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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”

#91

Post by selmnoo »

robterrell wrote: post #54
zeteo wrote: post #49

Earlier quoted context omitted.

> we're helpless and the world is again going to be a scary place Whoa there. According to the article, we have few new antibiotics precisely because the old ones have been so effective: >Infections are not that common compared to other types of conditions like high blood pressure or high cholesterol. [...] They have to develop drugs that will make money, and that’s not an antibiotic. When we had lots of development…

I still worry about the profit motive getting in the way. You'll buy antibiotics for days or maybe weeks; you'll buy drugs for high cholesterol the rest of your life.

This is touched in the FRONTLINE documentary. See 33:40-40:00 here: http://www.pbs.org/wgbh/pages/frontline/hunting-the-nightmar...

Basically Pfizer, one of the last companies working on antibiotics for gram-negative bacteria, pulled out due to pressure from shareholders, because there's little money to be made here. You spend billions of dollars on creating an antibiotic, and upon its release the recommended instruction is to "use it as less as possible"? -- there's no money in that obviously, there's more money in cholesterol drugs, ADHD drugs, and other drugs you'll continue taking for a long long time.

I feel bad to steer the discussion this way -- but this it, this perfectly underscores one of the scary faults of capitalism. Everyone wants to see a nice smooth growth curve. Growth is prioritized higher than long-term stability of society. We need to fundamentally re-think this.

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

#93

Post by dragonwriter »

ssmoot wrote: post #81
TsiCClawOfLight wrote: post #41

Earlier quoted context omitted.

Refuse behaving like the average (ahem, mostly american) and don't ask for medicine for benign illnesses.

I think as a rule people aren't as stupid as "common knowledge" would like to pretend. My 18mo daughter has had a half dozen ear infections and two staph infections. Antibiotics each time. Would it be better to leave a staph infection untreated with antibiotics? How? Lance and clean the infection site... and then what? Or ear infections? I had frequent undiagnosed ear infections as a small child and now have reduced…

The thing with Tragedy of the Commons -- which is exactly what the antibiotic situation is -- is that the decisions which are optimum for each individual actor in isolation are suboptimal on the whole.

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

#94

Post by vivin »

tokenadult wrote: post #70

The interviewed expert has very good credentials and clinical experience to be talking about what he is talking about, and his warnings should be taken seriously. But even at that, the fallacious teleological language he uses about biological evolution by natural selection suggests a way out of this problem. When he says, "Bacteria, like any living organism, want to survive," and "So anything that we do to try and ki…

I think it's a bit pedantic to argue about his usage of "desire". Evolution is a blind watchmaker. The bacteria are reacting to selective pressures. Large populations of bacteria around the world are getting exposed to different kinds of antibiotics. It's not a matter of "if" they will acquire resistance, but "when", and we're seeing this happening right now.

The fact that lines of bacteria go extinct does nothing to disprove the fact that bacteria are developing resistance to antibiotics. Is it possible that there are antibiotics out there that can stop the newly-resistant bacteria? Of course. But it's getting harder and harder to find newer and more-powerful antibiotics.

A promising alternative appears to be bacteriophages.

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

#95

Post by UnFleshedOne »

cliveowen wrote: post #40
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…

I think it's too easy to say that overuse of antibiotics is what brought us here. In the article it says that companies stopped developing new antibiotics when development costs became too high to justify given the narrow market. Now, if doctors were to use antibiotics only for very serious infections, a last resort method, then pharmaceutical companies wouldn't have had the incentive to develop even the drugs that w…

Kinda brings the free market idea into a different light, isn't it?

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

#96

Post by hooande »

One thing I learned from watching this episode of Frontline was that we aren't doing a lot of research into new antibiotics. Companies like Pfizer (the original makers of penicillin) would rather create drugs like Lipitor or Prozac, things that customers will take everyday for the rest of their lives. Antibiotics are intended to be used as sparingly as possible, which doesn't leave room for a lot of profit. Even the National Institute of Health has but antibiotic research on the back burner to pursue more pressing concerns.

The other big problem we face is that certain antibiotics are like steroids for farm animals. I believe that they kill the bacteria in the gut of a cow or big that signals when they should stop eating, resulting in larger stock (or something like that). This increases the exposure of bacteria to the antibiotics, making things less safe for all of us.

But drug companies and farmers aren't to blame for our antibiotic situation. Capitalism encourages profit and doesn't ask questions about how it's made. Corporations have a fiduciary responsibility. And doctors can't be faulted for overprrscribing antibiotics either. A sick person is the ultimate debugging task and most doctors will try anything that could help the patient. I don't know if this problem has a good solution.

If we research new antibiotics then bacteria will eventually evolve to resist them (kicking the can down the road). If we stop using antibiotics then more people will suffer, potentially unnecessarily (destroying the village to save the village). Trying to fight evolution is a losing game. I am, however, confident that someone somewhere will come up with a break through in the next few decades that will allow us to temporarily solve this problem once again.

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

#97

Post by taliesinb »

tokenadult wrote: post #70

The interviewed expert has very good credentials and clinical experience to be talking about what he is talking about, and his warnings should be taken seriously. But even at that, the fallacious teleological language he uses about biological evolution by natural selection suggests a way out of this problem. When he says, "Bacteria, like any living organism, want to survive," and "So anything that we do to try and ki…

Is there any indication that the organisms we have "stolen" antibiotic molecules from might become themselves suffer disruption from bacteria that they can no longer kill? Fungi are involved in many symbiotic relationships that we indirectly depend on, for example the fixation of nitrogen for plant growth.

One imagines a future in which we have a dwindling supply of biodiversity to 'sacrifice' in order to keep ourselves safe from bacterial onslaught.

Not unlike oil -- millions of years to produce, but destroyed in a few generations of exponential human growth.

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

#98

Post by snake_plissken »

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 is what I don't completely understand. Why has no one developed a disinfectant spray that hospitals can apply ad-nauseum (pun intended, the smell ideally wouldn't make people nauseous) all over the hospital? Or, do I not understand the vectors properly?

The way I perceive these stories is that hospitals are actually extremely dirty on a microbial level (as is most of the world), it's just counter-intuitive because I think a lot of people take for granted that a hospital is imagined to be a super sterile place. MRSAs could potentially reside on every surface; an act as simple as touching a bed railing could get you infected. You then have patients in recovery with healing wounds/depressed immune systems, which need antibiotic treatment of some kind when they have an infection. But it's not like you cannot become infected by a MRSA outside of a hospital, you can, and the same antibiotics won't work effectively for you just as they don't work effectively in the hospital. So the first step in my mind is making sure the hospital is 'clean'.

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

#99

Post by TillE »

nikbackm wrote: post #52
ramblerman wrote: post #38

Earlier quoted context omitted.

It's not an impossible scenario but have the decency not to wrap this 'End of the world fantasy' as a fact or certainty. There have been plenty of those before you and there will be plenty more to come. Y2K, Nuclear War, Swine Flu, Global Warming, Apocalypse, take your pick.

Well, none of those (if you replace Y2K with Y2038!) are down for the count yet.

Tne real threat of a Dr. Strangelovian nuclear apocalypse certainly died with the Soviet Union, which isn't to say that such conditions could never arise again. And of course the risk of a smaller scale nuclear war is still very real.

In each of these cases there seems to be a tendency to think that just because total disaster has not yet occurred, that the risks are nonexistent.

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

#100

Post by baddox »

jasonshen wrote: post #90
tokenadult wrote: post #70

The interviewed expert has very good credentials and clinical experience to be talking about what he is talking about, and his warnings should be taken seriously. But even at that, the fallacious teleological language he uses about biological evolution by natural selection suggests a way out of this problem. When he says, "Bacteria, like any living organism, want to survive," and "So anything that we do to try and ki…

You are completely right in that bacteria don't have the ability to "want" things since they don't have any kind of brain. However, desire is a useful way for the general public to understand what is happening. It's like saying "Water wants to flow to the lowest point of a room" or "The arrow wants to follow the path of least air resistance"

Yes, the talk of desire is clearly personification that's not meant to be taken literally.
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