds of writing. This analysis was ever present when writing my own arguments as well. Admittedly, this made it hard to feel as if what I was writing was adequate. The best example from my work this semester that demonstrates this core value is my Research paper.

Core Value 3. My work demonstrates that I rhetorically analyzed the purpose, audience, and contexts of my own writing and other texts and visual arguments.

The best example that I have met this core value is through my Visual Rhetoric Assignment. This assignment forced me to analyze the content of a short advertisement in which I attempted to get inside the mind of the director. This process meant figuring out what the director was trying to say through visual choices. I attempted to answer questions like: Why did the director choose a certain sequence, color scheme, order or chronology? what audience was the ad directed to? What emotions did the director want to illicit? It was a wonderful exercise in rhetorical analysis.

Core Value 4: My work demonstrates that I have met the expectations of academic writing by locating, evaluating, and incorporating illustrations and evidence to support my own ideas and interpretations.

Locating appropriate information for the purpose of an academic paper was the easy task. I made sure to us sources from only academic sources. These sources include academic journals, books, online newspapers with expert testimony and more. Evaluating and incorporating these sources was more difficult. My topic, being based in science and medicine required background vocabulary that I often did not have. This required me to research individual terms, lengthening the process of evaluating the sources. Once evaluated, I was able to insert appropriate quotes to emphasize my arguments or provide counter arguments.

Core Value 5. My work demonstrates that I respect my ethical responsibility to represent complex ideas fairly and to the sources of my information with appropriate citation. 

The best example for me that I have demonstrated this value is through my Research Paper. During this process I read and evaluated over 20 sources. Many of these sources I quoted directly. I used the informal APA citation to direct my readers to the root source of this citation. Some sources were used to gain general knowledge of content needed to make clear arguments. These sources are also cited, although I did not directly quote them. I do this to demonstrate integrity in the research I have done.

Definition—Marvel

Current hygiene practices increase our contraction of infectious disease. We have all seen the signs on the bathroom door or next to the sink that reads “employees must wash hands.” This signifies that OSHA (Occupational Safety and Health Administration) recognizes the importance of washing your hands after using the restroom. If this sign is abided by, customers are put at ease when eating at their favorite restaurant or buying muffins from their local baker. Customers can be rest assured that they are not going to contract some vile food bourn illness that will knock them out of commission for days. We forget about the dish rag that has been used all day to wipe the counters, or the bench seats at the diner that haven’t been cleaned properly. There is a growing need to address the way we clean and the products we use to clean. This extends to the antibiotics we take to “clean” our bodies and the antibiotics we use to treat the animals we eat.

The invention of penicillin awarded Alexander Fleming the noble prize. Fleming warned during his acceptance speech that the overuse of antibiotics would lead to a decline in their effectiveness. This overuse happens when bacteria evolve to have stronger defenses against certain antibiotics. The overuse is dangerous because as we take more antibiotics, bacteria are getting stronger and more likely to have a defense against the very thing meant to kill them. Today we are seeing an increased awareness to antibiotic resistant strains of bacteria. Immuno-compromised persons are at an increased risk due to their susceptibility to bacterial infection. This population consists of elderly and children as well as any person with an existing condition that would weaken their bodies ability to fight infection. Compounding these issues are those of improper hygiene among people that service these immune-compromised people.

According to The American Journal of Infection Control we should be taking a “risk-based approach” to hygiene. Knowing which cleaning products to use and when to use them is crucial to appropriate hygiene. Author, Sally F. Bloomfield says, “detergent-based cleaning can be used to break the chain of infection, in some cases an antimicrobial agent is required,” in an article titled, A Risk Assessment Approach to use of Antimicrobials in the Home to Prevent Spread of Infection. At one time the idea of using an antimicrobial  agent in the home was unnecessary but with a growing  immune-compromised populations that is receiving similar care in home as they once saw in a hospital it is becoming more crucial.This crucial step breaks the chain of the bacteria and allows for the person in contact with a once infected surface to know be safe from any bacterial infection. In addition to this step being crucial for the reduction of an infection, it also limits the use of antibiotics to treat an infection. By limiting the use of the antibiotics, we see a reduction in the risk for antibiotic resistant strains of bacteria.

Along with direct use of antibiotics in humans for treatment, the United States meat industry began using antibiotics both as a tool to keep animals from getting sick and as a tool to aid in weight gain. This practice is adding to the inappropriate hygiene practices. Maryn Mckenna writes in an article titled Drugs: gut response?, that “By saturating the environment with antibiotic residues, Blaser argues, we have effectively recreated that weight-gain programme in humans — and the result has been the seemingly unstoppable increase in obesity, especially in children.” This article is from the International Journal of Science. Mckenna is reviewing an article written by Martin J. Blaser on how the overuse of antibiotics is “Fueling our modern plagues”. Essentially, we are contaminating our food now with a product that was meant to treat infection. In doing so we are seeing a similar response in humans that these farmers see in their animals such as weight gain. Weight gain has many health repercussions on its own and now add to that the use of the antibiotics effecting efficiency when a person is ill. On top of the now sometimes inefficient antibiotics, Blaser discusses the idea that the overuse of antibiotics is destroying healthy benign bacteria that are necessary for normal, healthy, human function.

 

It appears that we are at a boiling point. With things like resistant bacteria and a growing immune-compromised population it is crucial that we begin to make strides in practicing appropriate hygiene. Don’t let that sign in the bathroom fool you. Just washing your hands is not enough. Appropriate hygiene goes beyond hand-washing.

 

 

 

https://www.sciencedirect.com/science/article/pii/S0196655313000217

https://www.nature.com/articles/508182a

https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/diagnosis-treatment/drc-20378852