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

391–400 of 414 posts

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

#391

Post by Fomite »

criley2 wrote: post #80
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.

Remember, it takes 8-12 years and $1,000,000,000 on average to whittle 10,000 drug candidates into 1 fully tested FDA approved drug. If a company is going to spend a decade and a billion attempting to develop a "management" antibiotic for continual profit, I'm willing to bet the profit motive exists for another company to make a normal antibiotic... that most doctors would happily prescribe over the ridiculous multi-…

Though one recent study of drug development costs had an antibiotic against C. difficile as one of the cheapest to develop.

I've actual found there's a fair amount of interest in antibiotic development among drug companies.

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

#392

Post by Fomite »

jabagonuts wrote: post #42
erichurkman wrote: post #11

Earlier quoted context omitted.

> 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.

I feel a lot less silly now for avoiding medical treatment unless absolutely necessary all my life.

So this would be a bad time to start talking about rates of community acquisition of MRSA and C. difficile, wouldn't it?

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

#393

Post by Fomite »

robot wrote: post #316

I've been hearing about MRSA since 2000s. What's new? I mean, what has changed now since 2000 that this is now more important?

It's more prevalent, and has gone from a weird bug mostly in hospitals to something you can pick up in the community.

Beyond that, it's no longer just MRSA. There's all manner of resistance mechanisms, for a very, very wide set of diseases, including some dirt common ones.

"Resistant" isn't an on/off switch. How resistant? Where are the resistant bugs? How many of them are there compared to non-resistant competitors, etc.

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

#394

Post by maxerickson »

VLM wrote: post #127
jacobquick wrote: post #105

Earlier quoted context omitted.

In the 80s we acted faster on freon/CFCs than we have on climate change in the ensuing 30 years, with less danger to human life and less evidence. The only thing that's new about climate change as a scientific theory is the annual increase in the pile of evidence that it's happening and we're the cause of it.

Absolutely horrible example because .com owns .gov and the primary patent for CFC production expired in 1979, obviously lots of money is going to be poured into encouraging the use of patented CFC replacements, such as making the use of CFCs illegal. I'm not questioning the science of it, I'm explaining why .com and .gov worked together really hard on banning CFCs in the early/mid 80s, because HCFCs and HFCs are more…

This is nonsense. Some large portion of industry would be happy enough to not pay royalties.

There are also at least several countries with little regard for patents and significant industrial bases that none the less signed on to treaties to limit and cease the production of CFCs...

But sure, Dupont made the US government strong arm India and China into paying for their new refrigerants. And Russia too.

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

#395

Post by stef25 »

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…

I worked for Pfizer, for 2 years in clinical trials to get Linezolid on the market. This was for treating MRSA infections. I was in close contact with nurses & doctors who seemed to think it worked well. Back then (around 10 yrs ago), there was almost no MRSA resistance, unheard of from what I remember.

Then I left and lost track of it all. Wikipedia now says it's 100USD / pill.

If there's really a lot of resistance to Linezolid, that would be quite shocking.

In my project there was a lot more MRSA in "poorer" parts of the country, in hospitals with lower hygiene standards. Hospitals also refused to report their MRSA stats ("it doesn't exist here", not wanting to be known as a place where it's found since it is related to hygiene).

Interesting stuff.

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

#396

Post by refurb »

ronaldx wrote: post #378
refurb wrote: post #342

Earlier quoted context omitted.

This gives a much better summary of the theory... http://blog.oup.com/2011/11/antibiotics/

Yes, I get the theory, but I think it's probably false. No clinical evidence is offered.

Care to share it?

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

#397

Post by brazzy »

Fomite wrote: post #385
brazzy wrote: post #380

Earlier quoted context omitted.

Actually, there are experimental treatments that involve an induced coma and seem to produce survival rates of over 10%: https://en.wikipedia.org/wiki/Milwaukee_protocol

I hadn't seen the newer revision of the protocol, only the original 2 out of 25 number. "Indistinguishable from 100%" was perhaps a little severe, but 90% survival is still pretty long odds.

It's not odds I'd like to face, but it's the difference between no hope and reasonable hope.

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

#398

Post by ronaldx »

refurb wrote: post #396
ronaldx wrote: post #378

Earlier quoted context omitted.

Yes, I get the theory, but I think it's probably false. No clinical evidence is offered.

Care to share it?

Just to be clear:

I can't share because that's exactly my point - as far as I can find, there isn't a single clinical example of stopping antibiotics early causing any problem of antibiotic resistance.

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

#399

Post by eranation »

carbocation wrote: post #69
eranation wrote: post #5

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

You basically have polymixins (colistin) and, depending on resistance profile, fosfomycin and tigecycline. Colistin is avoided if possible because of nephrotoxicity, but as usual, medicine is a field heavily involved in balancing risks and benefits.

I wish I haven't skipped Biology in school...

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

#400

Post by gnaritas »

einhverfr wrote: post #375
gnaritas wrote: post #371

Earlier quoted context omitted.

Semantics matter, communication is not possible without agreement on the meaning of words. And the OP made the argument, not me, I'm simply agreeing with his point that's it's wrong to personify evolution, it's why so many people don't understand it.

It's far worse than that. Not on;y is it not possible to have semantic communication without a general agreement on the meaning of words, but at the same time perfect agreement is impossible. This is generally understood (and has been understood for a hundred years) to be one of the causes of linguistic drift. Humans aren't computers.

No they aren't, which is why it's even more important to make sure we're actually talking about the same things. Semantics matter. I tire of people insisting that I know what they mean when what it's not what they said. I don't read minds, I hear words; the words you choose have meanings and those meanings matter if you want to convey your ideas to me.
Post reply on HN