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Rising Threat of Infections Unfazed by Antibiotics

nytimes.com

11–20 of 29 posts

Re: Rising Threat of Infections Unfazed by Antibiotics

#11
post #7

This is a disaster in slow motion. It is a few years old, but Betrayal of Trust is still an excellent overview of the problem: http://www.amazon.com/gp/product/0786884401?ie=UTF8&tag=...

I haven't read that one, but I read Garrett's earlier one, "The Coming Plague" - it was an hysterical, anti-Western, fear-mongering eco-nut screed. In the decade and a half since she wrote it, not a single one of the "plagues" she claimed were about to break out across the world has shown any signs of getting worse, much less becoming the sort of widespread "disaster" she claimed was imminent.

Re: Rising Threat of Infections Unfazed by Antibiotics

#12
post #8
post #3

At least the pharmaceutical companies are hard at work finding new drugs to make your eyelashes grow longer.

While the eyebrow example is wrong, let's assume that the gist was correct. In general, folks tend to produce things that other people are willing to pay for. Why should pharma be any different? And why is this wrong? You want more drugs that save peoples lives? Great! So do I. Here's how we do it. Make it possible for folks to get rich on drugs that save people's lives. Note - cost controls won't do it (unless we're…

Here's another way - socialize medical research funding, at least for antibiotics.

Antibiotics are inherently less profitable than other drugs because doctors try to avoid using new ones so that the bugs don't develop resistance to them. By the time they're freely used, the patent might have expired, as patents of the kidney-killing drugs mentioned in this article have decades ago.

I don't really see a good market-based solution here.

Re: Rising Threat of Infections Unfazed by Antibiotics

#13
I know someone who contracted MRSA after randomly scraping his knee. Almost killed him, and it came out of nowhere. Some hospitals have MRSA fatality rates over 20%. Scary as shit! Antibiotics abuse has screwed us, I guess, along with the sloppiness of many healthcare providers.

Re: Rising Threat of Infections Unfazed by Antibiotics

#14
post #2

This is the part of the article I most like: “You don’t really have much choice,” said Dr. Azza Elemam, an infectious-disease specialist in Louisville, Ky. “If a person has a life-threatening infection, you have to take a risk of causing damage to the kidney.” Such a tradeoff confronted Kimberly Dozier, a CBS News correspondent who developed an Acinetobacter infection after being injured by a car bomb in 2006 while o…

"Of course, I'm highly biased in that regard." This prompted me to look at your info and now reading your website ( http://www.healthgazelle.com/ ) and I am pleased, to say the least. I added my comment above (or below where ever it appears) without reading your website.

I suppose that answers your closing question of "Any ideas?". ;-)

Re: Rising Threat of Infections Unfazed by Antibiotics

#15

This article is scary. To me it seems that we are just creating more powerful strains of various bacteria with our use of anti-biotics. May be it is time we need to look at alternate ways to enhance our immunity so that we are not that much susceptible to bacterial (or virus) infection. May be alternative medicine or Michael Pollan way of eating. Any ideas?

we need to look at alternate ways to enhance our immunity

Vaccines suit this description. But natural selection will favor bacteria that beat your immunity, however your immunity is enhanced. The bacteria for which we have effective defenses, of whatever kind, we forget about, but the few kinds of bacteria that can harm human beings continue to be surprising. That's the arms race of natural selection.

Re: Rising Threat of Infections Unfazed by Antibiotics

#16
post #13

I know someone who contracted MRSA after randomly scraping his knee. Almost killed him, and it came out of nowhere. Some hospitals have MRSA fatality rates over 20%. Scary as shit! Antibiotics abuse has screwed us, I guess, along with the sloppiness of many healthcare providers.

Patients are equally sloppy. When they feel better, many discontinue antibiotic use. Providers too readily prescribe antibiotics to try to appease patients with, say, an obvious viral respiratory infection, but these are most often less valuable antibiotics such as first generation penicillins anyways.

Judicious antibiotic use is important, both for patient and provider, but there is a more pernicious problem lurking: the use of late-generation antibiotics - still critical for hospital use - in feed to produce larger livestock more cheaply.

Re: Rising Threat of Infections Unfazed by Antibiotics

#17
Despite the on-again off-again media hysteria, it would seem that there is some promising research on the horizon. Check out the TED talk by Kary Mullis: http://www.ted.com/talks/lang/eng/kary_mullis_next_gen_cure_... "Drug-resistant bacteria kills, even in top hospitals. But now tough infections like staph and anthrax may be in for a surprise. Nobel-winning chemist Kary Mullis, who watched a friend die when powerful antibiotics failed, unveils a radical new cure that shows extraordinary promise."

Re: Rising Threat of Infections Unfazed by Antibiotics

#18

This article is scary. To me it seems that we are just creating more powerful strains of various bacteria with our use of anti-biotics. May be it is time we need to look at alternate ways to enhance our immunity so that we are not that much susceptible to bacterial (or virus) infection. May be alternative medicine or Michael Pollan way of eating. Any ideas?

Multidrug therapy will become the mainstay. It works for HIV (HAART) because despite the high mutation rate of HIV, it is exceedingly rare for the virus to sustain the ~3 different mutations required to confer resistance to 3 different drugs simultaneously.

I imagine that this will, in fact, be how we end up applying our targeted cancer therapies as well.

Let me put it this way: each base of the genome of a {cancer, bacterium, virus} has some chance of mutation at each replication step. If you target just one protein, then you may need as little as one mutation to confer resistance. In a normal human genome, you would expect this to happen to the nucleotide of interest once every hundred thousand cell divisions. Obviously a cancer has a higher error rate and millions of rapidly dividing cells, so this would occur quickly. If you target two proteins, you would expect both mutations to co-occur once every (100,000 x 100,000) cell divisions. If you target three proteins... Now you are getting somewhere.

Certainly it is not quite this simple. If variants with one mutation are more fit than those without it, then resistance to one drug in the cocktail will be selected for. But with HAART, we have seen that the multidrug approach is fairly - perhaps surprisingly - robust to that possibility.

Re: Rising Threat of Infections Unfazed by Antibiotics

#19
post #8
post #3

At least the pharmaceutical companies are hard at work finding new drugs to make your eyelashes grow longer.

While the eyebrow example is wrong, let's assume that the gist was correct. In general, folks tend to produce things that other people are willing to pay for. Why should pharma be any different? And why is this wrong? You want more drugs that save peoples lives? Great! So do I. Here's how we do it. Make it possible for folks to get rich on drugs that save people's lives. Note - cost controls won't do it (unless we're…

In general, folks tend to produce things that other people are willing to pay for. Why should pharma be any different? And why is this wrong?

Because having individuals with limited resources independently pursuing their own goals doesn't necessarily maximize overall utility, or even any actual individual's utility. It's entirely possible to have a scenario where, say, nobody would individually pay for something to be researched, but everyone would be willing to chip in a small portion of the cost if everyone else did the same. Since it's difficult to ensure wide-scale cooperation, it doesn't happen and the result is that everyone is worse off.

I don't understand the mindset that sees a problem that, by elementary game theory, doesn't have an optimal outcome reachable by simple self-interest, and proposes that what we need is more self-interest.

Re: Rising Threat of Infections Unfazed by Antibiotics

#20
post #13

I know someone who contracted MRSA after randomly scraping his knee. Almost killed him, and it came out of nowhere. Some hospitals have MRSA fatality rates over 20%. Scary as shit! Antibiotics abuse has screwed us, I guess, along with the sloppiness of many healthcare providers.

Patients are equally sloppy. When they feel better, many discontinue antibiotic use. Providers too readily prescribe antibiotics to try to appease patients with, say, an obvious viral respiratory infection, but these are most often less valuable antibiotics such as first generation penicillins anyways. Judicious antibiotic use is important, both for patient and provider, but there is a more pernicious problem lurking…

Yep. In general, we too often use our powerful weapons with disregard, and it's coming back to bite us in the ass.
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