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https://www.ft.com/content/d6523eaa-ede5-11e6-930f-061b01e23655?ftcamp=published_links%2Frss%2Fworld_asia-pacific_china%2Ffeed%2F%2Fproductquote:Resistance to ‘last-resort’ antibiotic spreads from farms in China I thought this might deserve it's own thread. More from PRI. https://www.pri.org/stories/2017-01-17/think-antibiotic-resistant-super-bugs-are-only-distant-threat-think-again quote:Think antibiotic-resistant 'super-bugs' are only a distant threat? Think again. he;lp
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# ? Feb 8, 2017 20:59 |
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# ? Jun 8, 2024 09:09 |
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Anti biotics are also needed for surgery, and the number of antibiotics is limited.
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# ? Feb 8, 2017 21:22 |
this is as inevitable as it was predictable (completely)
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# ? Feb 9, 2017 02:08 |
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So, why aren't bacteria immune to all of these to start with? And were the parts of them that were once vulnerable just vestigial? it seems to me like eventually something would hit a snag, since I imagine there was a reason the pathways that were used to kill the bacteria with the antibiotics were originally open.
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# ? Feb 9, 2017 02:23 |
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I feel that we shouldn't be focusing on a call to develop new antibiotics, that's completely misidentifying the problem. We didn't stop developing new antibiotics because we became complacent, it's because we hit diminishing returns and discovered that effective and safe antibiotic compounds are relatively rare in nature and incredibly hard to develop. The focus should be on a ground floor reforming of industrial agriculture, more focus on preventing contamination in hospitals, and a focus on only prescribing antibiotics to people when absolutely necessary. Barring another miracle discovery on the order of penicillin within a century of the last one, we're not going to be able to do much beyond limiting the creation and spread of resistant strains.
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# ? Feb 9, 2017 02:25 |
oh wait no i meant the other thing. this was completely predictable and completely avoidable* *provided people are not idiots** **lol
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# ? Feb 9, 2017 02:26 |
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Chard posted:oh wait no i meant the other thing. this was completely predictable and completely avoidable* tragedy of the common colds
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# ? Feb 9, 2017 02:26 |
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I mean considering it requires people to never gently caress up, I think it honestly wasn't avoidable. We probably need to find another way to destroy bacteria.You know, one they can't just adapt to.
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# ? Feb 9, 2017 02:52 |
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If anyone ever travels to the part of the country in the quoted article in the OP and ends up getting sick, either go to Cali for treatment or succumb to the illness and die; your overall outcome will be better either way.
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# ? Feb 9, 2017 03:09 |
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Let's do that weird thing where we talk about this as a weird personal responsibility thing where we blame individuals or some nebulous evil group of family doctors even though the drugs involved are never ever ever handed out to people for mundane diseases.
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# ? Feb 9, 2017 03:17 |
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GhostofJohnMuir posted:The focus should be on a ground floor reforming of industrial agriculture, more focus on preventing contamination in hospitals, and a focus on only prescribing antibiotics to people when absolutely necessary. Yep, what's cool about drug resistant bacteria is that they will generally be outcompeted by non-drug resistant bacteria if they are in an environment that's not frequently exposed to low doses of antibiotics. I'm hopeful that all the new research into commensal microbiomes will eventually produce some usable technologies for farming, because figuring out how to help the good bacteria control the bad bacteria is a much more sustainable strategy than trying to race their rate of mutation with new drugs.
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# ? Feb 9, 2017 03:53 |
Owlofcreamcheese posted:Let's do that weird thing where we talk about this as a weird personal responsibility thing where we blame individuals or some nebulous evil group of family doctors even though the drugs involved are never ever ever handed out to people for mundane diseases. I don't think anyone's doing that? Overprescription and using antibiotics for no real purpose except "shut up go away" is like, the reason this is a thing.
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# ? Feb 9, 2017 03:57 |
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thechosenone posted:So, why aren't bacteria immune to all of these to start with? And were the parts of them that were once vulnerable just vestigial? it seems to me like eventually something would hit a snag, since I imagine there was a reason the pathways that were used to kill the bacteria with the antibiotics were originally open. Being immune to chemicals that gently caress with basic stuff like your cell wall synthesis takes energy and resources that could be spent reproducing. Bacteria without immunity will outcompete immune bacteria in a benign environment.
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# ? Feb 9, 2017 03:58 |
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It's right in the articles I posted you guys. Big ag is the problem.
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# ? Feb 9, 2017 03:58 |
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Agriculture is problem #1, but drat if you don't think bad physicians contribute to the problem. The amount of idiot doctors throwing heavy hitters at minor infections, or heaven forbid viral infections, is astounding. Some hospitals are better than others, though, so I know mine is particularly bad.
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# ? Feb 9, 2017 04:16 |
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GhostofJohnMuir posted:I feel that we shouldn't be focusing on a call to develop new antibiotics, that's completely misidentifying the problem. We didn't stop developing new antibiotics because we became complacent, it's because we hit diminishing returns and discovered that effective and safe antibiotic compounds are relatively rare in nature and incredibly hard to develop. The focus should be on a ground floor reforming of industrial agriculture, more focus on preventing contamination in hospitals, and a focus on only prescribing antibiotics to people when absolutely necessary. Barring another miracle discovery on the order of penicillin within a century of the last one, we're not going to be able to do much beyond limiting the creation and spread of resistant strains. Hope you're prepared to invade China and India because virtually all superbugs come from that region and they don't seem interested in sustainable agricultural reform. They were giving colistin to pigs.
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# ? Feb 9, 2017 04:17 |
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Also, phage therapy is really neat and I hope it takes off.
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# ? Feb 9, 2017 04:20 |
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As a dash of hope, phage therapy is looking promising alternative for antibiotics. Antibiotics are hard to develop for reasons already stated, but we already have other tools to kill bacteria with: Viruses. Bacterial viruses are relatively safe for us to use (because they can't really jump from bacteria to us; the transcriptional/translational machinery are too different) and tend to be highly specific in their targeting. They also reproduce themselves, so dosing is pretty much only whatever threshold is necessary to set a minimum population of virus in the target region. Phage therapy was the way the world was going until Fleming discovered his silver bullet, and then it ended up isolated to the Eastern bloc, right up until Stalin decided that this whole "genetics" thing sounded a bit too Hitler-y. Now, the only place that's been using it with any level of regularity has been the Republic of Georgia. We're already seeing a return in the food industry; it's pretty much guaranteed any goons in North America have eaten virus-laced foods for years now without knowing it. It's also seeing a start of a return to the medical world, a summary of which can be found here. There's even evidence phages might be able to infiltrate biofilms, something antibiotics persistently struggle with. (I tried to link publicly available docs where possible.) None of this is to downplay the seriousness of antibiotic resistance, incidentally; just to offer the idea that there is hope in a world where we have basically pissed away our silver bullet. Also, hey, if it gets more people interested in viruses, that just makes my day. e: Well, gently caress me, beaten again. 2e: Fojar38 posted:Hope you're prepared to invade China and India because virtually all superbugs come from that region and they don't seem interested in sustainable agricultural reform. China's also where we get all our super-deadly influenza strains from lately, because they keep pigs and chickens together. Pigs are basically giant mixing vessels for influenza viruses because their respiratory tracts contain the same sugar moieties found in the respiratory tracts of humans and the GI tracts of birds. Honestly, a lot of this can just be summed up as "China's agricultural system hosed it." Axelgear fucked around with this message at 04:23 on Feb 9, 2017 |
# ? Feb 9, 2017 04:21 |
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Holy poo poo, sorry. Nice post. I was talking to a researcher at Pfizer about some stuff, and as soon as I mentioned phage therapy he immediately clammed up. I don't know if he thought I was an idiot or there was some sort of NDA.
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# ? Feb 9, 2017 04:28 |
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Chard posted:I don't think anyone's doing that? Overprescription and using antibiotics for no real purpose except "shut up go away" is like, the reason this is a thing. The drug in this story is an Iv drug that gives you nerve and kidney damage when you use it. No one is taking this for a cold. People do not get given this to make them go away.
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# ? Feb 9, 2017 04:56 |
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Much like climate change, this can only be solved by a scientific breakthrough. If the agricultural industry can increase its margins by 0.5% by pumping livestock full of every available antibiotic then that's going to happen and there's nothing our governments will do about it. Much like we're going to melt every icecap/glacier/polar bear on the planet because switching to renewables or nuclear would erase a few quarter's profits. Pretty cool stuff about phage therapy. While googling it I learned that apparently viruses kill half the ocean's bacteria every day, which is great news.
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# ? Feb 9, 2017 05:16 |
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Owlofcreamcheese posted:The drug in this story is an Iv drug that gives you nerve and kidney damage when you use it. No one is taking this for a cold. People do not get given this to make them go away. I agree that overprescription/improper adherence among humans is not the issue here, but it's worth pointing out that polymyxins are in a lot more stuff for humans than these articles would suggest. They're in tons of topical and opthalmic (eye) products, including standard triple-antibiotic ointments, and are also used to treat some lung and GI infections since they're not readily absorbed through those routes into systemic circulation. Colistin for IV use is just a very dilute preparation of some of the more effective polymyxins.
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# ? Feb 9, 2017 05:53 |
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Arglebargle III posted:Being immune to chemicals that gently caress with basic stuff like your cell wall synthesis takes energy and resources that could be spent reproducing. Bacteria without immunity will outcompete immune bacteria in a benign environment.
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# ? Feb 9, 2017 05:55 |
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Viruses do more than just kill; they also play a major role in nutrient cycling. Marine snow - the thing which feeds a lot of life in the lower layers of the ocean, beneath the photic zone - likely has viruses play a big role in its formation. Viruses explode cells, releasing their sticky contents, which gunk up, aggregate, and sink. Viruses themselves are also non-motile and can carry materials down to the ocean floor, helping sequester carbon. They're pretty darn great. reagan posted:Holy poo poo, sorry. Nice post. Thanks! I can't speak for your researcher, friend, but everything I've heard from the people I know in the field makes it sound promising. The FDA is approving more and more tests with it and the results seem promising, albeit small scale at present. Even the immune response doesn't seem to hamper them. The one downside of viruses is that we actually need to discover, isolate, and culture them. That process is easier than finding new antibiotics but that's still relative.
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# ? Feb 9, 2017 06:03 |
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OneEightHundred posted:It doesn't necessarily even need to cost energy, it's just that there's never been enough penicillin-producing mold in the world to put a significant amount of selective pressure on it. It's been a long time since I've been in the antibiotics space but the hotness ~15 years ago was that antibiotics are generally means for cross species communication. That's why soil bacteria (organisms that exist in a highly heterogeneous matrix) produce all kinds of antibiotics. If you up the dosage, they become a "killing word" where you start to seriously gently caress poo poo up. That's a nicely selective give-and-take game, where you can have peaceful communication as well as biological warfare, depending on expression levels. We've been using antibiotics outside of their context. If you live in a world of screams, deafness makes sense. Same principle applies, only it's more often a gain of function or overexpression of existing mechanisms. Hearing so well you block out the screams, if you will.
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# ? Feb 9, 2017 09:02 |
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Shbobdb posted:It's been a long time since I've been in the antibiotics space but the hotness ~15 years ago was that antibiotics are generally means for cross species communication. That's why soil bacteria (organisms that exist in a highly heterogeneous matrix) produce all kinds of antibiotics. bacteria aren't people dude
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# ? Feb 9, 2017 11:35 |
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What's needed is just for biotech companies/public researchers to spend a little more than their current miniscule amount on new anti-biotic research, make some new drugs, and not sell it. Certainly not to the agricultural sector. Build up a strategic reserve of drugs and there's no crisis. Fundamental changes in industrial agriculture? Scientific breakthrough? This is a straightforward incentives problem.
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# ? Feb 9, 2017 11:50 |
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In regards to industrial agriculture I think the problem is completely political. For example, look at the EU. There are several member states that have made real progress in reducing the usage of anti-biotic's in husbandry through legislation. Simultaneously, other states have made huge competitive gains for their own agriculture sector's by doing the complete opposite while stalling any initiative for a pan-EU effort that would encompass the entire free-trade zone. That's without even talking about how lobbying factors into this which I'm sure the US has even worse problems with.
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# ? Feb 9, 2017 12:04 |
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why the gently caress are we giving superantibiotics to pigs. How the hell is this even allowed Why is there even enough being made to satisfy agri volume Christ
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# ? Feb 9, 2017 13:10 |
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blowfish posted:bacteria aren't people dude So?
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# ? Feb 9, 2017 16:59 |
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For whatever it's worth, colistin wasn't going to save us anyway; it's a pretty narrow spectrum antibiotic, affecting some but not all gram negatives; it won't do dick to save you from, say, a Staph infection. That's nothing to sniff at, but not all antibiotics are made equal. Polymixin resistance is only worrying because our Big Boys that are the tetracyclins and the streptomycins and the penicilins are losing their efficacy. The Last Resort antibiotics tend to be really nasty to the patient, really narrow spectrum, or both. Once we piss away the tetracyclins (literally; their release in urine contributes to this), the penicilins, the sulfonamides... Then we're beyond hosed. Unless phages turn out to be as good as we hope, anyway.
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# ? Feb 9, 2017 17:08 |
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Arglebargle III posted:Being immune to chemicals that gently caress with basic stuff like your cell wall synthesis takes energy and resources that could be spent reproducing. Bacteria without immunity will outcompete immune bacteria in a benign environment. aparmenideanmonad posted:Yep, what's cool about drug resistant bacteria is that they will generally be outcompeted by non-drug resistant bacteria if they are in an environment that's not frequently exposed to low doses of antibiotics. Does this mean that not using penicillin will eventually allow it to be effective again? What sort of time scale would it take?
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# ? Feb 9, 2017 17:22 |
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Phyzzle posted:Does this mean that not using penicillin will eventually allow it to be effective again? What sort of time scale would it take? Not one that actual patients would be comfortable with.
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# ? Feb 9, 2017 17:26 |
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It's not that hard to make new antibiotics. There is just no will to do it because there isn't (yet) enough of a financial return. It's expensive to bring a drug to market and antibiotics tend to be sold cheaply. Eventually (and after many avoidable deaths) there will be sufficient profit motivation to bring new classes of antibiotic drugs to market.
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# ? Feb 9, 2017 17:33 |
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Shbobdb posted:It's not that hard to make new antibiotics. There is just no will to do it because there isn't (yet) enough of a financial return. It's expensive to bring a drug to market and antibiotics tend to be sold cheaply. Eventually (and after many avoidable deaths) there will be sufficient profit motivation to bring new classes of antibiotic drugs to market. We can't really make new antibiotics on demand, finding something that kills bacteria while not disproportionately harming a human being or the beneficial human microbiome is pretty difficult. In theory, the solution to this problem is really easy: Don't give people antibiotics for minor infections that will go away on their own, or for infections that aren't bacterial to begin with. And more importantly don't give antibiotics to healthy farm animals for "prevention" or because they promote growth. The problem is that we need very large numbers of people to cooperate for this to work, and that's arguably harder than finding new antibiotics. Maybe alternative approaches like viruses and antibodies will save us, but it's a huge problem that will probably kill thousands if not millions of people over the next decades.
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# ? Feb 9, 2017 17:43 |
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Again, ~15 years ago the field of quorum sensing found a number of potential antibiotics that seemed to have minimal side effects in mammalian systems. There were some synthetic antibiotics that were designed around that time too. None of them made it to clinical trials, so who knows? It's not easy but it's not like the knowledge base isn't there. Bringing a drug to market isn't trivial but in terms of the kinds of medical questions being asked right now, it's on the easier side of things.
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# ? Feb 9, 2017 17:47 |
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MiddleOne posted:Not one that actual patients would be comfortable with. Actually, there have been studies on hospitals who have altered their antibiotic regimens in order to prove this. If I remember right, it's a few years before the class of antibiotics you're avoiding becomes really effective again and then you could cycle back.
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# ? Feb 9, 2017 20:12 |
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Rigged Death Trap posted:why the gently caress are we giving superantibiotics to pigs. It's mostly happening in underderveloped countries with weak institutions. China is the "colistin to pigs" case, and to be honest I have heard a ton of stories of Chinese doctors who clearly don't understand antibiotics just giving them out like candy to anyone who sees them (like literally just giving out bags of mixed antibiotics and probably not even checking which are in there), and frequently antibiotics aren't taken properly, are shared among families, etc. Fojar38 fucked around with this message at 20:59 on Feb 9, 2017 |
# ? Feb 9, 2017 20:57 |
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Shbobdb posted:Again, ~15 years ago the field of quorum sensing found a number of potential antibiotics that seemed to have minimal side effects in mammalian systems. There were some synthetic antibiotics that were designed around that time too. None of them made it to clinical trials, so who knows? This is incredibly disingenuous. It is easy to find all sorts of compounds that will kill (or at least inhibit growth of to some degree) bacteria and not kill eukaryotic organisms. Things like quorum sensing are good targets in one sense because no direct analog exists outside of bacteria, but in several other senses make lovely targets. Quorum sensing targets in particular tend to result in very narrow-spectrum targets, and result in resistance very quickly because they aren't necessary for bacteria replication, you inhibit growth of the organisms in certain conditions, but you quickly (on timescales that I can create in my lab) form subpopulations that have re-optimized their communication and regulation to ignore the compound. None of these have made it to clinical trials yet because most of them just don't work well enough long enough to even give feasible results in rodent models. edit: The number of papers that come out that show some 2-log reduction in IP infections of Salmonella in mice model on short time scales with a test compound is amazing, and it is great, but essentially every one of those compounds is worthless on its own, would need a great deal of medicinal chemistry work to come up with an analog that works better, and almost all of those still won't come close to being functional enough to actually clear a real infection with real-world strains. OnceIWasAnOstrich fucked around with this message at 21:00 on Feb 9, 2017 |
# ? Feb 9, 2017 20:57 |
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# ? Jun 8, 2024 09:09 |
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pidan posted:In theory, the solution to this problem is really easy: Don't give people antibiotics for minor infections that will go away on their own, or for infections that aren't bacterial to begin with. Is there any evidence this happens with IV antibiotics basically ever? Especially commonly enough to cause antibiotic resistance.
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# ? Feb 9, 2017 21:07 |