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The Antibiotic Era: Reform, Resistance, and the Pursuit of a Rational Therapeutics, by Scott H. Podolsky
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In The Antibiotic Era, physician-historian Scott H. Podolsky narrates the far-reaching history of antibiotics, focusing particularly on reform efforts that attempted to fundamentally change how antibiotics are developed and prescribed. This sweeping chronicle reveals the struggles faced by crusading reformers from the 1940s onward as they advocated for a rational therapeutics at the crowded intersection of bugs and drugs, patients and doctors, industry and medical academia, and government and the media.
During the post–World War II "wonder drug" revolution, antibiotics were viewed as a panacea for mastering infectious disease. But from the beginning, critics raised concerns about irrational usage and overprescription. The first generation of antibiotic reformers focused on regulating the drug industry. The reforms they set in motion included the adoption of controlled clinical trials as the ultimate arbiters of therapeutic efficacy, the passage of the Kefauver-Harris amendments mandating proof of drug efficacy via well-controlled studies, and the empowering of the Food and Drug Administration to remove inefficacious drugs from the market. Despite such victories, no entity was empowered to rein in physicians who inappropriately prescribed, or overly prescribed, approved drugs.
Now, in an era of emerging bugs and receding drugs, discussions of antibiotic resistance focus on the need to develop novel antibiotics and the need for more appropriate prescription practices in the face of pharmaceutical marketing, pressure from patients, and the structural constraints that impede rational delivery of antibiotics worldwide. Concerns about the enduring utility of antibiotics—indeed, about a post-antibiotic era—are widespread, as evidenced by reports from the Centers for Disease Control and Prevention, academia, and popular media alike. Only by understanding the historical forces that have shaped our current situation, Podolsky argues, can we properly understand and frame our choices moving forward.
- Sales Rank: #1164501 in eBooks
- Published on: 2015-01-01
- Released on: 2015-01-01
- Format: Kindle eBook
Most helpful customer reviews
1 of 1 people found the following review helpful.
How miracle drugs led to superbugs
By John Caronna
A masterly historical analysis of an important period in recent medical history. Dr Podolsky highlights the role that pharmaceutical companies, their direct marketing of antibiotics to physicians, and advertisements in medical journals had in persuading clinicians to overprescribe antibiotics. Highlights include documentation of the efforts of the AMA in alliance with big Pharma to protect the inalienable right of physicians to prescribe inappropriate and ineffective medicines, and the efforts of Republicans in Congress to thwart FDA attempts at drug oversight because they would lead to "socialized medicine". Fortunately the heroes of the story: infectious disease specialists in academia and Estes Kefauver in government prevail but not in time to prevent the development of antibiotic resistant "super bugs".
0 of 0 people found the following review helpful.
About more than just antibiotics
By Steve G
Ostensibly about antibiotics, the development of resistance, and rational drug use, this book is actually about much more. The story of the development and use of antibiotics is also about industry-physician relationships, drug marketing, regulations, the changing mandate of the FDA, and gown-town relationships. This book is more history than science. And author Scott Podolsky covers this all in a well-written and informative book. Indeed, the book was hard to put down.
Disclosure: I received this book for free in exchange for an honest review.
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