My wife has just got better from a case of pneumonia that developed rapidly within several hours. If not for antibiotics... We are back to medieval times if antibiotics stop working.
>if
when
The antimicrobial resistance crisis needs action now
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Re: The antimicrobial resistance crisis needs action now
#12My wife has just got better from a case of pneumonia that developed rapidly within several hours. If not for antibiotics... We are back to medieval times if antibiotics stop working.
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Re: The antimicrobial resistance crisis needs action now
#13I bet all those antibiotics prescribed for covid didn't help as well. That was happening on a massive scale in my country
Even in the US, pre COVID, every time I went to to doctor with a bad cold/flu, they'd just give you a Z Pak(antibiotics) and say...if it's bacterial this will kill it, if it's viral it'll work itself out. So I can definitely see how they're overprescribed.
They are cheaper than the tests to determine whether they're needed.
Re: The antimicrobial resistance crisis needs action now
#14Earlier quoted context omitted.
Why were doctors prescribing antibiotics for COVID?!
When I was in Peru, they kind of prescribed antibiotics for everything. Persistent cold? Antibiotics. Like that. Source: lived there with Peruvian partner for 18 months.
Same deal in Japan, every time my kid has a cold her mum takes her to the doctor and comes home with antibiotics. When I get a cold the first thing anyone asks is whether I went to the doctor yet. For what? “Medicine.”
Re: The antimicrobial resistance crisis needs action now
#15I am quite sure, that if a sufficient bounty was given out for developing new kinds of antimicrobials, they'd be developed in no time.
The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed. There are very many promising leads though, and either making development cheaper (by requiring smaller or fewer clinical trials) or ensuring good prices or bounties for successful development would likely create a plethora of antimicrobials in a quite short time frame.
Re: The antimicrobial resistance crisis needs action now
#16Earlier quoted context omitted.
Why were doctors prescribing antibiotics for COVID?!
Secondary infections of bacterial pneumonia were common with COVID iirc.
A study just came out showing that co-infections weren't common [0]
0: https://academic.oup.com/ofid/article/9/Supplement_2/ofac492...
Re: The antimicrobial resistance crisis needs action now
#17I am quite sure, that if a sufficient bounty was given out for developing new kinds of antimicrobials, they'd be developed in no time. The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed. There are very many promising leads though, and either making development cheaper (by requiring smaller or fewer clinica…
This is actually completely right. I believe there's some policy in the works in the US after talking to a friend who's doing some consulting work to help align the Cost-Benefit side of antimicrobial development.
I can't say if there's a plethora of drugs just waiting to be released after CT requirements are lowered, but definitely there is less of an R&D incentive currently because pts who take antimicrobials only take them temporarily and cases where you need an advanced antimicrobial to deal with an AMR case are thankfully uncommon.
Edit: I think this is the specific bill: https://www.congress.gov/bill/117th-congress/house-bill/3932...
Re: The antimicrobial resistance crisis needs action now
#18There are alternatives to antimicrobials being developed. Instead of directly killing bacteria and therefore putting selective pressure on them, you can prevent their ability to bind to host surfaces and wash them away. The best example is probably mannosides, which are high affinity mannose analogues currently in clinical trial in humans for UTI treatment.
Re: The antimicrobial resistance crisis needs action now
#19I bet all those antibiotics prescribed for covid didn't help as well. That was happening on a massive scale in my country
Even in the US, pre COVID, every time I went to to doctor with a bad cold/flu, they'd just give you a Z Pak(antibiotics) and say...if it's bacterial this will kill it, if it's viral it'll work itself out. So I can definitely see how they're overprescribed.
Z-pak (azithromycin) is not the recommended antibiotic for bacterial sinus infections nor pneumonia (common bacterial infections associated with upper respiratory infections) per most guidelines. Interestingly though, it does have anti-inflammatory properties in addition to its main antibacterial effect. When I see a clinician prescribe a Z-pak (urgent cares are notorious for having a low threshold for prescribing Z-paks), part of me wonders if it's to avoid overuse and potential resistance to appropriate antibiotics and placate patients who want a quick fix.
The downside is that since they feel better from the anti-inflammatory effect, its supports their initial thought they needed antibiotics and in the future will always think they need them, even though they very likely only have a viral infection.
Re: The antimicrobial resistance crisis needs action now
#20There are alternatives to antimicrobials being developed. Instead of directly killing bacteria and therefore putting selective pressure on them, you can prevent their ability to bind to host surfaces and wash them away. The best example is probably mannosides, which are high affinity mannose analogues currently in clinical trial in humans for UTI treatment. https://pubmed.ncbi.nlm.nih.gov/22089451/
How is this putting less selection pressure on them?