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ANN ARBOR&#151From questions about how and when the powerful antibiotic Cipro should be prescribed in anthrax scares to concerns about potential health effects of antibiotics in livestock, consumers and health professionals alike are talking about antibiotics these days. University of Michigan experts are available to talk about a variety of related topics, including new uses for antibiotics and reasons the medical community should exercise caution in their use. Antimicrobial resistance: Clinical pharmacists Randolph Regal and Daryl DePestel, faculty members at the U-M College of Pharmacy, have examined problems stemming from indiscriminant use of antibiotics, including increased resistance, and how changes can be made to reverse these trends. "Antimicrobial resistance ranks right up there with AIDS as a worldwide public health threat," Regal said. "Antimicrobials have contributed significantly to human longevity and quality of life. The implications of not managing the resistance problem now, while we still have an opportunity for damage control, are too serious to ignore." Regal heads the University of Michigan Health System‘s antimicrobial restriction program, which aims to reduce the unnecessary or indiscriminate use of antibiotics at UMHS hospitals. For more on this project: http://www.umich.edu/~pharmacy/news/antibiotics.html Regal also can speak to antibiotics in agricultural and livestock settings. Dental disease prevention: Walter Loesche, professor emeritus at U-M School of Dentistry, has written many numerous articles about treating gum disease with antimicrobials, both topicals like gels or films and systemic drugs, typically pills. In one study, Loesche found that about 90 percent of periodontal disease cases were caused by anaerobic bacteria on the teeth producing toxins that can damage the gums. He suggests that the best treatment is a mix of traditional scraping of the surface of the teeth with short-term use of antibiotics. In the of the American Dental Association, Loesche and colleagues reported that metronidazole or doxycycline produced a 93 percent reduction in the need for periodontal surgery among patients originally recommended for surgery and a 67 percent reduction in need for extraction among patients initially recommended for extraction. The study followed patients for five years and found no appreciable relapse, indicating long-term benefits from short-term use of antibiotics. For more on Loesche’s latest work: http://www.umich.edu/~newsinfo/Releases/2002/Apr02/r041102a.html For information on his labs: http://loeschelabs.dent.umich.edu Over the counter treatments: Urinary tract infections account for 6 to 7 million doctor visits a year, making it one of the most common problems seen by primary care physicians. Those troubled by the uncomfortable infection likely would enjoy the convenience of having treatments available over the counter, but Betsy Foxman, professor at U-M School of Public Health, suggests offering the drugs without prescriptions could create problems. For example, people might misdiagnose themselves and take unnecessary antibiotics, leading to resistance to the drugs and leaving them with fewer treatment options in the future. Misdiagnosis also delays treating the real disease, which could be chlamydia, vaginal yeast infection or genital herpes. Foxman’s recent research shows that the bacteria that cause urinary tract infections are becoming more resistant to antibiotics. She’s also collaborating with Shannon Manning, Carl Marrs and Mark Pearlman, all at U-M, to study antibiotic resistance among group B streptococcus. Foxman’s profile: http://www.sph.umich.edu/epid/faculty/bfoxman.html Drugs in wastewater: Consumers looking to minimize overuse of antibiotics don’t only have to think about the pills they take, but the water they drink to wash the pills down. Rolf Deininger, professor at U-M School of Public Health, is an expert on drinking water supplies and teaches graduate-level courses in water quality management. In his classes, Deininger discusses growing concern about treating wastewater for pharmaceuticals&#151those consumers flush down the toilet, those found in human waste, and those coming from farms where animals are raised for food. Deininger’s profile: http://www.sph.umich.edu/faculty/rad.html RELATED LINKS:

U-M College of Pharmacy >> University of Michigan Health System >> http://www.umich.edu/~pharmacy/news/antibiotics.html >>