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Axelgear posted: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. This is cool and all, just wanted to point out how badass it is that we're filling ourselves with symbiotic viruses, like sci fi supergenius race stuff we are all Venom
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Feb 10, 2017 03:32
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Owlofcreamcheese posted:Is there any evidence this happens with IV antibiotics basically ever? Especially commonly enough to cause antibiotic resistance. MIC creep with vancomycin isn't caused by giving colistin to pigs, so yes I believe it has.
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Feb 10, 2017 03:43
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reagan posted:MIC creep with vancomycin isn't caused by giving colistin to pigs, so yes I believe it has. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426332/ The glycopeptide avoparcin was first introduced for growth promotion in 1975 (37). At that time it was used extensively in most parts of Europe and the rest of the world with the notable exception of Canada and USA where avoparcin never has been approved for animals (38). Avoparcin was mainly used for broilers and pigs but to some extent also for turkeys, veal calves and other animals (37, 39, 40). The extent of avoparcin use is demonstrated by data from Denmark where 24 kg of vancomycin was used in human medicine in 1994, and in the same year more than 24,000 kg of avoparcin was used for growth promotion (39). A similar example is Australia, where from 1992 to 1996 less than 600 kg of vancomycin but over 62,000 kg of avoparcin was imported (41). As avoparcin confers cross-resistance to vancomycin the (mis)use of avoparcin selected for VRE (42). Hence, VRE, i.e. E. faecium carrying the vanA genotype was common in the intestinal flora of farm animals in Europe during the 1990s (43, 44). By contrast, since avoparcin has never been approved in Canada and USA, VRE had until 2008 never been isolated from farm animals in USA (45).
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Feb 10, 2017 04:07
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I mean I've got an anecdote about use of IV antibiotics inappropriately but I don't know about studies. Doc told me it was a super low chance I had something that would be antibiotic responsive and said he'd get me ciprofloxacin IV, I replied that if it was super low I'd rather take the chance and not contribute to antibiotic resistance. He shrugged and gave the order to the nurse who proceeded to hook it up and get the pump going then not connect it to my IV line. I pointed it out and they gave me the remainder half that was still in the bag. That was an interesting night. The whole bit about the role of antibiotic use in animals is interesting, and hopefully the new feed directives starting this year that outlaw use of antibiotics as growth promoters and requirement of a prescription for any antibiotic use in livestock will not only make people think twice, but also start generating data on usage. One of the main antibiotics used in Ag is monensin which has no related drug used in human med and apparently doesn't confer cross-protection. Interestingly enough, there's been some data to show some organic farms with more resistant organisms since organic farms are allowed one antibiotic administration (so theory is that instead of using lower tier antibiotics they're just reaching for higher tier off the bat). Heck there's even evidence that feeding pigs zinc as an antimicrobial agent leads to some vancomycin resistant strains. There's a lot of weird things in animal med. There needs to be more funding and more research in this. That being said, its highly likely the issue isn't the use of antibiotics itself, but rather the cramped and terrible conditions livestock live in on factory farms leading to the need of antimicrobials, but that's a whole other discussion.
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Feb 10, 2017 06:47
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Here's an interesting thing: Scientists recreated an ancient remedy, tested it on MRSA and it loving worked: http://www.bbc.com/news/uk-england-nottinghamshire-32117815
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Feb 10, 2017 18:23
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HelloSailorSign posted:I mean I've got an anecdote about use of IV antibiotics inappropriately but I don't know about studies. Why is that a story about inappropriate use? You denied a doctor recommended treatment then you accepted it when it was physically nearer to you.
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Feb 10, 2017 21:22
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Because it was the doc's plan to use it while it wasn't actually indicated. I wasn't exactly in a good state to sit there arguing about it either and felt that I should point out the fact that they didn't connect up the thing that was running (that they were charging me for).
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Feb 10, 2017 21:31
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HelloSailorSign posted:Because it was the doc's plan to use it while it wasn't actually indicated. I wasn't exactly in a good state to sit there arguing about it either and felt that I should point out the fact that they didn't connect up the thing that was running (that they were charging me for). What are you basing any of this on?
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Feb 10, 2017 23:25
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Alhazred posted:Here's an interesting thing: Scientists recreated an ancient remedy, tested it on MRSA and it loving worked: I don't want cow bile in my eye though I know that some plant recipes are very effective against certain bacteria, there's a similar thing happening with horseradish and UTIs. I always wonder whether bacteria aren't just going to become resistant to those things as well, I don't imagine the underlying mechanism is fundamentally different from modern antibiotics
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Feb 11, 2017 00:26
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pidan posted:I don't want cow bile in my eye though As was mentioned before, these antibiotic resistances consume organism resources that make the bacteria less competitive against those not resistant against the bacteria (in the absence of the antibiotic, obviously). My guess is that it could be a plan to make a pattern of propagating antibiotics, phage treatments, and other effective cures in periods so that, as they become resistant to one solution, a new solution is implemented + the old solution halted and the prior organisms are beaten by the originals and the new bact resistant to the newer solution I'm not a scientist so for all I know I just said a bunch of gibberish, so vOv
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Feb 11, 2017 00:41
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Owlofcreamcheese posted:What are you basing any of this on? His own admission of low likelihood and having an understanding of medicine.
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Feb 11, 2017 05:13
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Neurolimal posted:As was mentioned before, these antibiotic resistances consume organism resources that make the bacteria less competitive against those not resistant against the bacteria (in the absence of the antibiotic, obviously). My guess is that it could be a plan to make a pattern of propagating antibiotics, phage treatments, and other effective cures in periods so that, as they become resistant to one solution, a new solution is implemented + the old solution halted and the prior organisms are beaten by the originals and the new bact resistant to the newer solution No in principle this is a useful strategy but in reality it's really hard to implement because given the wide variety of resistances you'll 1) have to do it strictly so eventually you're going to run into cases where you have to tell some patient "yeah we could save you but welp gotta manage some resistances so thank you for your sacrifice for future generations" or 2) have an unregulatable mess where you have to trust that antibiotics declared to be last resort will actually only be used as last resort until they get rotated back into regular use (lol no we already can't manage that even for one or two poo poo rear end old antibiotics)
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Feb 11, 2017 11:34
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I CANNOT EJACULATE WITHOUT SEEING NATIVE AMERICANS BRUTALISED!
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Hey, so, sorry for resurrecting this thread, but this seemed like something people might enjoy. It's only ("only") a mouse model, but it shows promise, and that these techniques/therapies are in development.
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Mar 14, 2017 14:59
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Antibiotic overprescription is a minor cause compared to agriculture. The amount of antibiotic from farm run-offs entering the environment is astronomical. The way to evolve resistance is chronic low level exposure and that is basically what farms do in huge radii around their point locations. There are also two parts: initial evolution of resistance (point mutations, gene loss, expression changes, etc..) and resistance gene transfer. The latter is a more concerning problem because many environmental soil bacteria are resistant to a lot of antibiotics naturally but they aren't pathogens. In humans those bugs aren't present, but on farms you mix those antibiotic resistance source bacteria with opportunistic and pathogenic bacteria in animals and their poo poo and then mix in farmers. All the components are there, which is why most people that are patient 0 for these terrible bacteria are farmers. Some soil bacterium develops resistance, its DNA gets transferred in to another bacterium through a number pf mechanisms and then that second bacterium starts an opportunistic infection by chance in a farmer through a scrape or whatever and then if we're all very unlucky that bug then gives its DNA to a human pathogen that was also in the farmer at the time and now we have a crisis. Also phage therapy is cool because when you need have anew resistant bacterium you just go down to the ocean and scoop up another trillion phage in a couple mL of water to use for plaque forming assays. cowofwar fucked around with this message at 15:57 on Mar 14, 2017 |
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Mar 14, 2017 15:50
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cowofwar posted:Antibiotic overprescription is a minor cause compared to agriculture. The amount of antibiotic from farm run-offs entering the environment is astronomical. The way to evolve resistance is chronic low level exposure and that is basically what farms do in huge radii around their point locations. The antibiotic overprescription boogieman seems like such a transparent plot to shift the blame to individuals and low level family doctors. And it sucks, because it's building up this narrative of "trust doctors about viruses and vaccines but also they all are trying to POISON OUR COMMUNITY with HARMFUL ANTIBIOTICS that you don't even need and will KILL YOUR CHILDREN so just say no to their murder shots! They just lie to you about you needing them anyway".
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Mar 14, 2017 16:27
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reagan posted: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. Vancomycin is a big one for us. It probably should not be considered a broad spectrum antibiotic but many doctors treat it as such, especially considering how dangerous it can be to skin tissue and kidneys
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Mar 14, 2017 16:29
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Plenty of countries without well developed health care systems or standards let people obtain and use a lot of antibiotics however they want. Feel sick? Here's some IM penicillin, have fun! Dosing and use are completely up to regular people, so, while they will take them for appropriate poo poo like strep throat, they will also do things like stop short of a full course, take them for influenza or a rhinovirus, or use them prophylactically for all sorts of medically unsound reasons. I agree agricultural misuse is the worst culprit of all, and that we should do better in the US, Europe, etc. but the above poo poo also needs to stop.
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Mar 14, 2017 19:42
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aparmenideanmonad posted:Plenty of countries without well developed health care systems or standards let people obtain and use a lot of antibiotics however they want. Feel sick? Here's some IM penicillin, have fun! Dosing and use are completely up to regular people, so, while they will take them for appropriate poo poo like strep throat, they will also do things like stop short of a full course, take them for influenza or a rhinovirus, or use them prophylactically for all sorts of medically unsound reasons. That really does sound like "turn off the water while you brush your teeth" sort of advice. Like it's technically true, but personal abuse is just such a tiny tiny factor. Like there is no realistic amount of antibiotics a person is going to casually take for colds or something that comes anywhere close to the damage they do eating a single bacon burger for lunch or something. Like don't be an rear end and abuse antibiotics also, but it's a really tiny amount of the problem.
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Mar 15, 2017 16:01
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To be fair our treated sewage effluent is jam packed with antibiotics (and other pharmaceuticals). You can imagine the problem in other countries where antibiotics are unregulated and sewage isn't treated. Just massive dumping of sub MIC levels of antibiotics in to the environment.
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Mar 28, 2017 20:57
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blackguy32 posted:Vancomycin is a big one for us. It probably should not be considered a broad spectrum antibiotic but many doctors treat it as such, especially considering how dangerous it can be to skin tissue and kidneys
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Mar 28, 2017 21:19
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