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Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them |  | Author: Brad Spellberg
Publisher: Prometheus Books
Category: Book
List Price: $26.00
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Seller: mrmoose2003
Rating:  11 reviews
Sales Rank: 38914
Media: Hardcover
Edition: 1
Pages: 264
Number Of Items: 1
Shipping Weight (lbs): 1.2
Dimensions (in): 9 x 6.2 x 1
ISBN: 1591027500
Dewey Decimal Number: 616.9041
EAN: 9781591027508
ASIN: 1591027500
Publication Date: September 22, 2009
Availability: Usually ships in 1-2 business days
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Product Description
Antibiotic-resistant microbes infect more than 2 million Americans and kill over 100,000 each year. They spread rapidly, even in such seemingly harmless places as high school locker rooms, where they infect young athletes. And throughout the world, many more people are dying from these infections. Astoundingly, at the same time that antibiotic resistant infections are skyrocketing in incidence creating a critical need for new antibiotics research and development of new antibiotics has ground to a screeching halt!In Rising Plague, Dr. Brad Spellberg an infectious diseases specialist and member of a national task force charged with attacking antibiotic resistant infections tells the story of this potentially grave public health crisis. The author shares true and very moving patient stories to emphasize the terrible frustration he and his colleagues have experienced while attempting to treat untreatable infections, not to mention the heart-break and tragedy that many of these patients' families had to endure. Dr. Spellberg corrects the nearly universal misperception that physician misuse of antibiotics and "dirty hospitals" are responsible for causing antibiotic-resistant infections. He explains the true causes of antibiotic resistance and of the virtual collapse of antibiotic research and development. Most important, he advocates ways to reverse this dire trend and instead bolster the production of desperately needed new and effective antibiotics. He also warns against complacency induced by the decades-old assumption that some miracle drug will always be available to ensure the continuation of our "antibiotic era". If we do nothing, we run the risk of inviting a bleak future when infectious diseases will once again reign supreme. Then many of the medical breakthroughs that we now take for granted from routine surgery and organ transplants to intensive care and battlefield medicine might all be threatened. This crucial and timely book is lucidly written in terms that everyone can understand. It issues a call to action, explaining how, through a strong and concerted effort, we can all help prevent this nightmare scenario from happening. By following this courageous doctor's recommendations, we can assure that magic bullets will be there for our families and us in the future.
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Showing reviews 1-5 of 11
 Is an era ending? December 22, 2009
wiredweird (Earth, or somewhere nearby)
6 out of 7 found this review helpful
My parents lived in the time when antibiotics won out over bacterial infection. My very real fear is that they will live to see bacteria win again. Dr. Spellberg describes what that time was like, when capricious infections would strike at healthy adults and cripple or kill them in just a few days. More to the point, he describes what this time is like, when he sees drug-resistant infections doing the same, now, even in the most advanced of western hospitals.
Antibiotic resistance follows inevitably from antibiotic use. Every time a new antibiotic appears, billions of bacteria take on the evolutionary problem of dealing with it. Sooner or later, somewhere, one does - and that's all it takes. That one's progeny thrive in the presence of that drug, to the exclusion of all others. Spellberg omits, almost completely, a technical point that makes the problem even worse, though. "Horizontal gene transfer" means that one bacterium can pass its resistance on to others, not just its descendants, and not just within its bacterial species. In particular, one resistant bug can pass resistance on to a bug already resistant to something else, creating a superbug with multi-drug resistance. In rare cases, some pathogen resists all known medications. That's when the infectious disease specialist has to say something that hasn't been said since the dawn of the antibiotic era, "We've tried everything. There is nothing left to try."
Acquired resistance is not just a problem. It must be considered a basic fact of life. All the best policy in the world regarding hand-washing, infection control, and the rest can not change that fact. Instead, the problem must be addressed on the human side, by coming up with new drugs and new ways of using them. That is where Spellberg's story takes its most appalling turn: We are doing nothing. In fact, many companies have already shut down development of new antibiotics.
Step by dismal step, Spellberg describes how this has occurred. Part of the problem lies in misuse of the drugs, in ways that very nearly ensure the rise of resistant bacteria. Another part lies in governmental blunders that fail to reward, or seem actively to punish creation of new drugs. For example, drug patents last for some fixed number of years, as does any patent on anything else. Legalities require that the patent be submitted before the drug goes into testing, however, and legally mandated tests can go on for years. During all of those years, the developer keeps adding to the cost of development, which often exceeds a billion dollars. Only when the drug is approved can the company begin to recoup development costs - when as much as a third of the patent's lifetime has already expired. Even if successful, any one patient uses antibiotics for only a few days. It makes obvious economic sense to market drugs that a patient will take for a lifetime: things like Lipitor, Viagra, or diabetes medication. Pursuing uneconomic drug development could even put a company at risk of lawsuits from its shareholders.
Oddly, Spellberg does not mention phages as potential therapeutic agents. Phages are viruses that attack bacteria but not people, and are already used in the US to prevent food-borne disease. Since phages occur naturally, however, they can't be patented. The company that funds development of phage therapy has no realistic way to recover development and testing costs. Once a phage hits the market, competitors can culture it and sell it immediately - at a price that doesn't need to recover expenditures already invested. Until some business model arises to make phage therapy profitable, there is no economic reason for a company to pursue it.
Spellberg notes that solving the problem has so many interlocking parts that assigning blame is impossible, in addition to being a positive hindrance to creating solutions. Many solutions just can not work. Spellberg cites a lawyer's proposal for better hospital procedures to block the spread of resistant germs, very nearly a proposal to sue drug resistance out of existence. Spellberg gently points out the many fallacies that underlie this, as well as those underlying other seemingly meaningful proposals. In his final chapter, he goes even farther. In addition to 'stewardship' activities designed to preserve a drug's useful lifetime, he offer suggestions that create incentives for antibiotic development. Instead of radical new proposals, his are based on existing legislation with a proven record of motivating the drug companies.
But, as Spellberg points out, any eventual solution must follow public recognition that a problem even exists. Then, a period of discussion will inevitably follow. As has already happened, educated people will enter that discussion with no idea - worse, with wrong ideas about the nature of the problem. Spellberg addresses these fundamentals. He shows that there is a problem, he states it in clear, understandable language, and shows how people can use that knowledge to fight back against drug resistance. And we'd better start fighting soon. The bacteria outnumber us by billions to one, and they're pulling ahead.
-- wiredweird
A chilling warning September 9, 2009
Robert C. Ladendorf (Los Angeles, CA USA)
5 out of 6 found this review helpful
As a fan of TV's medical drama "House," I've been amazed at the range of diseases and adverse medical conditions of humans, as well as the swiftness of their effects, but I wasn't prepared for the alarming descriptions by Dr. Brad Spellberg in his engrossing book Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them about antibiotic-resistant bacteria and the scary increase in infections and deaths because new antibiotics aren't being developed. If this book doesn't send a chill up your spine, you're probably spineless.
But Spellberg is at the same time hopeful that we can turn things around, and I think his book will be that alarm bell calling attention to this problem. What's more, his moving descriptions of those helped by antibiotics throughout the years, such as the four-year-old girl near death from a staph infection (with photos of her before and after the infection), remind all of us not to be complacent about the future.
I had the privilege of hearing a compelling talk he gave at the Center for Inquiry-L.A. about his book, and readers interested in understanding how antibiotics work on bacteria, which are examples of how fast evolution works, and how to combat this rising plague should not miss this book.
Rising Plague September 11, 2009
Catherine Michaels (California)
2 out of 2 found this review helpful
This book was recommended to me by someone in the healthcare field, and I'm sure glad it was! I was surprised by how readable and easy to understand this book was. It is deeply moving, interesting, and scary all at one time. I had no idea that there is,on our horizon, a deadly threat more frightening than the much talked about Swine Flu! This book is a must read and a wake-up call for all of us. I especially liked the case studies at the beginning, any one of which would have intrigued Drs. House, Kildare, and Ben Casey. Television drama writers take note: this subject is fascinating, real life and important.
You need a solution, not just a problem October 21, 2009
M. Collins (New York, NY)
2 out of 3 found this review helpful
The author does an amazing job of presenting why drug resistant microbial diseases exists today without playing the blame game that is frequently heard in the media. The rising problem is presented through case studies described as personal antidotes that make the material captivating to interested laypeople and experts alike. Most importantly, Dr. Spellberg lays out a clear agenda that can alter the current state of drug development and government oversight that will alleviate the "rising plague" of drug resistance. This is a pressing matter that is not getting the attention it deserves. This book and the efforts of Dr. Spellberg and others will hopefully change the future of antibiotics.
Every medical and many a public library needs this December 18, 2009
Midwest Book Review (Oregon, WI USA)
1 out of 2 found this review helpful
RISING PLAGUE: THE GLOBAL THREAT FROM DEADLY BACTERIA AND OUR DWINDLING ARSENAL TO FIGHT THEM is packed with information from an infectious diseases specialist and member of a national task force assigned to attack antibiotic resistant infections. From patient case histories to attempts to treat resistant infections and worries about a coming public health crisis, this explains the real causes of antibiotic resistance and the collapse of antibiotic research and development - and offers some solutions. Every medical and many a public library needs this.
Showing reviews 1-5 of 11
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Copyright © 2009 Diseases, Medical, and Preventive Ways
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