Per the article, these bleach (sodium hypochlorite) resistant spores are a HUGE problem. At my office, we clean surfaces with quaternary ammonium compounds, and those are supposed to be superior against spores. But still, if the required contact times to disinfect surfaces keep increasing in healthcare settings, we are going to have a major issue where only the most resistant spore-forming bacterial strains survive (basically, we'll be selecting for the strongest... you know, evolution).
Fortunately TANSTAAFL[0] applies to evolution as well, right? Specific adaptations come with increased metabolic cost, so e.g. strongly bleach-resistant bacteria should eventually start losing resistance to other antimicrobials/antiseptics. Right?
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[0] - https://en.wikipedia.org/wiki/No_such_thing_as_a_free_lunch
Man. Way to rustle the ol' memory tree.
I think the first time I saw this in print was in Programming Perl back in the mid-1990's.
I was unlucky enough to get CDI in medical school when flagyl was first line and had to pay OOP for PO vanco, I assume that’s changed now.
What’s first line in Canada these days, is fidaxomycin covered?
Couldn’t tell you about inpatient hospital use. Outside of hospital, it’s covered by the public drug plan in Ontario if you’ve failed (or have allergies to) vancomycin treatment.
Metronidazole is still first line under that program for “mild” cases, otherwise it’s vanco. But nobody is really checking, so it comes down to how your doctor wants to document it.
Private drug coverage will vary in their rules.
I remember we used to give patients vanco IV bags to drink on discharge for outpatient therapy because the PO formulation was too expensive for some (iirc I paid $300 for a 10 day course).
Thanks for the info!
It did not originate there.
https://en.m.wikipedia.org/wiki/No_such_thing_as_a_free_lunc...