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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”

#181

Post by swamp40 »

ceejayoz wrote: post #82
swamp40 wrote: post #64

Earlier quoted context omitted.

> tools of last resort only to be used in emergencies, with great hesitation, and only when absolutely necessary. Really? And whose lives are you willing to play that game with? Your 8 y.o son, who just broke his arm and has new swelling three days after the arm has been set? Your wife, with a bladder infection so severe it's bleeding and she has a fever? "Sorry, son - your suffering is for the betterment of mankind.…

Those examples both qualify as necessary and emergent. What's been happening for decades is things like kids getting a cold and doctors wanting to appease panicked parents by prescribing an antibiotic (that's obviously going to do nothing to a virus).

I'm not sure how prevalent your example is these days.

I have plenty of recent experience bringing kids to pediatricians, and they do not hand out antibiotics like popcorn.

They do lots of rapid in-office tests that detect strep, flu, swine flu, fungus etc. within minutes - so the diagnoses are much more accurate than in the past.

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

#182

Post by vidarh »

dsizzle wrote: post #169
ghaff wrote: post #119

Earlier quoted context omitted.

You've been voted down but there is actually a school of thought that excess use of antibacterials and generally going "overboard" (whatever that means exactly) with preventing children from being exposed to natural flora can potentially result in weakened immune systems. There's a lot of pseudo-science in these claims but that doesn't mean there's absolutely no truth to them. It would probably be hard to do a study…

Ignoring the snark (of the parent comment), I've often wondered why it was bad to use anti-bacterial soap (and antibiotics in general), but not regular soap, since both leave some amount of bacteria behind, which presumably have genetics making them more resistant to the pressure. I think part of the answer is that its just not possible to evolve resistance to any amount of soap and hand washing, unlike resistance to…

It obviously is possible to evolve resistance to soap and hand washing: It doesn't kill us.

But the gap from a bacteria to something that can withstand the physical barrage of a thorough wash is huge in comparison to the relatively tiny changes to overcome some antibiotics. E.g. an antibiotic might disrupt a single process of the bacteria that is beneficial (for them) but that have a multitude of similar alternatives that are different enough for the antibiotic to fail. Compare that to even just being able to strongly enough attach to the skin to not be flushed away by sheer force from a wash.

There are many reasons that tends to be given for being careful about stronger measures: 1) it is not necessary. It's a matter of being cautious - by using the least effective means that is effective enough, we exert the minimum pressure necessary, leaving us with a larger arsenal of (to us) gentle alternatives to step up to. 2) the stronger methods, the more we kill off beneficial or neutral bacteria too, and by doing so we may make conditions better for bacteria that are nasty for us if we happen to pick them up. 3) we reduce our immune systems exposure to relatively harmless amounts of bacteria and some believe this may be sufficient to actually reduce our overall immune defence.

As DanBC pointed out in response to one of my other comments, there's also the issue of physical damage. While we can bring the heavy artillery and effectively kill anything that lives on our skin, we can as collateral damage cause damage to our skin that creates additional places to hide - effectively a worse variation of washing away good/neutral baceteria - not only may we be removing the competition, but we may be opening cracks and folds that'll be excellent hiding places.

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

#183

Post by Bjoern »

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…

> And this is the way forward to developing new antibiotics.

I personally think there is much potential in Phages in the future. It has already show to be one of the ways to go fighting resistant bacteria.

https://en.wikipedia.org/wiki/Phage_therapy

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

#184

Post by moocowduckquack »

With the development of generic anti-virals like DRACO ^1 - http://web.mit.edu/newsoffice/2011/antiviral-0810.html - I wonder if we might see viruses become largely treatable even while bacterial infections are becoming less so.

^1 who names these things and are they purposely trolling conspiracy theorists?

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

#185

Post by selectodude »

ssmoot wrote: post #179
TsiCClawOfLight wrote: post #145

Earlier quoted context omitted.

I'm not talking about infants, I'm talking about the majority of the adult population which can take good care of it's own.

Yeah, it's still a superiority insult. I think I've been prescribed antibiotics for an obviously viral infection one time in my adult life. I can count the number of times (in my late 30s) that I've been prescribed antibiotics as an adult on one hand. When you factor in that people just don't go to Dr's all that often in the US, especially the poor, I'd need to see some actual data before I believe this is a grossly…

http://www2.costco.com/Pharmacy/DrugInfo.aspx?p=1&SearchTerm...

30 pills - $5.90. So a normal cycle would be about 3 dollars. In the United States. Antibiotics are so inexpensive.

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

#186

Post by mitchty »

mjt0229 wrote: post #24
ronaldx wrote: post #15

> 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 ev…

>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. I'm not convinced that there must be a cost; furthermore, I think it's unlikely that if there is a cost, it is high enough to be significant. Bugs evolve, but they do…

There is a catch here however, any resistance a bacteria has, has implicit cost to the bacteria in the form of copying the resistances' dna into new cells. This costs the organism energy and time to copy. If it confers no benefit it will be dropped from the genome.

I really recommend everyone here read Power, Sex, Suicide, mitochondria and the meaning of life. Amazon link (no affiliation/referral) http://www.amazon.com/Power-Sex-Suicide-Mitochondria-ebook/d...

Bacteria both evolve resistance quickly, they also lose it just as quick. Because unless it directly is needed in the here and now, the bacteria that remove it and survive without it outcompete the rest of the bacteria.

This is my understanding at least, a real bacteriologist can comment what I inevitably got wrong. But the recent study that used existing antibiotics in a certain way to kill bacteria is a great demonstration of bacteria not being able to select for all simultaneously and retain the old resistance in the future.

I'm not overly concerned about bacterial resistance given there are ways we can work around it.

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

#187

Post by TaffeyLewis »

patrickg_zill wrote: post #118

While most view colloidal silver as quackery, the fact is that using silver in colloidal form along with other medicine administered at the same time, was standard practice 80 years ago. Perhaps silver in nanoparticle form will make a comeback, as bacteria don't seem to be as able to survive the cell wall disruption that silver can cause.

There are actually studies being done around implementing exactly that with antibiotics... However there is also the fun danger of your skin turning incurably silvery blue thanks to the silver component in the antibiotics... No really.

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

#188

Post by mturmon »

zeteo wrote: post #65
robterrell wrote: post #54

Earlier quoted context omitted.

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.

>you'll buy drugs for high cholesterol the rest of your life Not if you get killed by an infection first.

This humorous observation does not affect the argument, it just derails it. It's easier to make money off drugs for chronic conditions than for one-off infections.

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

#189

Post by bradleyjg »

nostromo wrote: post #53

80% of the antibiotics we use are given to animals.[1] That seems like a good place to cut back. [1] http://www.nytimes.com/2012/09/04/health/use-of-antibiotics-...

There's a bill introduced in the Senate that would restrict antibiotics that are approved in humans from being used in agricultural in a prophylactic way.[1] A similar bill has been introduced in the House[2] by Rep. Louise Slaughter who has degrees in microbiology and public health.

Given the pernicious and undemocratic over-representation of rural interests embodied in the structure of the Senate, I don't expect them to go anywhere.

[1] Preventing Antibiotic Resistance Act of 2013 -- http://thomas.loc.gov/cgi-bin/query/z?c113:S.1256.IS:/

[2] Preservation of Antibiotics for Medical Treatment Act of 2013 -- http://thomas.loc.gov/cgi-bin/bdquery/z?d113:H.R.1150:@@@L

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

#190

Post by Symmetry »

ataggart wrote: post #135
stcredzero wrote: post #63

Earlier quoted context omitted.

In Denmark, they prevent infections in chicken houses by thoroughly cleaning them, then using techniques developed for clean rooms to prevent infections. In the US, we let them wade in their own filth and pump them full of antibiotics. We should just make it flat out illegal to use antibiotics across entire herds of livestock. We should also fine doctors for prescribing antibiotics to patients with a viral infection…

>We [sic] should just make it flat out illegal to... >We [sic] should also fine doctors for... Why is violence an appropriate response to these non-violent issues?

If someone is going to put a single bullet in his gun, spin the cylinder, point it at someone and fire then I think I would subsequently be quite justified in restraining them even if the gun didn't happen to go off that time. Likewise if the person was doing something that had a 1 in 60 chance of killing 10 people, and likewise if what they were doing had an tiny chance of killing millions of people.
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