A doctor who travels through two eras

Chapter 853 Broad-Spectrum Drug Cefuroxime

Faced with the questions from the deans, Lin Sanqi quickly explained:

"Teachers, here's what I'm thinking. I have a few projects overseas, so I want to do some support projects."

To give you an example, imagine a country with a large land area and a large population, but its domestic economy, industry, and scientific research conditions are extremely poor; it lacks everything.

If I were to provide antibiotics to such a poor country, which types or categories do you think I should provide first? The requirements are broad-spectrum antibacterial activity, low cost, and the ability to be mass-produced.

Dean Wang was somewhat puzzled: "Africa has large countries? Aren't they all small countries that are constantly fighting each other to the death?"

Dean Xie Lei said disdainfully:
“Africa does have some large regional powers, such as Algeria, North Sudan, and the Democratic Republic of Congo, all of which have an area of ​​more than two million square kilometers, which is equivalent to more than 20 Zhejiang provinces. Do you think that's big enough?”

However, while these countries are large, their populations are not large. The largest, Congo, has just over 100 million people, and it's so poor it lacks almost everything, resulting in a very low quality of life for its population. Our medical system provides counterpart support to these countries every year.

Dean Zhang Yuezheng of the School of Pharmacy pondered for a moment, then analyzed the situation for Lin Sanqi from a professional perspective:

"Currently, there are many types of antibiotics used in clinical practice, mainly including β-lactams, macrolides, tetracyclines, lincomycins, polypeptides, aminoglycosides, quinolones, and sulfonamides."

The most widely used and extensively used drugs are β-lactams, including penicillins, cephalosporins, as well as β-lactamase inhibitors and compound preparations, such as cephalosporins and amoxicillin.

β-lactam antibiotics have a broad antibacterial spectrum and are effective against various infections caused by Gram-positive cocci and Gram-negative bacilli, which should meet your broad-spectrum requirement.

However, if you want to help a country establish a complete antibiotic system, other types of antibiotics are equally indispensable, because each type of antibiotic has its own strengths.

For example, in cases of infection caused by mycoplasma or chlamydia, macrolides such as erythromycin, azithromycin, and roxithromycin are needed.

Lincomycin is quite effective against infections caused by Gram-positive cocci and anaerobic bacteria, including lincomycin and clindamycin.

Oh, by the way, there's also a commonly used antibiotic, quinolones, which are very effective against Escherichia coli, Shigella, Klebsiella, Staphylococcus aureus, and so on.

For example, levofloxacin and moxifloxacin are broad-spectrum antibiotics.

There is also norfloxacin, also known as norfloxacin, which was used by ordinary people as a miracle drug to treat diarrhea, wound infections, and pneumonia.

As for relatively less common antibiotics with significant side effects, such as aminoglycosides, sulfonamides, tetracyclines, and extremely expensive peptides like vancomycin, these can be disregarded in impoverished areas.

Dean Wang also pointed out:
"You're preparing to provide antibiotics to poor countries where the population has almost no exposure to antibiotics. This is actually an advantage. You can take any antibiotic there, and because there's no drug resistance, you can achieve the best results."

So don't be greedy. Choose one representative drug for each type to build a basic framework. You can gradually expand the drug range when you have the resources in the future. This way, it won't cost much.

Lin Sanqi quickly refilled the tea cups for the deans and humbly asked for their advice:
"For example? How do I choose?"

Dean Zhang tapped his fingers on the table before picking up his teacup and pondering:
"Right now, the cheapest thing is penicillin. I remember one ton of penicillin sodium raw material costs about 20 to 30 yuan, which is very cheap. One ton of penicillin raw material can make 200 million bottles of penicillin, which is enough for the people of Africa."

However, this penicillin has purity issues and is very likely to cause infusion reactions. If you think African lives are worthless and you don't need to pay compensation if they die, then you can use it. But I feel it's morally wrong; we should use good raw materials.

Dean Lou said impatiently at this point:
"Why would we need penicillin? This isn't the Republic of China era anymore, where penicillin was an incredible life-saving drug. Clinical penicillin has been upgraded now; who uses the regular kind?"

They use drugs like azlocillin, mezlocillin, amoxicillin, piperacillin, etc., and if you want to ensure quality, the raw materials for these drugs are not cheap either.

If you ask me, I'd say we should just go straight for cephalosporins. They have a similar antibacterial spectrum, are safer, don't require skin testing, are easy to use, and the raw materials aren't expensive.

Although Panax notoginseng is produced by the same company, the medicines they export represent China. We can't afford to embarrass ourselves internationally. So, either we don't use it, or we use the best medicine.

Lin Sanqi nodded slightly, thinking that this was indeed the case.

These "anti-inflammatory drugs" were taken to another dimension, and they were used by our compatriots. Of course, Chinese people cannot cheat other Chinese people.

Cephalosporins are indeed a good option.

The risks of using regular penicillin are too high; the allergy rate, or even the mortality rate, is consistently high. Many people die from anaphylactic shock during skin testing. Doesn't this diminish the benefits of using Panax notoginseng?

Dean Zhang Shengjian of the School of Laboratory Medicine and Biotechnology also nodded in agreement:
"Yes, cephalosporins are better, and they are now mainly administered orally, which is more convenient. If you use injections, you would have to train a group of nurses to give injections, which is not suitable for the situation in Africa."

"Yes, let's go with cephalosporins."

"I also think cephalosporins are better than penicillin."

The other deans also agreed, but Lin Sanqi still had a question:

"There are so many types of cephalosporins. Which one is safe, economical, and offers the best value for money?"

Dean Zhang thought for a moment and replied:

"There are now four generations of cephalosporin drugs."

For example, first-generation cephalosporins typically include cefazolin and cephalexin, which generally have good antibacterial activity against positive bacteria.

Second-generation cephalosporins typically include cefuroxime and cefaclor, which are effective against various infections caused by Gram-positive cocci and Gram-negative bacilli.

Third-generation cephalosporins, such as cefotaxime and ceftriaxone, are more active against Gram-negative bacteria.

As for fourth-generation cephalosporins, such as cefpirome and cefepime, they are generally used for moderate to severe infections and have the best efficacy, but they are very expensive and not suitable for widespread use in Africa.

Dean Lou grew impatient: "All this talk is making my head spin. You're not just trying to pad your numbers, are you? Just tell me which cephalosporin you're choosing."

Dean Zhang burst into laughter before making the final decision:
"Let's choose cefuroxime. Second-generation cephalosporins are more comprehensive and have good effects on both positive and negative bacteria. Anyway, what the people of Africa need is a broad-spectrum antibiotic."

Alternatively, you can choose the most commonly used moxifloxacin or azithromycin. These three drugs can cover almost all the most common bacteria and treat most diseases.

As for infections caused by certain special bacteria, well, that's up to fate. If it's treatable, treat it; if it's not, so be it. We have no obligation to provide meticulous care to Africans.

How many impoverished people in our country are unable to receive medical assistance due to lack of medical care and medicine? They can't even take care of their own families, yet they're thinking about rescuing foreigners?

I disagree with this viewpoint. That's far too benevolent. It's like selling one's father's land without a care in the world—as if things that aren't one's own can be given away so easily? And it'll raise a bunch of ungrateful children.

Upon hearing this, Lin Sanqi quickly waved his hand in denial:

"Teacher Zhang, I'm innocent! I never intended to save Africans' lives. This is all business. I need to export my domestic products, so I have to maintain good relationships with the other side."

Besides, I'm not sourcing drugs for free; it's all about making a huge profit. I don't do business that loses money, haha.

Dean Zhang took a sip of tea and corrected him:
"I'm not talking about you, but about this unhealthy trend in China right now."

Some companies invest hundreds of millions or even billions of dollars in Africa. Then, when the situation in those African countries deteriorates, all their investments are lost, leaving them with nothing.

To be honest, this kind of corporate investment is practically criminal. No prior planning or risk assessment? And no remedial measures afterward? Is this kind of investment so reckless?
I really don't understand. Even I, as a teacher, know the risks are enormous. How could they not see that?

Dean Wang was quite indignant upon hearing this:
"What else could it be? There must be something fishy going on here. Do you really think they're stupid? They're smart to advocate investing in Africa. They're manipulating things, and who knows how much of the money is going into their own pockets. It's the public funds and the company's money that are being lost."

Lin Sanqi broke out in a cold sweat, thinking to himself, "You old folks really dare to talk back," so he quickly changed the subject:
"Teachers, everything is ready at the restaurant. Today we have Tibetan pork, yak meat, and mountain goat meat, all freshly slaughtered."

Dean Wang chuckled upon hearing this: "Alright, with such delicious food before us, let's put national affairs aside, haha, Sanqi, bring me the Moutai!"

"Alright, plenty of Moutai!"

(End of this chapter)