Anti-biotic Resistance

The Something Awful Forums > Discussion > Debate & Discussion > Anti-biotic Resistance

namaste friends: Sep 18, 2004; by Smythe

https://www.ft.com/content/d6523eaa-ede5-11e6-930f-061b01e23655?ftcamp=published_links%2Frss%2Fworld_asia-pacific_china%2Ffeed%2F%2Fproduct

quote:

Resistance to �last-resort� antibiotic spreads from farms in China
Researchers say transfer from flies to humans adds urgency to drug development

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https://www.ft.com/content/d6523eaa-ede5-11e6-930f-061b01e23655?ftcamp=published_links%2Frss%2Fworld_asia-pacific_china%2Ffeed%2F%2Fproduct

Bacteria resistant to colistin, the so-called last resort antibiotic, are probably being transferred to humans from poultry farms in China, say researchers, adding to fears that time to develop new types of medicine is running out.

The 2015 discovery in China of�bacteria with mcr-1, the colistin resistance�gene, sparked fears over the future of human health. Margaret Chan, head of the World Health Organization, said last year that medicine risked �going back to the dark ages� without action to spur development of new antibiotics and to preserve the dwindling numbers that remain effective.

Since the discovery in animals on farms where colistin was widely used as a growth enhancer, bacteria with mrc-1 have been identified in more than 30 countries including the US, Germany, Spain, Thailand and Vietnam. A patient in the US was found to have been infected with e-Coli carrying the gene last year.

Developed for clinical use in 1959, colistin was little used on human patients because of side effects including kidney damage. But it has been thrust under�a spotlight as resistance to the more commonly used family of last-resort antibiotics known as�carbapenems has risen, provoking alarm among health professionals.

E-Coli bacteria with the mcr-1 gene were found among patients at Chinese hospitals in two large cities, according to a study in the Lancet last month. The incidence of resistant strains was around 1 per cent, the researchers said. �The emergence of mcr-1 heralds the breach of the last group of antibiotics,� said Professor Tim Walsh of Cardiff University, one of the paper�s authors.

According to a separate paper published this week in Nature Microbiology, the same team found high rates of bacteria with colistin resistance genes in flies at poultry farms in China, suggesting the insects could spread resistance.

�There is a higher rate of incidence among people living close to farms,� said Jianzhong Shen of the China Agriculture University, one of that paper�s authors. �That�s an interesting result. Flies and migratory birds are probably important modes of transmission. Drug-resistant genes can be transmitted through the environment, through the animal food chain and to humans.

�It is a warning that in animal breeding we must use antibiotics sparingly, and ensure that facilities are kept clean to cut the chain of transmission,� Dr Shen added.

Some bacteria the researchers found in flies and in poultry for sale in Chinese markets carried bacteria resistant to both colistin and carbapenem, raising the risks of �super bacteria� resistant to several kinds of last-resort antibiotics.

Yu Yunsong of Zhejiang University co-authored�a separate study published in the Lancet last month that found mcr-1 and carbapenem-resistant bacteria in samples from 28 Chinese hospitals, but said it was �too early to say that super bacteria resistant to all antibiotics are imminent�.�

China reacted to the discovery of colistin-resistant bacteria on farms by banning the use of the drug as a growth stimulant for animals last year. But its use to treat sick animals is not restricted, and Chinese hospitals plan to begin using it to treat human patients this year. Dr Yu said that efforts to reduce the rampant over-prescription of antibiotics in Chinese hospitals, which are dependent on drug sales for revenues, are beginning to see results.

China is the world�s top producer of colistin, with Hebei province in the north home to the world�s largest factory producing the antibiotic, with output capacity of 10,000 tonnes a year for domestic use and export. Despite the ban the Financial Times was able to find several Chinese websites selling colistin for agricultural use.�

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.

If it sometimes seems like the idea of antibiotic resistance, though unsettling, is more theoretical than real, please read on.

Public health officials from Nevada are reporting on a case of a woman who died in Reno in September from an incurable infection. Testing showed the superbug that had spread throughout her system could fend off 26 different antibiotics.

�It was tested against everything that�s available in the United States � and was not effective,� said Dr. Alexander Kallen, a medical officer in the Centers for Disease Control and Prevention�s division of health care quality promotion.

Although this isn�t the first time someone in the US has been infected with pan-resistant bacteria, at this point, it is not common. It is, however, alarming.

�I think this is the harbinger of future badness to come,� said Dr. James Johnson, a professor of infectious diseases medicine at the University of Minnesota and a specialist at the Minnesota VA Medical Center.

Other scientists are saying this case is yet another sign that researchers and governments need to take antibiotic resistance seriously. It was reported Thursday in Morbidity and Mortality Weekly Report, a journal published by the CDC.

The authors of the report note this case underscores the need for hospitals to ask incoming patients about foreign travel and also about whether they had recently been hospitalized elsewhere.

The case involved a woman who had spent considerable time in India, where multi-drug-resistant bacteria are more common than they are in the US. She had broken her right femur � the big bone in the thigh � while in India a couple of years back. She later developed a bone infection in her femur and her hip and was hospitalized a number of times in India in the two years that followed. Her last admission to a hospital in India was in June of last year.

The unnamed woman � described as a resident of Washoe County who was in her 70s � went into hospital in Reno for care in mid-August, where it was discovered she was infected with what is called a CRE � carbapenem-resistant enterobacteriaceae. That�s a general name to describe bacteria that commonly live in the gut that have developed resistance to the class of antibiotics called carbapenems � an important last-line of defense used when other antibiotics fail. CDC Director Dr. Tom Frieden has called CREs �nightmare bacteria� because of the danger they pose for spreading antibiotic resistance.

In the woman�s case, the specific bacteria attacking her was called Klebsiella pneumoniae, a bug that often causes of urinary tract infections.

Testing at the hospital showed resistance to 14 drugs � all the drug options the hospital had, said Lei Chen, a senior epidemiologist with Washoe County Health District and an author of the report. �It was my first time to see a [resistance] pattern in our area,� she said.

A sample was sent to the CDC in Atlanta for further testing, which revealed that nothing available to US doctors would have cured this infection. Kallen admitted people in this field experience a sinking feeling when they�re faced with a superbug like this one.

�I think it�s concerning. We have relied for so long on just newer and newer antibiotics. But obviously the bugs can often [develop resistance] faster than we can make new ones,� he said.

Doctors and scientists who track the spread of antibiotic resistance � the rapidly proliferating swarm superbugs � see this case as a big red flag.

�If we�re waiting for some sort of major signal that we need to attack this internationally, we need an aggressive program, both domestically and internationally to attack this problem, here�s one more signal that we need to do that,� said Lance Price, who heads the Antibiotic Resistance Action Center at George Washington University.

There is international recognition of the threat, which an expert report published last year warned could kill 10 million a year by 2050 if left unchecked. In September, the UN General Assembly held a high-level meeting on antibiotic resistance, only the fourth time the body had addressed a health issue.

The woman in Nevada was cared for in isolation; the staff who treated her used infection control precautions to prevent spread of the superbug in the hospital. Chen and Randall Todd, a health department colleague, told STAT testing was done to look for additional infections, but so far none have been detected.

Johnson said it�s likely, though, that other people in the US are carrying similar bacteria in their guts and could become sick at some point. �It�s possible that this is the only person in the US and she had the bad luck to go to India, pick up the bad bug, come back and here it is, we found her and now that she�s dead, it�s gone from the US. That is highly improbable,� he said.

�People have asked me many times �How scared should we be?� � �How close are we to the edge of the cliff?� And I tell them: We�re already falling off the cliff,� Johnson said. �It�s happening. It�s just happening � so far � on a relatively small scale and mostly far away from us. People that we don�t see � so it doesn�t have the same emotional impact.��

he;lp

# ? Feb 8, 2017 20:59

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# ? Apr 27, 2024 14:37

free basket of chips: Sep 7, 2012; by FactsAreUseless

Anti biotics are also needed for surgery, and the number of antibiotics is limited. :eek:

# ? Feb 8, 2017 21:22

Chard: Aug 24, 2010

this is as inevitable as it was predictable (completely)

# ? Feb 9, 2017 02:08

thechosenone: Mar 21, 2009

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.

# ? Feb 9, 2017 02:23

GhostofJohnMuir: Aug 14, 2014; anime is not good

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.

# ? Feb 9, 2017 02:25

Chard: Aug 24, 2010

oh wait no i meant the other thing. this was completely predictable and completely avoidable*

*provided people are not idiots**

**lol

# ? Feb 9, 2017 02:26

GhostofJohnMuir: Aug 14, 2014; anime is not good

Chard posted:

oh wait no i meant the other thing. this was completely predictable and completely avoidable*

*provided people are not idiots**

**lol

tragedy of the common colds

# ? Feb 9, 2017 02:26

thechosenone: Mar 21, 2009

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.

# ? Feb 9, 2017 02:52

Avalanche: Feb 2, 2007

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.

# ? Feb 9, 2017 03:09

Owlofcreamcheese: May 22, 2005; Can't post for 9 years!; Buglord

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.

# ? Feb 9, 2017 03:17

aparmenideanmonad: Jan 28, 2004; Balls to you and your way of mortal opinions - you don't exist anyway!; Fun Shoe

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.

# ? Feb 9, 2017 03:53

Chard: Aug 24, 2010

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.

# ? Feb 9, 2017 03:57

Arglebargle III: Feb 21, 2006

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.

# ? Feb 9, 2017 03:58

namaste friends: Sep 18, 2004; by Smythe

It's right in the articles I posted you guys. Big ag is the problem.

# ? Feb 9, 2017 03:58

reagan: Apr 29, 2008; by Lowtax

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.

# ? Feb 9, 2017 04:16

Fojar38: Sep 2, 2011; Sorry I meant to say I hope that the police use maximum force and kill or maim a bunch of innocent people, thus paving a way for a proletarian uprising and socialist utopia

also here's a stupid take
---------------------------->

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.

# ? Feb 9, 2017 04:17

reagan: Apr 29, 2008; by Lowtax

Also, phage therapy is really neat and I hope it takes off.

# ? Feb 9, 2017 04:20

Axelgear: Oct 13, 2011; If I'm wrong, please don't hesitate to tell me. It happens pretty often and I will try to change my opinion if I'm presented with evidence.

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.

They were giving colistin to pigs.

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

reagan: Apr 29, 2008; by Lowtax

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.

# ? Feb 9, 2017 04:28

Owlofcreamcheese: May 22, 2005; Can't post for 9 years!; Buglord

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.

# ? Feb 9, 2017 04:56

Nocturtle: Mar 17, 2007

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.

# ? Feb 9, 2017 05:16

aparmenideanmonad: Jan 28, 2004; Balls to you and your way of mortal opinions - you don't exist anyway!; Fun Shoe

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.

# ? Feb 9, 2017 05:53

OneEightHundred: Feb 28, 2008; Soon, we will be unstoppable!

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.

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.

# ? Feb 9, 2017 05:55

Axelgear: Oct 13, 2011; If I'm wrong, please don't hesitate to tell me. It happens pretty often and I will try to change my opinion if I'm presented with evidence.

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.

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.

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.

# ? Feb 9, 2017 06:03

Shbobdb: Dec 16, 2010; by Reene

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.

# ? Feb 9, 2017 09:02

suck my woke dick: Oct 10, 2012; I CANNOT EJACULATE WITHOUT SEEING NATIVE AMERICANS BRUTALISED!

Put this cum-loving slave on ignore immediately!

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.

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.

bacteria aren't people dude

# ? Feb 9, 2017 11:35

Fangz: Jul 5, 2007; Oh I see! This must be the Bad Opinion Zone!

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.

# ? Feb 9, 2017 11:50

MiddleOne: Feb 17, 2011

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.

# ? Feb 9, 2017 12:04

Rigged Death Trap: Feb 13, 2012; BEEP BEEP BEEP BEEP

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

# ? Feb 9, 2017 13:10

Shbobdb: Dec 16, 2010; by Reene

blowfish posted:

bacteria aren't people dude

So?

# ? Feb 9, 2017 16:59

Axelgear: Oct 13, 2011; If I'm wrong, please don't hesitate to tell me. It happens pretty often and I will try to change my opinion if I'm presented with evidence.

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.

# ? Feb 9, 2017 17:08

Phyzzle: Jan 26, 2008

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?

# ? Feb 9, 2017 17:22

MiddleOne: Feb 17, 2011

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.

# ? Feb 9, 2017 17:26

Shbobdb: Dec 16, 2010; by Reene

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.

# ? Feb 9, 2017 17:33

pidan: Nov 6, 2012

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.

# ? Feb 9, 2017 17:43

Shbobdb: Dec 16, 2010; by Reene

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.

# ? Feb 9, 2017 17:47

HelloSailorSign: Jan 27, 2011

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.

# ? Feb 9, 2017 20:12

Fojar38: Sep 2, 2011; Sorry I meant to say I hope that the police use maximum force and kill or maim a bunch of innocent people, thus paving a way for a proletarian uprising and socialist utopia

also here's a stupid take
---------------------------->

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

OnceIWasAnOstrich: Jul 22, 2006

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?

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.

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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# ? Apr 27, 2024 14:37

Owlofcreamcheese: May 22, 2005; Can't post for 9 years!; Buglord

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.

# ? Feb 9, 2017 21:07

The Something Awful Forums > Discussion > Debate & Discussion > Anti-biotic Resistance

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