Hospitals & Asylums 






Over-the-counter Antimicrobial Agent Course for the FDA: A Trade for Organic Antibiotics by the Holidays HA-20-11-10


By Anthony J. Sanders


Let the land produce vegetation: seed bearing plants and trees on the land that bear fruit with seed in it (Genesis 1:11)


1.      The 90 Day Pertussis of 2010

2.      The Antimicrobial Spectrum of Oral Medication

3.      Antibiotic Resistance

4.      The Probiotic Microbiome


Table 1: Bacterial Infections 2006

Table 2: Mechanisms of Action of Resistance to Major Classes of Antibacterial Agents


The 90 Day Pertussis of 2010


The Bordetalla pertussis epidemic unleashed by the Patient Protection and Affordable Care Act of July 2010 P.L. 111-148 has heightened sensitivity to the compelling need for the Food and Drug Administration (FDA) to ensure the Commissioner appoints an advisory review panel to establish an Over-the-counter monograph under 21CFR§330.10 to ensure Americans have safe, effective, adequate and affordable stockpiles of oral antimicrobial agents, both organic antibiotics and synthetics, as well as appropriately labeled antimicrobial cleaning supplies and detergent.  Only then will the people and primary care physicians stop calling the Act the “Patient Pertussis and Affordable Rheum Attack of 2010” and call it the “Productive Patient and Affordable Home”.  Pertussis, is a highly contagious respiratory infection, with a distinctive phlegm producing cough, known as whooping cough, that lasts six weeks with associated rheumatic pains throughout the body.  Primary Care Physicians have dubbed this whooping cough epidemic the “90 day Pertussis” because many cases drag on as long as three months, probably as the result of re-exposure because one does not become immune to pertussis without a DTaP (Diptheria and Pertussis) vaccine.  Smoke-stopping is recommended by physicians, but the most important thing, is to avoid being coughed on, fast to avoid all proteins and get lots of aerobic exercise especially jogging and hiking, bathe and wash all fabrics and surfaces frequently to disinfect the cloud of infectious material spread by respiratory phlegm droplets as cloy as tobacco smoke (Samoss ’10).   


To the layman antibiotic consumer Pertussis is discernable from a viral cold because the Public Health Service has declared a whooping cough epidemic.  Pertussis does not respond to antibiotics after it has descended to the lungs from the extremely runny nose of the first week.  Unvaccinated persons who succumb to whooping cough can sterilize Pertussis against other opportunistic infections and reduce their contagiousness with a full course of antibiotics.  Vaccination and antibiotics have been effective at controlling the incidence of pertussis for the past century.  Between 1922-1925 the average annual number of reported cases of Bordetella pertussis was 147,271, by 2001 incidence of whooping cough had decreased 95 percent to 7,580 (Fisher ’06: 7).  Whooping cough kindly does not attack the heart like the common rheumatic Streptococcus, Pertussis however increases vulnerability to pneumonia and can be deadly in infants and small children who are not up to date in their DTaP vaccination.  All infants and children with a family income of less than 100% poverty are insured by Medicaid for office visits and DTaP vaccinations under the Omnibus Budget Reconciliation Act of 1990 P.L.101-508 (Morone & Jacobs ’05: 277-278). 


Having been educated in Western medicine’s Sreptococcus pyrogenes (Group A) by an insured high school junior whose mother abandoned us a month before I too relocated from Washington State. Physicians prescribing antibiotics for juveniles for Streptococcus should issue a refillable script for antibiotics to sterilize their household against prolonged exposure to Group A or Pertussis.  Th that time as much as $6.66 billion, may have been extorted by Washington State Medicaid contractors with disputed contracts under color of Doe v. Reed, ultra vires Washington election law, and the PPC Act, that paid the grossly overfunded health care system more money without any promise of universal coverage or primary care reimbursements, in June/July 2010 - $3 billion from Washington State, $3 billion from the Center for Medicaid, Medicare and SCHIP (CMS) and $600 million for the border police. To restore efficiency a Medicaid Integrity Program must be instituted to return Washington Medicaid spending to its previous low levels of toxicity by protecting patient complaints for the sovereign immunity of the State budget.  Subsequently the nation has suffered an epidemic of whooping cough. In the State of Washington, so recently treated its methicillin resistant staphylococcus aureus (MRSA) with Nafcillin and/or vancomycin (Fisher ’06: 334) the bacteriological warfare, has become so irritable many college students were hospitalized from a party and alcoholic, energy drinks have been banned and the FDA has brought manufacturers to consider a revision of their recipe (Sanders ’10).  


One wedding guest returned home to Oregon after a weekend in Washington to have an extortionate emergency appendectomy of what was probably a Clostridium species treatable with penicillin.  Pathology reports were inconclusive.  At only a 4 on the pain scale they should have gone to a family physician for more than 24 hours before being coerced into surgery as the result of the paucity of research of the past 100 years.  Being one of the only surgeries with no greater than the 0.1% risk of dying from general anesthetic, and with no known complications, emergency appendectomies have cost 10% of the population large sums of money over the past 100 years.  The literature omits prescribing an experimental bacterial sterilization course of Antibiotics before the Appendectomy, or potentially deadly ruptured appendix, also treatable with antibiotics.  Appendicitis researchers, suddenly more afraid of mortality than morbidity, must be given a chance to experiment with Over-the-counter antimicrobial agents for themselves (Scelza ’10). 


Antibiotic resistance amongst physicians is simply outrageous.  One frustrated caregiver complained to an ethicist, “My mother’s doctor is refusing to give her antibiotics.  He says that she’s ninety-two and an infection will kill her sooner or later, so it might as well be this infection” (Smith ’00: 1).  If doctors are going to cause scarcity in the supply of antibiotics and immunizations to perform extraordinarily expensive and unnecessary procedures and CMS contractors are going to wage bacteriologic warfare when it’s not flu season, millions of uninsured, non-immunized Americans must be allowed to purchase safe, effective, understandable and affordable courses of organic antibiotics over-the-counter, to avoid re-exposure to Western military medicine.  To be a member of the Hospitals & Asylums revolution, it has been dissembled that one may not pay any health insurance premiums because only the sick are due any credit for acts of healing (Sanders ’10).  


2.      The Antimicrobial Spectrum of Oral Medication


Bacterial cells are prokaryotes, which lack nuclei and endoplasmic reticulum.  Their cell walls are relatively rigid, composed either of two phospholipid bilayers with a peptidoglycan layer sandwiched in between (gram-negative species) or of a single bilayer covered by peptidoglycan (gram positive bacteria).  Bacteria synthesize their own DNA, RNA and proteins but depend on their host for favorable growth conditions. (Cotran et al ’94: 306). There are 10 times more microbes than human cells in our bodies (Zimmer ‘08).  Humans live in symbiosis with an estimated 1014.001 bacteria.  Normal persons carry 1012 bacteria on the skin, including the Staphylococcus, we do most of our hand-washing to protect against, epidermidis and Propionibacterium acnes, the agent responsible for adolescent pimples.  Normally, 1014 bacteria reside inside the gastrointestinal tract, 99.9% of which are anaerobic, including Bacteroides species (Cotran et al ’94: 306).  Without these symbiotic gut flora humans would not gain any nutrition from their food and die.  Other bacteria are necessary for the proper functioning of certain joints.


There is an international effort to catalogue thousands of new microbe species by gathering their DNA sequences. They’re finding that the micro-biome does a lot to keep us in good health. Micro-biome first came to light in the mid-1600s, when the Dutch lens-grinder Antonie van Leeuwenhoek scraped the scum off his teeth, placed it under a microscope and discovered that it contained swimming creatures. A number of teams are working together to tackle this problem in a systematic way. The biggest of these initiatives is known as the Human Microbiome Project. The $150 million initiative was started in 2007 by the National Institutes of Health. The project team is gathering samples from 18 different sites on the bodies of 300 volunteers and are sequencing the entire genomes of some 900 species that have been cultivated in the lab. Before the project, scientists had only sequenced about 20 species in the microbiome. The scientists published details on the first 178 genomes. They discovered 29,693 genes that are unlike any known genes. The entire human genome contains only around 20,000 protein-coding genes. In the mouth alone, there are between 500 and 1,000 species (Zimmer ’08). Next to viruses, bacteria are the most frequent and diverse class of naturally occurring human pathogens (Cotran et al ’94: 306) but this may not hold true as our understanding of the microbiome increases.


The development of drugs able to prevent and cure bacterial infections is one of the twentieth century’s major contributions to human longevity and quality of life.  The term antibiotics literally means “against life” in this case against microbes.  There are many types of antibiotics, antibacterials, antivirals, antifungals and antiparasitics.  Some drugs are effective against many organisms, these are called broad-specturm antibiotics.  Others are effective against just a few organisms and are called narrow-spectrum antibiotics.  The most commonly used antibiotics are antibacterials (Fisher ’06: 136).  In 1920, British scientist Alexander Fleming was working in his laboratory at St. Mary’s Hospital in London when almost by accident, he discovered a naturally growing substance that could attack certain bacteria.  In one of his experiments Fleming observed colonies of the common staphylococcus aureaus bacteria that had been worn down or killed by mold growing on the same plate or petrie dish.  He determined that the mold made a substance that could dissolve the bacteria.  He called this substance penicillin, after the Penicillium mold that made it, by 1941 they recognized even small doses of penicillin cured bacterial infections and Fleming was awarded the Nobel Prize in Physiology and Medicine. During World War II antibiotics came into use curing battlefield wound infections and pneumonia.  By the mid-to late 1940s it became widely accessible for the general public.  Before antibiotics 90% of children with bacterial meningitis died, strep throat was at times a fatal disease (fisher ’06: 139).


Antibacterial agents are among the most commonly prescribed drugs of any kind worldwide.  At least 150 million antibiotic prescriptions are written in the United States each year, many of them for chidren.  Use of antibacterial agents in hospitals in the United States accounts for 20 to 50 percent of all drug costs and represents the largest expenditure for any pharmacologic class.  In the outpatient setting, the costs of antibacterial drugs are second only to those of cardiovascular agents.  A survey of office-based physician found that between 1980 and 1992 there was a marked increase in the use of expensive broad spectrum antimicrobials.  It is not unusual for the purchase cost in 1995 of a newer parenteral antibiotic to be $1,000 to $2,000 for a 10 to 14 day course of treatment.  Therapy with a new oral antibiotic can easily cost $50 to $60.  The cost of an office visit to get a prescription, administrative costs, monitoring costs and pharmacy charges must be added to these figures for a start-up fee for an as needed refillable prescription of around $150 dollars (Fauci et al ’98: 869). 


Table 1: Bacterial Infections 2006




Usual Antibiotic


Actinomyces israelii

Actinomycosis, lumpy jaw disease, abscesses


An anaerobic infection

Arcanobacterium haemolyticum



Rash similar to scarlet fever

Bacillus anthracis


Penicillin, ciprofloxacin, doxycycline

Rate in nature; was used as a bioterrorism weapon

Bacillus cereus


Supportive care

Food borne

Bacteroides species



Anaerobes; part of normal flora of the bowel

Bartonella henselae

Cat-scratch disease

None or azithromycin

Kittens are the usual transmitters

Bordetella pertussis

Whooping cough

Erythromycin, azithromycin

Infection can be prevented by immunization

Borrelia burgdorferi

Lyme disease

Doxycycline, amoxicillin, ceftriaxone

Transmitted by ticks

Borrelia recurrentis

Relapsing fever


Transmitted by body live and ticks

Brucella species: abortus, melitensis, suis, canis

Brucellosis: flu-like symptoms


Rare in the United States; acquired by animal contract or drinking unpasteurized milk

Burkholderia cepacia



Causes illness in people with cystic fibrosis or chronic granulomatous disease

Campylobacter species: fetus, jejuni, coli



Transmitted by food and animals

Chlamydia psittaci

Psittacocis (pneumonia)


Acquired from birds

Chlamydia trachomatis

Genital tract infection, newborn conjunctivitis, infant pneumonia, trachoma

Erythromycin, doxycycline

Sexually transmitted infection; newborns are infected during birth; trachoma rare in the United States

Clostridium botulinum


Supportive care; antitoxin or antibody

Food-borne and infant botulism

Clostridium difficile


Stop antibiotics, metronidazole

Occurs in people who have been on anti-biotics

Clostridium perfringens

Food poisoning, diarrhea

Supportive care

Food-borne infection

Clostridium species: perfringens, sordellii, septicum, novyi

Gas gangrene

Surgery, penicillin

Anaerobic bacteria; uncommon infection of muscles

Clostridium tetanus


Antitoxin, metronidazole

Rare in United States because of immunization

Corynebacterium diphtherieae


Antitoxin, erythromycin

Rare in the United States because of immunization

Escherichia coli

Sepsis, meningitis, urinary tract infection, diarrhea, others

Depends on the site of infection

Can be part of normal flora of the bowel

Francisella tularensis



Transmitted by fleas or ticks or contact with infected wild animals

Haemophilus ducreyi



Sexually transmitted ulcer disease; unusual in the United States

Haemophilus influenza nontypeable

Otitis media (ear infection)

Amoxicillin clavulanate

Not all ear infections require antibacterial therapy

Haemophilus influenza type b

Meningitis, epiglottis, arthritis, pneumonia


Now rare because of immunization

Helicobacter pylori


Combinations: amoxicillin, tetracycline, metronidazole, clarithromycin

Persistent infection increase the risk for cancer

Kingella kingae

Joint and bone infections


Not very common

Legionella pneumophila

Legionnaries disease (pneumonia)


Rare in children

Leptospira species

Leptospirosis: fever, rash, flu-like illness, organs

Penicillin, doxycycline

Acquired through contact with dog or wild animal urine

Listeria monocytogenes

Sepsis, meningitis


Occurs in pregnant women, newborns, and children with immune problems

Moraxella catarrhalis

Otitis media, sinusitis

Ampicillin clavulanate

Not all infections require antibacterial therapy

Mycobacterium leprae



Rare in the United States

Mycobacerium tuberculosis


Combinations: isoniazid, pyrazinamide, rifampin ethambutol

Most infected people have no symptoms; one third of the world’ population is infected

Mycoplasma pneumoniae

Bronchitis, walking pneumonia

Doxycycline, erythromycin

Common cause of pneumonia in school-aged children

Neisseria gonorrhoeae

Gonorrhea, newborn eye infection, join infection

Ceftriaxone, cefixime

Sexually transmitted infection; newborns can acquire it during birth

Nocardia species

Pneumonia, skin

Trimethoprim sulfamethoxazole

Serious infection; usually in children with weakened immunity

Nontuberculous mycobacteria: Mycobacterium fortuitum, kansasii, marinum, avium-intracellulare

Lymph glands in the neck, pneumonia, blood

Surgery; antibiotic depends on the organism and infection

Lymph node infections in toddlers; invasive infections in children with weakened immunity

Pasteurella multocida

Bite wound infection


Common in cats and dogs

Prevotella species

Abscesss (dental and lung)


Anaerobic; part of normal flora of the mouth

Salmonella species

Diarrhea, bone, joint, kidney, meningitis

None for diarrhea; depends on site for other infections

Acquired by contact with animals or contaminated foods

Shigella species: sonnei, flexmero. Boydii. dysenteriae


None, trimethoprim sulfamethoxazole, others

Food borne or contact with infected person

Staphylococcus aureus

Diarrhea, skin, pneumonia, joint, bone, heart

Nafcillin, vancomycin; depends on susceptibilities

Becoming more and more resistant to usual antibiotics

Steptobacillus agalactiae (group B streptococcus)

Meningitis, sepsis, pneumonia, skin, urinary tract infection


Serious in babies in pregnant women, endocarditis in susceptible adults

Streptococcus pneumoniae

Pneumonia, otitis media (ear infection), joint infection, meningitis

Penicillin, ceftriaxone, cefotaxime

Most serious infection (85%) prevented by immunization

Streptococcus pyrogenes (group A streptococcus)

Pharyngitis, skin, pneumonia, joint


Rheumatic fever, rheumatic heart disease, and glomerulonephritis can follow an infection after a week

Treponema pallidum



Sexually transmitted disease; can affect the fetus

Ureaplasma urealyticum



Sexually transmitted disease

Vibrio cholerae


Fluids, doxycycline

A risk for travelers

Yersinia enterocolitica


Trimethprim sulfamethoxazole

Food borne from pork, especially chitterlings

Yersinia pestis



Rare in the United States; transmitted by rodent fleas

Source: Fisher ’06 Immunizations and Infectious Diseases pgs. 330 - 334


Numerous surveys have reported that approximately 50 percent of antibiotic use is in some way “inappropriate”.  Aside from the monetary cost of unnecessary antibiotics, that would be much less if organic broad spectrum antibiotics were sold Over-the-counter, there is the 1-4% risk contracting recurrent Pseudo-membranous colitis and the excess costs of treating more resistant organisms (Fauci et al ’98: 869).  In the 1970s the CDC’s extensive Study on the Efficacy of Nosocomial Infection Control found that nosocomial infection rates fell by 32 percent in hospitals that established programs with organized surveillance and control activities, a trained, effectual infection-control physician, and one infection-control practitioner per 250 beds.  In contrast, rates in hospitals without effective programs increased by 18 percent (Fauci et al ’98: 849). The most common side effect of antibacterial agents are an increase in the prevalence of naturally occurring antibiotic resistant C. difficile, which can cause recurrent Pseudo-membranous colitis but is reluctantly treatable with metronidazole (Fisher ’06: 328, Cotran et al ’94: 795).   Nearly 4% of the population were allergic to the original penicillin, but that rate has gone down to 1%.


Physicians need to be generous with the refillable prescriptions of broad spectrum antibiotics and antibacterial agents when treating infectious diseases so their patients can give the effective antibacterial chemotherapy to the people they infect, sparing them the cost of the doctor’s visit and incidental unnecessary exposure to Western medicine.  Antibacterial agents, like all antimicrobial drugs are directed against unique targets not present in mammalian cells.  The goal is to limit toxicity to the host and maximize chemotherapeutic activity affecting invading microbes only.  There are a number of mechanisms of antimicrobial action – inhibition of cell-wall synthesis, inhibition of protein synthesis, inhibition of bacterial metabolism, inhibition of nucleic acid synthesis or activity and the alteration of cell-membrane permeability.  The term antibacterial agent refers to all natural, synthetic and semi-synthetic compounds that kill bacteria or inhibit their growth.  The term antibiotic is reserved for those compounds produced by living organisms (Fauci et al ’98: 856).  Used appropriately these drugs are lifesaving.  However, their indiscriminate use drives up the costs of health, leads to a plethora of side effects and drug interactions, and fosters the emergence of bacterial resistance, rendering previously valuable drugs useless.  The rational use of antibacterial agents is dependent on an understanding of their mechanisms of action, pharmacokinetics. Toxicities and interactions, bacterial strategies for resistance, and bacterial susceptibility in-vitro.  In addition patient-associated parameters, such as the site of infection and the immune and the excretory status of the host, are critically important to appropriate therapeutic decisions (Fauci et al ’98: 856). 


3.      Antibiotic resistance


Antimicobial agents are able to target bacterial cells but not human cells by a number of different mechanisms.  Some microbes are resistant or have evolved resistance to all or specific antibiotics.  One major difference between bacterial and mammalian cells is the presence in bacterial cells of a rigid wall external to the cell membrane.  The structure conferring cell-wall rigidity and resistance to osmnotic lysis in both gram-positive and gram-negative bacteria is peptidoglycan, a large, covalently linked sacculus that surrounds the bacterium.  Chemotherapeutic agents directed at any stage of the synthesis, export, assembly or cross-linking of peptidoglycan lead to inhibition of bacterial cell growth and, in most case, to cell death. β-Lactam antibiotics, penicillins, cephalosporins, carbapenems and monobactams are characterized by a four membered β-lactam ring, prevent the cross-linking reaction called transpeptidation.  The β-lactam ring of the antibiotic forms an irreversible covalent acyl bond with the transpeptide, known as the penicillin-binding-proteins, preventing the cross-linking reaction.  Virtually all the antibiotics that inhibit bacterial cell-wall synthesis are bacteriocidal and eventually result in the cell’s death (Fauci et al ’98: 859).  Bacitracin is a cyclic peptide antibiotic that inhibits the conversion of the lipid carrier to its active form that moves the water soluble cyto-plasmic peptidoglycan subunits through the cell membrane to the cell exterior.  Glycopeptides such as vancomycin and teicoplanin, are high molecular weight antibiotics that bind to the terminal D-alanine-D-alanine component of the stem peptide while the subunits are external to the cell membrane but still linked to the lipid carrier, thus inhibiting peptidoglycan backbone (Fauci ’98: 856). 


Table 2: Mechanisms of Action of Resistance to Major Classes of Antibacterial Agents


Antibacterial Agent

Major Cellular Target

Mechanisms of Action

Major Mechanisms of Resistance

Β-Lactams (penicillins and cephalosporins)

Cell wall

Inhibit cell-wall cross-linking

1.Drug inactivation β-lactamase

2. Insensitivity of target (altered penicillin-binding proteins)

3.Decreased permeability (altered gram-negative out-membrane porins)


Cell wall

Interferes with the addition of new cell-wall subunits (muramyl pentapeptides)

Alteration of target (substitution of terminal amino acid of peptidoglycan subunit)


Cell wall

Prevents addition of cell-wall subunits by inhibiting recycling of membrane lipid carrier

Not defined

Macrolides (erythromycin)

Protein synthesis

Bind to 50S ribosomal unit

1.Alteration of target (ribosomal methylation

2.Drug interaction

3.Decreased intracellular drug accumulation (active efflux)

Lincosamides (clindamycin)

Protein synthesis

Bind to 50S ribosomal unit

Alteration of target (ribosomal methylation)


Protein synthesis

Binds to 50S ribosomal unit

Drug inactivation (chloramphenicol acetyltransferase)


Protein synthesis

Bind to 30S ribosomal subunit

1.Decreased intracellular drug accumulation (active efflux)

2.Insensitivity of target

Aminoglycosides (gentamicin)

Protein synthesis

Bind to 30S ribosomal subunit

Drug inactivation (aminoglycoside-modifying enzyme)


Protein synthesis

Inhibits isoleucine tRNA synthetase

Insensitivity of target (mutation of target gene or acquisition of gene for new, insensitive enzyme)

Sulfonamides and trimethoprim

Cell metabolism

Competitively inhibit enzymes involved in two steps of folic acid biosynthesis

Production of insensitive targets (dihydropteroic acid [sulfonamides] and dihydrofolic acid [trimethoprim] that bypass metabolic block


DNA synthesis

Inhibits DNA dependent RNA polymerase

Insensitivity of target (mutation of polymerase gene)


DNA synthesis

Intracellularly generates short-lived reactive intermediates by electron transfer system

Not defined

Quinolones (ciprofloxacin)

DNA synthesis

Inhibit DNA gyrase (A subunit)

1.Insensitivity of target (mutation of gyrase genes)

2. Decreased intracellular drug accumulation (active efflux)


DNA synthesis

Inhibits DNA gyrase (B subunit)

Not defined


Cell membrane

Disrupt membrane permeability by charge alteration

Not defined


Cell membrane

Forms pores

Not defined

Source: Fauci, et al. Harrison’s Principles of Internal Medicine. 14th Edition. 1998. Table 140-1. Pg. 857


Most of the antibacterial agents that inhibit protein synthesis interact with the bacterial ribosome.  The difference between the composition of bacterial and mammalian ribosomes gives these compounds their selectivity.  Aminoglycosides, such as gentamicin, kanamycin, tobramycin, streptomycin, netilmycin and amikacin, are a group of structurally related compounds containing three linked hexose sugars.  They exert a bactericidal effect by binding irreversibly to the 30S subunit of the bacterial ribosome and blocking initiation of protein synthesis. Spectinosmycin an aminocyclitol antibiotic, also acts on the 30S ribosomal subunit but has a different mechanism of action from the aminoglycosides and is bacteriostatic rather than bactericidal.  Macrolides, such as erythromycin, clarithromycin, and axithromycin, are antibiotics that consist of a large lactone ring to which sugars are attacked.  They bind specifically to the 50S portion of the bacterial ribosome.  After attachment of mRNA to the initiation site of the 50S subunit becomes bound to the 30S component to form the 70S ribosomal complex, and protein chain elongation proceeds, thereby inhibiting protein chain elongation (Fauci et al ’98: 859). 


Lincosamides, such as clindamycin and lincomycin, although structurally unrelated to macrolides, bind to a site on the 50S ribosome nearly identical to the binding site for macrolides, the number and types of bacteria against which these two groups of agents are active differ.  Chloramphenicaol, a small antibiotic with a single aromatic ring and short side chain, binds reversibly to the 50S portion of bacterial ribosome at a site close to but not identical with that of macrolides or lincosamides, and inhibits peptide bond formation.  Tetracycline, doxycycline and minocycline, consist of four aromatic rings with various substituent groups, which interact reversibly with the bacterial 30S ribosomal subunit, blocking the binding of aminoacyl tRNA to the mRNA-ribosome complex, but this mechanism is markedly different from that of the aminoglycosides.  Mupirocin, pseudomonic acid, is produced by the bacterium Pseudomonas Fluorescens and its mechanism of action is unique in that it inhibits the enzyme isoleucine tRNA synthetase by competing with bacterial isoleucine for its binding site on the enzyme that is unique to bacteria (Fauci et al ’98: 858). 


The inhibition of bacterial metabolism is caused by antimetabolites that are synthetic compounds that interfere with the synthesis of folic acid.  Products of the folic acid synthesis pathway function as coenzymes for the one-carbon transfer reaction that are essential for the synthesis of thymidine, all purines and several amino acids, inhibition of folate synthesis leads to cessation of cell growth and, in some case, bacterial death.  The principal antimetabolites are sulfonamides, such as sulfisoxazole, sulfadiazine, and sulfamethoxazole, and trimethoprim.  Sulfonamides are structural analogues of p-aminobenzoic acid (PABA), one of the three structural components of folic acid, the other two being pteridine and glutamate, the sulfonamides compete with PABA as substrates for the enzyme.  Trimethoprim is a diaminopyrimidine, a structural analogue of the pteridine moiety of folic acid.  It is a competitive inhibitor of the dihydrofolate reductase, the enzyme responsible for reduction of dihydrofolic acid to tetrahydrofolic acid.  


4.      The Probiotic Microbiome


Anti-biotic associated colitis, Pseudomembranous colitis, is an acute colitis characterized by the formation of an adherent inflammatory pseudomembrane overlying sites of mucosal injury.  It is usually caused by toxins of Clostridium difficile, a normal gut commensal.  This disease occurs most often in patients without a background of chronic enteric disease, following a course of broad spectrum anti-biotic therapy.  Nearly all bacterial agents have been implicated.  Presumably toxin-forming strains flourish following alteration of the normal intestinal flora, the factors favoring the initiation of toxin production are not understood.  The condition may rarely appear in the absence of antibiotic therapy, typically after surgery of superimposed on a chronic debilitating illness.  Infrequently the small intestine is involved. Antibiotic associated colitis occurs primarily in adults as an acute of chronic diarrheal illness, although it has been recorded as a spontaneous infection in young adults without predisposing influences.  Diagnosis is confirmed by the detection of the C. difficile cytotoxin in stool.  Response to treatment is usually prompt, but relapse occurs in up to 25% of patients (Cotran et al ’94: 795)


The morphology of the pseudomembranous colitis derives its name from the plaque-like adhesion of fibrinopurulent-necrotic debris and mucus to damaged colonic mucosa, these are not true “membranes” because the coagulum is not an epithelial layer.  Pseudomembrance formation is not restricted to C. difficile induced colitis, it also may occur following any severe mucosal injury, as in ischemic colitis, volvulus, and with necrotizing infections (staphylococci, shigella, candida, necrotizing enterocolitis).  What is striking about C. difficile toxin induced colitis is the microscopic lesion.  The surface epithelium is denuded, and the superficial lamina propria contains a dense infiltrate of neturophilis and occasional capillary fibrin thrombi.  Superficially damaged crypts are distended by a mucopurulent exudate, which erupts out of the crypt to form a mushrooming cloud that adheres to the damaged surface, the coalescence of this cloud forms the pseudomembrane (Cotran et al ’94: 795).


One common sense procedure that many people with auto-immune disorders of the gut, particularly antibiotic associated colitis that is not treatable by antibiotics, might benefit from is fecal transplant, otherwise known as bacteriotherapy.  More than 15 fecal transplants have been performed, 13 of which cured their patients.  It is a harmless procedure that one might be able to perform at home with a healthy loved one, but neither modern or traditional medicine perform it.  In 2008, Khoruts, a gastroenterologist at the University of Minnesota, took on a patient suffering from a vicious gut infection of Clostridium difficile. She was crippled by constant diarrhea, which had left her in a wheelchair wearing diapers. Khoruts treated her with an assortment of antibiotics, but nothing could stop the bacteria. His patient was wasting away, losing 60 pounds over the course of eight months. Khoruts decided his patient needed a transplant. But he didn’t give her a piece of someone else’s intestines, or a stomach, or any other organ. Instead, he gave her some of her husband’s bacteria. Khoruts mixed a small sample of her husband’s stool with saline solution and delivered it into her colon. Writing in the ‘Journal of Clinical Gastroenterology’, Khoruts and his colleagues reported that her diarrhea vanished in a day. Her Clostridium difficile infection disappeared as well and has not returned since.  The procedure, known as bacteriotherapy or fecal transplantation, had been carried out a few times over the past few decades.


Assisted by information and technology of the Human Genome Project Khoruts and his colleagues were able to do something previous doctors could not: They took a genetic survey of the bacteria in her intestines before and after the transplant. Before the transplant, they found, her gut flora was in a desperate state. “The normal bacteria just didn’t exist in her,” said Khoruts. “She was colonised by all sorts of misfits.” Two weeks after the transplant, the scientists analysed the microbes again. Her husband’s microbes had taken over. “That community was able to function and cure her disease in a matter of days,” said Janet Jansson, a microbial ecologist at Lawrence Berkeley National Laboratory and a co-author of the paper. “I didn’t expect it to work. The project blew me away” (Zimmer ’08).  The human microbiome has not yet been fully surveyed, let alone incorporated into standard medical practice, but the Human Microbiome Project holds far greater potential for curing diseases than the Human Genome Project, whereas 75% of the immune system occurs in the gut and micriobiomes help to digest all nutrients so they may be absorbed into the body.  The Human Microbiome Project is even more laborious than the Human Genome Project.  After studying 178 distinct genome sequences 29,693 genes that are unlike any of the 20,000 human protein-coding genes identified in the Human Microbiome Project that faces complications extracting unmutated bacteria from all locations deep within its living hosts (Zimmer ’08). The Microbiome Project already offers a promising and harmless bacteriotherapy of fecal transplant that might cure even antibiotic resistant auto-immune diseases at little or no cost (Cotran et al ’94: 306).  The digestive system is reputed to be 75% of the immune system.


For bacterial infections originating in the gut garlic is a natural antibiotic, while live culture acidophilus yoghurt is a natural pro-biotic.  Proteins, such as milk, meat, beans and chilies are however likely to foster enterococcal infections in endocarditis and should be avoided.  Bacterial infections of the lung, such as Steptococcus pyrogenes and Bordetella pertussis are highly contagious, spread by cough droplets, and can live in fabrics for lengthy periods of time, and spread from a shirt to couch, but can be washed in hot water or with antimicrobial detergent, unlike plaque causing chemical dyes.  The sometimes undetectable infection of the lung often triggers rheumatic pains in other parts of the body.  Protein, inactivity, and sedentary employment aggravate rheumatic conditions greatly.  Vigorous sustained exercise is needed.  All day hiking and camping in a tent, with clean clothes and sleeping bag, tends to eliminate Streptococcus but not Pertussis. If Pertussis is not treated with antibiotics while a runny nose, barely distinguishable from a common viral cold, descends into the lungs as a whooping cough for six weeks, and is possibly deadly to newborns and small children unvaccinated with routine DTaP (Diptheria and Pertussis) vaccine routinely administered at the ages of 2, 4 and 6 months again at 15 to 18 months, 4 to 6 years and at specified intervals for DTP, DTaP and tdap generations of vaccines, thereafter (Fisher ’06:24). 


Both Group A and B Streptococcus cause rheumatic heart disease in auto-immune heart patients, Group A that causes strep throat in young adults, waits a week after all nasal symptoms stop, while Group B that is dangerous to children and pregnant mothers causes a more instant rheumatic infection.  Both interact with a resurgence of the underlying enterococcal infections that cause endocarditis. Toxic shock syndrome may result from the mixture of Staphylococcus aureau, a leading cause of food poisoning that occurs in the skin, and Streptococcus pyogenes (Group A), so shower frequently, wash your hands and your vegetables carefully and exercise.  Garlic is a natural antibiotic, avoid protein, beans, chilies, milk and meats that take from 1 to 3 weeks to digest while vegan fare is excreted in one day and fish in 3. Antibiotics have greatly helped to bring the mortality rate of rheumatic heart disease down in to the United States from 20.6 per 100,000 in 1940 to 2.2 in 1982 (Cotran et al ’94: 547).  Auto-immune heart patients are susceptible to bacterial infections that leave residue called “vegetations”.  They must be kept on a strictly vegan diet, with lots of exercise and no beans, potatoes or chilies, until the “vegetation” undergoes cellular death, decomposes and is washed away.  All auto-immune patients should possess a refillable prescription for a low cost course of broad spectrum antibiotic like penicillin, ampicillin or erythromycin or metronidazole for bacterial infections complicated by antibiotic associated colitis (Fisher ’06: 328-329).  If there is any good reason that these antibiotics should not be sold Over-the-counter let them be explained on the package for the consumer to make an educated purchase, wait at least a week between courses if there is recurrent bacterial infection and stop if they develop a rash, fever, colitis, or sense a pseudomembrane in their colon (Cotran et al ’94: 795).


This course on antibiotics has challenged no less than 15 hours of vestigial post-Internet medical transcription from pathology, internal and family medicine textbooks, gained a better understanding of the microbial spectrum and is fair trade for a refillable prescription for a low cost generic refillable prescription for any organic broad spectrum penicillin or analogue in stock.  I pray this petition is as inspiring of your respect of Western medicine as it was for mine.  Maybe the Primary Care Physicians of the Community Health Center will accept this copyright in trade for a prescription for penicillin.  Hospitals & Asylums is down to two erythromycin, recommended for pertussis.  My Streptococci and Enterococci demand for penicillin is nearly as urgent and more easily fulfilled than Haiti’s Vibrio cholerae is for doxycycline (Fisher ’06: 364).  My aim is true and the Community Health Center might not only have a responsibility to supply the family members of their vaccinated and highly exposed workers with antibiotics but might purchase this copyright in trade for a prescription for penicillin to allow their ad hoc ethical review board (ERB) to petition the FDA for Over-the-counter antibiotics for everyone.  No Hospital can suffer a bacterial infection to live or the healing environment would be ruined for everyone. Nor, as this viability study has proven, is it acceptable for a West Coast health institution to pose as an Ethics Committee when an Ethical Review Board (ERB) better describes the politics. Please restock Hospitals & Asylums with safe, low cost, highly effective, generic broad spectrum organic antibiotics, to cure a vegan. 




Cotran, Ramzi S.; Kumar, Vinay; Robbins, Stanley.  Robbins Pathologic Basis of Disease.  5th Edition. Edited by Frederich J. Schoen.  W.B. Saunders Company. A Division of Harcourt Brace & Company. Philadelphia, Pennsylvania. 1994


Doe et al v. Reed, Washington Secretary of State No. 09-559 argued by the U.S. Supreme Court April 28, 2010 and decided June 24, 2010


Fauci, Anthony S.; Braunwald, Eugene; Isselbacker, Kurt J.; Wilson, Jean D.; Martin, Joseph B.; Kasper, Dennis L.; Hauser, Stephen L.; Logo, Dan L. Harrison’s Principles of Internal Medicine. 14th Edition. McGraw-Hill Health Professions Division. San Francisco. 1998


Fisher, Margaret C. Immunizations and Infectious Diseases: An Informed Parent’s Guide. American Academy of Pediatrics. 2006


Food and Drug Administration. Over the Counter (OTC) Human Drugs which are Generally Recognized as Safe and Effective and Not Misbranded. Procedures for classifying OTC drugs as generally recognized

as safe and effective and not misbranded, and for establishing monographs. 21CFR§330.10


Morone, James A.; Jacobs, Lawrence. Healthy, Wealthy and Fair: Health Care and the Good Society. Oxford University Press. New York. 2005


Omnibus Budget Reconciliation Act of 1990 P.L.101-508


Patient Protection and Affordable Care Act. P.L. 111-148. July 2010


Sammos, Rivka A. MD. Epidemiologic Preponderence of 90 Day Pertussis Symptoms.  Hospitals & Asylums. October 13, 2010


Sanders, Tony J. Medical Ethics Committee Viability Study: A Bill for 24 Hours Reading and Writing. Hospitals & Asylums. HA-15-10-10


Sanders, Tony J. Rolling Back the Tobacco Tax Act of 2009/ Hospitals & Asylums. HA-10-10-10


Sanders, Tony J. The Case for Trashing Treason (Vegetable Garden Trampling Omitted). Hospitals & Asylums. HA-12-7-10


Scelza. Sharon M. Ulcerative Colitis and Fatigue: Is Fatigue Manageable. Hospitals & Asylums HA-20-4-09


Smith, Wesley J. Culture of Death: The Assault on Medical Ethics in America. Encounter Books. San Francisco. 2000


Zimmer, Carl. Bacteriotherapy a new wonder treatment for antibiotic associated colitis. New York Times. Deccan Herald reprint. 2008