. Krista, Mark, Steve A group of multinational corporations produce consumer
products for a variety of retail outlets. The product lines
are diverse and different brand names are used to create and
maintain brand loyalty among consumers. Although marketed
separately, the companies have created a particular line of
such products which all contain specific ingredients which
adversely affect the ecosystem. (There is no question in the
scientific or medical community that there is strong
evidence to support this). Questions have been raised in the scientific community in
recent years about the prudence of the continued public use
of these products, but the availability and prevalence of
these products has only increased. In fact, the dangerous
ingredients have been incorporated into even more
products. The companies use advertising techniques that prey on
consumers' fears and tend to send the message that using
these products will ameliorate a particular "deleterious"
condition. There is an increasing consumer demand for these
products. Key issues and Values: b. Benefit vs. risk, consumer education c. Freedom in business practices d. Public Welfare Who should be in charge of the decision-making processes
required to solve this problem? How should the process
proceed? Case Studies: A young mom drives to the store to pick-up a few items
for dinner. On her way through the detergent aisle, she
remembers to buy hand soap. After perusing a variety of
products, she finally decides to buy the brand that promises
"antimicrobial disinfection." She used to think that all
soaps killed germs, but TV commercials claiming that
"antimicrobial" products worked better than regular soap
swayed her choice. Even though the antimicrobial soap is a
little more expensive, it seems to be a good value if it
will eliminate more of the germs. References: 1. Antibiotic resource site: http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/A/Antibiotics.html 2. Antibiotic
resistance and its effect on persons living with
HIV/AIDS. KeepAntibioticsWorking.com 2. Gilbert DN, Kohlhepp SJ, Slama KA, Grunkemeier
G, Lewis G, Dworkin RJ, Slaughter SE, and Leggett JE, 2001.
Phynotypic
resistantce of Staphylococcus aureus, selected
Enterobacteriaceae, and Pseumonas aeruginosa
after single and multiple in vitro exposures to
ciprofloxacin, levofloxacin and trovafloxacin.
Antimicrob Agents & Chemother, 45(3):883-892. 3. Bakker-Woudenburg IAJM, ten Kate MT, Guo L,
Working P and Mouton JW, 2002. Ciprofloxiacin
in polyethylene glycol-coated liposomes: efficacy in rat
models of acute or chronic Pseudomonas aeruginosa
infection. Antimicrob Agents & Chemother,
46(8):2575-2581. 4. Tuberculosis antibiotics: http://www.brunel.ac.uk/depts/bl/project/biocomp/bentley/Tuberculosis%20antibiotics.htm ..
Background:
a. Regulatory issues involving product
availability (to whom, when).
An eight-yearr old presents in the ER with a temperature of
105°F. After a brief examination, the doctor quickly
determines that the patient is suffering from a seasonal
flu. Although he knows that antibiotics are ineffective
against viral infections, he also knows that the parents
expected him to prescribe medication. He ultimately
prescribes a 10 day course of the antibiotic penicillin.
A 40 year-old female AIDS patient is brought to the
emergency room by relatives. She has been HIV positive for
over 10 years and takes a daily cocktail of protease
inhibitors to combat the virus. She has a very low viral
load and tries to avoid contracting infections as much as
possible. On intake, she reports coughing for more than 3
weeks, weight loss, fatigue, night sweats, and fevers. She
does not smoke. After a positive skin test, a chest x-ray
and a culture from the patient's sputum reveal the doctor's
suspicions: the patient has an acute infection of
Mycobacterium tuberculosis [TB]. During a six
month regimen of ciprofloxacin and ethionamide the patient's
condition worsened. The doctor must continue the treatment
and the patient is treated for three more months with
several other antibiotic cocktails. In spite of the doctor's
attempts to formulate more potent cocktails and regimens,
the patient dies a few weeks later.
Updated 3/16/03 by thatcher@sonoma.edu