Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

pbs.org

Post reply on HN
Print view View original

191–200 of 414 posts

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

#191

Post by mturmon »

JumpCrisscross wrote: post #139

" These are companies that are for-profit companies, and like you said, they have to answer to people. They have to develop drugs that will make money, and that’s not an antibiotic. " The profit motive is almost as blind a watchmaker as natural selection. We've built an environment which encourages bacteria to develop antibiotic resistance. Let's structure a pharmaceutical industry in which antibiotics are profitable…

It turns out there is a whole sub-field of interaction between medicine and finance devoted to the economics of drug discovery. You can google it, but here's one example:

http://www.nature.com/clpt/journal/v87/n3/pdf/clpt2009298a.p...

I attended a talk by an economist (whose name I don't recall, alas) who discussed establishing a futures market for drugs, with portfolios which would smooth out variabilities in what works and does not. It's pretty much the same as what you described.

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

#192

Post by refurb »

selmnoo wrote: post #91
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.

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 instruc…

Keep in mind that Pfizer's strategy is in response to the incentives offered by the marketplace including regulations set forth by the FDA and patent office. It's not a free market that sense.

It's not hard for the FDA to streamline approval process so that development costs are lowered or for them to offer extended periods of market exclusivity so that costs can be recouped over a longer period of time.

The FDA has already moved on the regulatory aspect and companies have responded. Antibacterials is a much more attractive market now than it was 5 years ago.

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

#193

Post by Tloewald »

jmsduran wrote: post #126
vivin wrote: post #94

Earlier quoted context omitted.

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…

I have never heard of bacteriophages before. Doing some light research, I found their protein/body structures to look almost machine-like. Very fascinating stuff. From Wikipedia's Bacteriophage page: "Medical trials were carried out, but a basic lack of understanding of phages made these invalid". I seriously hope alternatives like bacteriophages are being revisited and reconsidered within the medical community, as i…

Phages were the subject of one or two novels by Greg Bear. I often wonder when we might see more research in this area bearing fruit.

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

#194

Post by thwarted »

mistercow wrote: post #138
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'm slightly bugged by "desire" type language because it does actually cause problems in how laymen think about evolution. It's not uncommon to hear them make the mistake of thinking evolution will "think ahead". But the bigger problem I have with it is the "anything we do ... bacteria will eventually discover". Some problems are just very difficult to evolve around, and it's hard to predict what they'll be even if y…

It took evolution billions of years to make machines that can run 60 miles per hour. It took humans a few thousand years to create machines that run about 12 times that fast.

It took evolution billions of years to make machines that could make machines that run about 700 miles per hours.

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

#195

Post by mixmastamyk »

narrator wrote: post #176
baddox wrote: post #100

Earlier quoted context omitted.

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

"Desire" implies that the bacteria is acting purposefully and planning ahead. This isn't what's happening unless you attribute the bacteria's activity to some sort of intelligence. On the contrary, we eliminated smallpox which was one of the most devastating diseases in history so this fatalism is basically disproved. More depressingly, we've also made extinct thousands of species who have not evolved to resist us.

Also, individuals don't evolve, populations do. So there is no "wanting" whether you've got a brain that can or not.

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

#196

Post by nathan_long »

hodder wrote: post #86

The anthropomorphism of bacterial evolution makes the article hard to follow for the layman (me). Can someone familiar with bacterial evolution please explain to me how the use of antibiotics leads to superbugs? I am clearly misunderstanding something. I was under the impression that in a population of bacteria, genes express themselves in any number of random ways. If we expose the bacterial culture to antibiotics,…

My guess: before the antibiotic, the minority resistant bacteria have to compete with the majority non-resistant. After, they can proliferate freely. Repeat with the next antibiotic, and soon all the ones we see are resistant to all the antibiotics we have.

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

#197

Post by resu_nimda »

mistercow wrote: post #138
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'm slightly bugged by "desire" type language because it does actually cause problems in how laymen think about evolution. It's not uncommon to hear them make the mistake of thinking evolution will "think ahead". But the bigger problem I have with it is the "anything we do ... bacteria will eventually discover". Some problems are just very difficult to evolve around, and it's hard to predict what they'll be even if y…

Evolution is actually a really crappy optimization algorithm. The reason it has worked so well is not that it is so effective, but because it's the only game in town. It took evolution billions of years to make machines that can run 60 miles per hour.

You come off as being dismissive of the power and beauty of evolution, although I don't think that's your intent. Evolution assembled the most complex system known to exist, starting from a handful of molecules, without any "thought" or "reasoning." The entire concept/illusion of life and consciousness was fabricated out of simple natural elements and physical processes. Amazing. Sure, once all of that has been put in place, it's trivial to expand upon. I'm sure you agree, I just like to take any opportunity to point this out. :)

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

#198

Post by mtdewcmu »

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…

Evolution doesn't work the same way in bacteria as in other organisms due to horizontal gene transfer[1]. Bacteria can't be split into well-defined lines, because they share a common pool of genetic information.

[2] is a good book to get a perspective on antibiotic resistance.

[1] http://en.wikipedia.org/wiki/Horizontal_gene_transfer [2] http://www.perseusbooksgroup.com/dacapo/book_detail.jsp?isbn...

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

#199

Post by jmilloy »

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 don't get the sense from this comment that you totally know what you're talking about (neither is it my area of expertise). On the one hand, you're right that many humans are actively working on this problem. On the other hand, the data suggests to me that you might be overly optimistic. Only 2 new classes of antibiotics (oxazolidinones and cyclic lipopeptides) have been developed in the last 40 years. The rate of new antibiotic drugs reaching the market has decreased significantly as well. There are a finite number of biological mechanisms for antibiotics to disrupt, and the methods that bacteria use to develop resistance are quite general.

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

#200

Post by djrogers »

kephra wrote: post #132
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-...

Antibiotics in animal farms should be banned world wide. Unfortunate the only nation who has the power to convince others joining this ban, is one of the worst abusers of antibiotics. Consumers might have a choice, if they are wealthy enough to afford it. If you are a beef consumer, eat beef from Namibia, where antibiotics for animals are banned, and avoid US or South Africa. Ask you butcher, if he can offer antibiot…

Unfortunate the only nation who has the power to convince others joining this ban, is one of the worst abusers of antibiotics.

I'm curious as to just exactly how you think the US is going to convince China, Russia, India, etc to ban antibiotics? The US could obviously afford to do so, as the incremental cost in the price of animal protein (due to smaller yields) could be absorbed by modifications to eating habits or redistribution models (i.e. food stamps).

I'm not sure the same could be said in some of the countries that are much larger and have huge difficulties with food production/distribution already.

Post reply on HN