All people with TB should be treated with antibiotics

I must say your argument looks impressive but let’s break it down and look at it individually. First issue I would like to bring up is when you stated that “An untreated infection can lead to a person infecting 10-15 new people every year, as it is highly contagious.” This quote came from CNN. CNN is not a reliable source for medical knowledge but clear at the bottom it said these facts came from the World Health Organization (WHO). I went to the WHO website to see what I can find and I could not find this fact. However in the book Medical Surgical Nursing: Patient-Centered Collaborative Care 7th edition by Ignatavicious and Workman states that it takes repeated close exposure for another person to contract TB[1]. How many people (outside of healthcare workers) are in repeat close exposure to a person with TB in the United States? Second issue is the following quote “Here's the full list (note that these are not all individual antibiotics): thioamides, cycloserine, aminoglycosides, PAS (4-aminosalicylic acid), cyclic peptides, and fluoroquinolones.” Most of these are not antibiotics rater than classes of antibiotics and some are not even antibiotics. Thiomides is a class of drugs that medications like methimazole (Tapazole). Thiomides are not antibiotics; rather they affect thyroid hormones by preventing the formation of T3 and T4 in the thyroid cells[2]. TB is a bacteria that normaly effects the lungs not they thyroid. Aminoglycosides are antibiotics that prohibit protein synthesis in susceptible strains of bacteria and streptomycin (which I mentioned in my first argument) belongs in this class[3]. Cycloserine (Seromycin) is also an Aminoglycoside. Cyclic peptides are not antibiotics rather than parts of proteins and I could not find any reference of those in the source you cited[4]. Fluroquinolones are class of antibiotics used for UTIs[5]. I could not find anything related to PAS (4-aminosalicylic acid) in the book Focus on Nursing Pharmacology by Amy Karch. I Googled it and found out that this is a very old expensive drug and has been replaced with rifampin (mentioned above in my first argument) because PAS is extremely toxic and the benefit is limited[6] . I feel that you should revisit the claim that I miss evaluated the treatment. Third issue he brings up Medicaid and I assume he is trying to ask what I mean by someone who can’t afford the medication. When I said people who can’t afford the medication I meant people who cannot afford medication weather that means uninsured or just not having the financial resources. The fourth issue is how to define a substance abuser. I did not realize this needed expansion and I figured that the DSM-IV-TR diagnostic criteria to define a drug abuser. The DSM-V diagnostic criteria are not available on the internet and I don’t know about you but I do not wish to pay in order to see it for this debate. The link here will show you the criteria for substance dependence: http://www.buppractice.com... Fifth issue brought up is the degree to which a person must have renal or hepatic failure in order to deny treatment. I figured this was obvious. If the person is so bad where the treatment would kill them prior to ridding them of the bacteria, they should not be treated. The reason the doctor should make that decision is the average person is not qualified to determine how bad there renal failure or hepatic failure is. For example if a doctor come up to you and says your BUN is 200mg/dL, your creatinine is 20 mg/dL and your urine output is 0.3ml/hr can you tell what stage renal failure you are in? How bad is your renal failure? Are those numbers good? Are you kidneys healthy enough to handle the antibiotics? Moving on to his rebuttals. 1) Doctors also have a duty to protect the community and general population. It is the doctors who have create this situation with so many MDROs by overprescribing antibiotics, using too small of a dose , or just using the wrong antibiotics[7],[8]. PRO goes n to make the statement “They would have their background checked for drug abuse, and probably have to have their bodies checked for signs of said abuse before treatment.” To this I must ask how is this bad? Shouldn’t the patient be thourly examined to rule out drug causes, a different issue such as cancer, and to make sure the treatment will not kill the patient faster that the infection will? 2) Doctors can be sued for anything, weather the lose or not depends on if doctors follow governmental policies, institutional polices, and recent evidenced based guidelines. If a doctor were to be sued the patient will have to show they have received harm because the doctor deviated from the protocols. 3) Please see above. TB is not transmitted as easily as you believe. 4) Your right it is classist and unfair, but it’s not about being fair it’s about protecting the larger population. 5) This argument is misrepresenting my argument and not following an actual diagnosis of substance abuse disorder. 6) I’m arguing for the US 7) Drugs are giving in combination even if one has the side effect it’s still a side effect of the combination. Also going along with this the aminioglcosides are horribly hard on the kidneys and if peek and trough levels are not measured regularly the patient can easily slip into renal failure[9]. Most commonly drugs are excreted threw the kidneys in urine. If the body it not producing urine the drug is not filtered out drug levels can quickly rise to unsafe levels resulting in potentially serious complications[10],[11]. Moving on to your plan, 1) Where is the money coming from? Also this does not ensure that homeless people will seek healthcare and if they do it will not ensure that they will follow the strict drug plan. 2) Where is the money coming from? Also how can the doseages be modified in order to completely rid the bacterium and not contribute to an MDR form of TB? 3) This does not fix the current problem. [1] Medical-Surgical Nursing: Patient Centered Collaborative Care 7th edition by Ignatavicius and Workman. [2] Focus on Nursing Pharmacology by Amy M. Karch. [3] Focus on Nursing Pharmacology by Amy M. Karch. [4] http://en.wikipedia.org... [5] Focus on Nursing Pharmacology by Amy M. Karch. [6] http://www.tbonline.info... [7] http://www.colorado.gov... [8] Focus on Nursing Pharmacology by Amy M. Karch. [9] Introduction to Critical Care Nursing 6th edition by Sole [10] Introduction to Critical Care Nursing 6th edition by Sole [11] Focus on Nursing Pharmacology by Amy M. Karch.