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Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

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Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#11

Post by erichurkman »

AaronFriel wrote: post #6

For the past half century, we should have been treating our antibiotics like weapons of mass destruction - tools of last resort only to be used in emergencies, with great hesitation, and only when absolutely necessary. The industry and the doctors responded: antibiotics were too profitable and the risk seemed too distant. Now we have no weapons; we're helpless and the world is again going to be a scary place where a…

> Now we have no weapons; we're helpless and the world is again going to be a scary place where a cut or a scrape can land you in a hospital or in a mortuary.

Perhaps most terrifying is that the mere act of hospitalization will likely be the highest vector of transmission of nearly untreatable infections. Go in for a routine procedure and end up in the isolation ward due to some highly infectious, deadly disease.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#12

Post by kubiiii »

I was wondering if resistant bacterial strain would drop resistances against one antibiotic if we stop using it for long enough. Maintaining a resistance comes at a cost for a living organism (synthesizing an enzyme), so the bacteria that would drop it would be promoted.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#13

Post by w4 »

eranation wrote: post #5

What about Linezolid? http://en.wikipedia.org/wiki/Linezolid

The Wiki article you linked specifically mentions Linezolid isn't necessarily effective against many Gram-negatives (the resistant bacteria):

Linezolid has no clinically significant effect on most Gram-negative bacteria. Pseudomonas and the Enterobacteriaceae, for instance, are not susceptible.[90] In vitro, it is active against Pasteurella multocida,[2][91] Fusobacterium, Moraxella catarrhalis, Legionella, Bordetella, and Elizabethkingia meningoseptica, and moderately active (having a minimum inhibitory concentration for 90% of strains of 8 mg/L) against Haemophilus influenzae.[87][90] It has also been used to great effect as a second-line treatment for Capnocytophaga infections.[43][92]

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#14

Post by frakkingcylons »

mmoche wrote: post #7

I remember hearing about Soviet research into phage therapy, where bacteriophages are cultured to consume particular strains of bacteria. I believe the treatment is only in use in a couple ex-Soviet states. Is this a reasonable avenue once we're essentially dealing with only MRSA-like infections?

I believe the MRSA-like infections you're thinking of are the Gram-negative bacteria [1] mentioned in the article. Based on the Wikipedia page for phage therapy [2], it should be an effective treatment option where the bacteria have polysacharride layer in the cell envelope, which most antibiotics cannot penetrate. There's more in the treatment section [3], which doesn't mention phage therapy however.

[1]: http://en.wikipedia.org/wiki/Gram-negative_bacteria [2]: http://en.wikipedia.org/wiki/Phage_therapy [3]: http://en.wikipedia.org/wiki/Gram-negative_bacteria#Medical_...

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#15

Post by ronaldx »

> Eventually bacteria will evolve, and they’ll adapt ways around that to overcome that obstacle.

I am more optimistic than that.

Sure: as long as antibiotic resistance is crucial for bacterial survival, bacteria have a natural need to evolve it. And, they will.

But, this will come with a genetic cost to the bacteria.

The reason that antibiotics work is because they are attacking some function that has deliberately evolved, through natural selection, to be like that. Antibiotic resistance must literally cost bacteria some efficiency in some of their other functions.

This cost was originally such that the bacteria would die. Fantastic. But note: we wouldn't actually benefit from all bacteria dying at the mention of the word antibiotic, and some bacterial resistance is good for us.

Under normal circumstances, bacteria that don't need to carry around antibiotic resistance with them will most likely have a lower genetic cost and thrive better. This may be why we have seen MRSA predominantly in hospitals and rarely in the 'wild'. (If MRSA was necessary or not costly, all SA would be MR all the time).

This gives me some hope - that antibiotic resistance is balanced, genetically forcing bacteria to be less effective in other ways and less competitive in other circumstances.

We humans are not out yet.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#16

Post by legitsource »

erichurkman wrote: post #11
AaronFriel wrote: post #6

For the past half century, we should have been treating our antibiotics like weapons of mass destruction - tools of last resort only to be used in emergencies, with great hesitation, and only when absolutely necessary. The industry and the doctors responded: antibiotics were too profitable and the risk seemed too distant. Now we have no weapons; we're helpless and the world is again going to be a scary place where a…

> Now we have no weapons; we're helpless and the world is again going to be a scary place where a cut or a scrape can land you in a hospital or in a mortuary. Perhaps most terrifying is that the mere act of hospitalization will likely be the highest vector of transmission of nearly untreatable infections. Go in for a routine procedure and end up in the isolation ward due to some highly infectious, deadly disease.

The return of the sanitarium and things like leper colonies could be in our futures.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#17

Post by w4 »

erichurkman wrote: post #11
AaronFriel wrote: post #6

For the past half century, we should have been treating our antibiotics like weapons of mass destruction - tools of last resort only to be used in emergencies, with great hesitation, and only when absolutely necessary. The industry and the doctors responded: antibiotics were too profitable and the risk seemed too distant. Now we have no weapons; we're helpless and the world is again going to be a scary place where a…

> Now we have no weapons; we're helpless and the world is again going to be a scary place where a cut or a scrape can land you in a hospital or in a mortuary. Perhaps most terrifying is that the mere act of hospitalization will likely be the highest vector of transmission of nearly untreatable infections. Go in for a routine procedure and end up in the isolation ward due to some highly infectious, deadly disease.

This, right here, is the biggest issue. Routine, minor surgery? No longer a risk free proposition. This sort of antibiotic resistance will have, and is having, enormously deleterious effects on the kind of basic health care and medical science we take for granted.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#18

Post by mesaaz »

sailfast wrote: post #4

This resistance scares me a great deal, especially as a new dad. I'm hopeful that in the coming years we'll be able to target bacteria and viruses more specifically using nano-technology and other tools at a cost effective level (admittedly I don't have a lot of knowledge in this area but I'm hopeful.) If all else fails, I guess we'll depend on the cycles of nature's adaptations and break out a new set of antibacteri…

There is reason for guarded optimism if we can eliminate, or at least drastically reduce, irresponsible use of antibiotics:

The capacity to resist antibiotics extracts a small metabolic/competitive "tax" on bacteria. In the presence of antibiotics, the costs of this tax are outweighed by the obvious benefits of antibiotic resistance.

In an environment without antibiotics, the costs of the tax outweigh their benefits, so these antibiotic-resistant bacteria will eventually be outgrown by "normal" bacteria.

If we can discipline ourselves to use antibiotics only when necessary, gradually antibiotic-resistant bacteria should become less common. Unfortunately, I doubt this will happen until the antibiotic-resistance problem becomes much more serious.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#20

Post by kubiiii »

jmcgough wrote: post #10
benmarks wrote: post #3

Really don't like the anthropomorphism.

Same - he's trying to dumb it down but really misrepresenting some things by doing so (like how evolution works).

Dumbing it down on purpose might be the key to political action.
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