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Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them Hardcover – September 22, 2009

ISBN-13: 978-1591027508 ISBN-10: 1591027500 Edition: 1st

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Product Details

  • Hardcover: 264 pages
  • Publisher: Prometheus Books; 1 edition (September 22, 2009)
  • Language: English
  • ISBN-10: 1591027500
  • ISBN-13: 978-1591027508
  • Product Dimensions: 6.2 x 0.8 x 9.3 inches
  • Shipping Weight: 1.2 pounds (View shipping rates and policies)
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (19 customer reviews)
  • Amazon Best Sellers Rank: #316,831 in Books (See Top 100 in Books)

Editorial Reviews


As seen on The Doctors, PBS Frontline, and Katie!

"Clear and concise, with a good mix of dramatic (and, at times, tragic) examples and hard statistics.... The book ends with an admonition to take the threat of drug-resistant bacteria seriously; when you’ve finished reading, you’ll find it impossible to disagree.” 
-San Francisco Book Review 

“This readable, well-written volume will resonate with a diverse audience, It provides an excellent review of the problems associated with antibiotic resistance, explains the causes, and recommends solutions to encourage discovery and development of new antibiotics. Highly recommended.”

"Avoiding medical jargon, this fast-paced call to action should be read by anyone concerned about our medical future. Highly recommended.”
-Library Journal 

About the Author

Brad Spellberg, MD (Los Angeles, CA) is associate professor of medicine at the David Geffen School of Medicine at UCLA and is based in the Divisions of General Internal Medicine and Infectious Diseases at the Los Angeles Biomedical Research Institute and Harbor-UCLA Medical Center. He was featured on an Emmy award-winning episode of NOVA called "Rise of the Superbugs." He is the author (with Carlos Ayala, MD) of the popular Boards and Wards series of medical review books.

More About the Author

Dr. Spellberg is an Associate Professor of Medicine at the David Geffen School of Medicine at UCLA and the Harbor-UCLA Medical Center. He received his BA in Molecular Cell Biology-Immunology in 1994 from UC Berkeley. He then attended medical school at the Geffen School of Medicine at UCLA, where he received numerous academic honors, including serving as the UCLA AOA Chapter Co-President, and winning the prestigious Stafford Warren award for the topic academic performance in his graduating class. Dr. Spellberg completed his Residency in Internal Medicine and subspecialty fellowship in Infectious Diseases at Harbor-UCLA Medical Center, where he received the Department of Medicine Subspecialty Fellow of the Year award.

In addition to his patient care, teaching, and administrative responsibilities, Dr. Spellberg is an NIH-funded scientific investigator, whose research focuses on using the immune system to prevent and/or treat infections. He has worked to develop a vaccine that targets the bacterium Staphylococcus aureus and the fungus Candida, which are the second and third most common causes of bloodstream infections. The vaccine is now entering clinical trials. Dr. Spellberg is also developing genetically engineered white blood cells that recapitulate neutrophil functions and can be used to overcome the technical barriers to neutrophil transfusion therapy for neutropenic infections. Most recently, Dr. Spellberg's laboratory has begun focusing on the immunology of Acinetobacter infections, including attempting to define a vaccine for this bacterium. He also is a scientific adviser for Zimek Technologies, which has exciting technology to improve disinfection of hospital rooms.

Dr. Spellberg established the first auditable, peer-reviewed dataset that confirms the decline in new antibiotic development over the last two decades, underscoring the need for development of new immune-based therapies for infections. He has worked with staff members at the Infectious Diseases Society of America (IDSA) to attempt to bring attention to the problems of increasing drug resistance and decreasing new antibiotics. His dataset regarding new drug development has been a cornerstone of the IDSA's white paper, Bad Bugs, No Drugs, and has been cited extensively in medical literature and on capital hill. He is a Fellow in the IDSA and joined the IDSA's Antimicrobial Availability Task Force (AATF) to continue working on this critical problem. As a member of the AATF, he has first-authored consensus IDSA position papers on the appropriate clinical trial designs for infectious diseases.

Dr. Spellberg is the author of Rising Plague, which he wrote to inform and educate the public about the crisis in antibiotic resistant infections and lack of antibiotic development. He is also the author (along with Carlos Ayala) of the popular Boards and Wards series of medical review books.

Customer Reviews

It is deeply moving, interesting, and scary all at one time.
Catherine Michaels
I was afraid that maybe this book will be to hard to understand but I was very surprise that it was so easy to read and understand.
Sandra M. Dry
Part of the problem lies in misuse of the drugs, in ways that very nearly ensure the rise of resistant bacteria.

Most Helpful Customer Reviews

12 of 13 people found the following review helpful By wiredweird HALL OF FAMETOP 1000 REVIEWER on December 22, 2009
Format: Hardcover
My parents lived in the time when antibiotics won out over bacterial infection. My very real fear is that they will live to see bacteria win again. Dr. Spellberg describes what that time was like, when capricious infections would strike at healthy adults and cripple or kill them in just a few days. More to the point, he describes what this time is like, when he sees drug-resistant infections doing the same, now, even in the most advanced of western hospitals.

Antibiotic resistance follows inevitably from antibiotic use. Every time a new antibiotic appears, billions of bacteria take on the evolutionary problem of dealing with it. Sooner or later, somewhere, one does - and that's all it takes. That one's progeny thrive in the presence of that drug, to the exclusion of all others. Spellberg omits, almost completely, a technical point that makes the problem even worse, though. "Horizontal gene transfer" means that one bacterium can pass its resistance on to others, not just its descendants, and not just within its bacterial species. In particular, one resistant bug can pass resistance on to a bug already resistant to something else, creating a superbug with multi-drug resistance. In rare cases, some pathogen resists all known medications. That's when the infectious disease specialist has to say something that hasn't been said since the dawn of the antibiotic era, "We've tried everything. There is nothing left to try."

Acquired resistance is not just a problem. It must be considered a basic fact of life. All the best policy in the world regarding hand-washing, infection control, and the rest can not change that fact. Instead, the problem must be addressed on the human side, by coming up with new drugs and new ways of using them.
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9 of 10 people found the following review helpful By Robert C. Ladendorf on September 9, 2009
Format: Hardcover
As a fan of TV's medical drama "House," I've been amazed at the range of diseases and adverse medical conditions of humans, as well as the swiftness of their effects, but I wasn't prepared for the alarming descriptions by Dr. Brad Spellberg in his engrossing book Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them about antibiotic-resistant bacteria and the scary increase in infections and deaths because new antibiotics aren't being developed. If this book doesn't send a chill up your spine, you're probably spineless.

But Spellberg is at the same time hopeful that we can turn things around, and I think his book will be that alarm bell calling attention to this problem. What's more, his moving descriptions of those helped by antibiotics throughout the years, such as the four-year-old girl near death from a staph infection (with photos of her before and after the infection), remind all of us not to be complacent about the future.

I had the privilege of hearing a compelling talk he gave at the Center for Inquiry-L.A. about his book, and readers interested in understanding how antibiotics work on bacteria, which are examples of how fast evolution works, and how to combat this rising plague should not miss this book.
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29 of 39 people found the following review helpful By Richard Reese (author of Sustainable or Bust) on June 4, 2010
Format: Hardcover
Rising Plague was written by Brad Spellberg, MD, a professor of medicine at UCLA. It's about the rise in drug-resistant microbes, and the fact that the drug industry has waning interest in developing new antibiotics. Where he explains the problem, the book is great, as far as it goes. He is good at discussing highly complex subjects in an understandable manner. I learned a lot.

But the important subject of antibiotic use in animals is discussed in just two sentences. In fact, 70% of antibiotics are given to livestock, poultry, fish, shellfish, and pets. He doesn't mention that excrement contains active antibiotics. Plants absorb active antibiotics when the soil is treated with manure. Antibiotics are accumulating in groundwater. Every day, we are receiving small doses of active antibiotics in our water, milk, meat, vegetables, fruit. Some antibiotic molecules are remarkably stable, and can remain active even after being cooked at 273 degrees Fahrenheit. He does not mention these issues.

This daily low-dose exposure certainly hastens the development of drug-resistant microbes. Antibiotics make animals grow faster and larger, so they are very popular among producers of industrial meat. Eliminating or sharply reducing antibiotic use on animals is not mentioned in the book. The meat industry has vast political power. If we ignore the animal issue, then it makes no sense to spend billions to develop new antibiotics.

Spellberg devotes a single paragraph to the notion that, in the world of antibiotic research, the low-hanging fruit has already been picked. Developing new antibiotics is going to be far more difficult, expensive, and time-consuming. We'll have to discover new, radically different bug-killing paradigms, according to Dr. Alfonso J.
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5 of 6 people found the following review helpful By LDubz on January 23, 2010
Format: Hardcover Verified Purchase
I am employed by a small biotechnology company that is working hard to discover new antibiotics that are effective against dangerous drug-resistant bacteria like MRSA and other nasty bugs like Acinetobacter. A colleague recently gave me Rising Plague as a gift. When I started reading it I became so alarmed, I knew that I wanted my extended family to be exposed to its content, so I sent one to everyone in my family as a Christmas present.

My intent in giving this book a positive review isn't about my promoting my company or the drug industry - it's more of a public service message. I had always assumed, probably like most who are reading this, that bacterial infections kill and maim only the very old and sick, and the immunocompromised. Not true - there are anecdotes in the book relating to people who were largely young and healthy, with no apparent pre-existing conditions, who became infected by these super-virulent bacteria that were not prevalent 50 years ago, and it permanently changed their lives in very short order. The importance and relevance of these anecdotes is supported by the statistics: bacterial infections now kill more people in this country than does HIV. There are several factors that contribute to the rise of these terrible pathogens, which I leave to you to discover in the book, should you choose to read it.

This is really scary stuff. Though this is an extremely important book, not everyone will be interested in reading it; I wouldn't fault them for not wanting to - life is busy, after all, and some of us don't like to be scared. Those who work in hospitals may know all about this subject, and so may choose to pass on it. But for the rest of us, knowledge is power.
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