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Rising Threat of Infections Unfazed by Antibiotics

nytimes.com

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Re: Rising Threat of Infections Unfazed by Antibiotics

#21

Post by gort »

rsheridan6 wrote: post #12
anamax wrote: post #8

Earlier quoted context omitted.

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-ba…

And even if they do get used they heal the patient; whereas the most profitable drugs are the ones requiring continued use.

Re: Rising Threat of Infections Unfazed by Antibiotics

#22

Post by yummyfajitas »

anamax wrote: post #8
jrockway wrote: 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…

Another advantage to lifestyle drugs is that they are unlikely to be taken away by politicians.

Politicians are likely to nationalize/cost control/otherwise interfere with lifesaving drugs. Standing up to those greedy people trying to make money by preventing people's suffering is just good media exposure.

On the other hand, cost controls for an eyelash extender? Seems less likely.

Re: Rising Threat of Infections Unfazed by Antibiotics

#23

Post by electromagnetic »

tumult wrote: 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.

MRSA lives in the community just as much, if not more, than it lives in the hospitals. From what I know of the area, some hospitals had up to 80% community-acquired infections as opposed to hospital-acquired infections, this meant that the majority of these patients were being killed by their families. I know many ICU's in the UK have full out bans on any family members entering, because if anyone in an ICU catches MRSA they're gone.

It's easy to blame the healthcare providers, and I'm sure in many cases it is the healthcare providers' fault. However, if they simply flat-out banned people from visiting in the hospital MRSA infection rates (in good hospitals) would drop like a rock.

I wouldn't be surprised if hospitals with MRSA fatality rates over 20% allow visitors in the ICU and don't have well established visitor protocols in the regular hospital. I know some wards in the UK (I have friends and family who work in hospitals) will escort you out if they see you go between patients' beds; essentially they allow you to visit 1 person per day, and they frequently have visiting hours only a couple hours long so they can actively enforce this.

My advice to anyone visiting a friend in hospital, don't touch them. No handshakes, especially no hugs. This seems extreme, but patients have died from MRSA infection in key-hole surgery incisions.

Re: Rising Threat of Infections Unfazed by Antibiotics

#24

Post by camccann »

tokenadult wrote: post #15
ledger123 wrote: post #9

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.

I've heard it proposed that we could try and work with this instead of against it, by "domesticating" diseases. Take some harmful bacteria, breed a strain that's mostly benign and moderately contagious, then let it loose to displace the more harmful strains while carefully avoiding doing too much to kill it. In other words, create selection pressures that favor mild strains.

Re: Rising Threat of Infections Unfazed by Antibiotics

#25

Post by tumult »

electromagnetic wrote: post #23
tumult wrote: 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.

MRSA lives in the community just as much, if not more, than it lives in the hospitals. From what I know of the area, some hospitals had up to 80% community-acquired infections as opposed to hospital-acquired infections, this meant that the majority of these patients were being killed by their families . I know many ICU's in the UK have full out bans on any family members entering, because if anyone in an ICU catches…

Right, I think it is sloppy of a hospital to allow people to walk in and cause that kind of damage. I think not allowing outsiders into the ICU could be a good move for many.

Re: Rising Threat of Infections Unfazed by Antibiotics

#26

Post by anamax »

camccann wrote: post #19
anamax wrote: post #8

Earlier quoted context omitted.

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 b…

> Because having individuals with limited resources independently pursuing their own goals doesn't necessarily maximize overall utility, or even any actual individual's utility.

If folks would rather spend their money on Viagra than antibiotics....

> 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.

The problem with that theory is that it doesn't account for the claimed observation that eyelash extenders get funding while antibiotics don't.

So, either the theory or observation is wrong.

> 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.

Are you actually claiming that the vast majority of people have more self-interest in eyelash extenders that antibiotics?

Re: Rising Threat of Infections Unfazed by Antibiotics

#27

Post by JunkDNA »

anamax wrote: post #8
jrockway wrote: 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…

You've hit the nail on the head. I spent several years in one of the biggest antibiotics research centers in big pharma. I watched as they systematically disbanded it. The business folks had decided that there was no money in antibiotics. The reason? The FDA (and similar agencies in other countries) are pretty much guaranteed to make any new, very successful antibiotic a "drug of last resort". This means you can only give it to an individual who has failed all the standard line therapy.

From a business perspective, why develop something if you are never going to be able to sell it in decent enough quantities to make a profit? Now, you could argue that at some point in the future, that drug will become standard line therapy when all the current front line drugs are completely useless. Unfortunately, by that time the drug is off patent and generic competition will ensure there won't be much profit.

This is a complex situation, and I'm not pretending that there is an easy solution. It seems there are a confluence of regulations and politics that conspire to prevent serious attempts at new antibiotics development. The situation is changing somewhat, and my hope is that once the problem becomes more acute, the necessary incentives will be aligned.

Re: Rising Threat of Infections Unfazed by Antibiotics

#28

Post by jrockway »

JunkDNA wrote: post #27
anamax wrote: post #8

Earlier quoted context omitted.

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…

You've hit the nail on the head. I spent several years in one of the biggest antibiotics research centers in big pharma. I watched as they systematically disbanded it. The business folks had decided that there was no money in antibiotics. The reason? The FDA (and similar agencies in other countries) are pretty much guaranteed to make any new, very successful antibiotic a "drug of last resort". This means you can only…

"Hi, we're the government. Instead of bombing Iraq, we would like to buy the IP for this critical drug you developed."

It's already developed, and they don't want to commercialize it, so why not sell the IP to the government or a charity. (The government could even theoretically compel the agreement via eminent domain. Or, the pharmaceutical company could donate the drug to the public domain and take a massive tax write off.)

Re: Rising Threat of Infections Unfazed by Antibiotics

#29

Post by JunkDNA »

jrockway wrote: post #28
JunkDNA wrote: post #27

Earlier quoted context omitted.

You've hit the nail on the head. I spent several years in one of the biggest antibiotics research centers in big pharma. I watched as they systematically disbanded it. The business folks had decided that there was no money in antibiotics. The reason? The FDA (and similar agencies in other countries) are pretty much guaranteed to make any new, very successful antibiotic a "drug of last resort". This means you can only…

"Hi, we're the government. Instead of bombing Iraq, we would like to buy the IP for this critical drug you developed." It's already developed, and they don't want to commercialize it, so why not sell the IP to the government or a charity. (The government could even theoretically compel the agreement via eminent domain. Or, the pharmaceutical company could donate the drug to the public domain and take a massive tax wr…

Drug companies do sell or give away IP from time to time. But even in the scenario you suggest, with finite resources, why put money into antibiotics development? Why not just fund cancer research at a higher level? I think most pharmas wouldn't want to take the risk that the governmnt would leave them holding the bag. Contrary to the popular meme, drug companies don't generally want to sit on a drug that is ready to go.

But all that aside, there is nothing stopping the NIH from starting a research program and developing their own antibiotics (or any academic institution). This happens a bit already, but then it comes time to run the clinical trials and develop the research compound into an actual medicine. This requires expertise and infrastructure that does not exist in the public sector at a sufficient level to get the job done.

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