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The antimicrobial resistance crisis needs action now

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Re: The antimicrobial resistance crisis needs action now

#131

Post by busyant »

Brendinooo wrote: post #22

At the risk of sounding ignorant… I’ve been hearing stuff like this for twenty years now. And yet the crisis hasn’t happened. Why is that?

> And yet the crisis hasn’t happened. Why is that?

I used to think this, too (and this is coming from someone who worked at an antibiotic drug-discovery startup in the early 2000s).

I think it's not that there will be a comprehensive event in which "this bacterial pathogen is now unassailable by any antibiotic in our arsenal."

It's more that, if you are on the front lines of a hospital, you'll come across many (but not all!) patients with bacterial infections for whom antibiotics won't work.

If you are an MD with enough of those types of patients, it will fuck with your decision making process. It will also cause a lot of prolonged health issues as well as death. It just won't be a wall-to-wall comprehensive type of antibiotic resistance.

Re: The antimicrobial resistance crisis needs action now

#132

Post by selimthegrim »

yawnxyz wrote: post #49

I could rant on all day about this. AMR is actually a SOLVED problem at this point. If we threw money at it like we threw them at Patriot missiles, we wouldn't run out. But... here we are. Rant on why things are why they are: 1. Making antibiotics is hard and expensive. The "low-hanging fruit" are all gone, and in the last few decades we've just been rehashing different variations of the same classes of antibiotics.…

I have half a mind to study deep sea microbes and how the immune system might react when presented with them using AI/ML and see if that helps this any. Following you on Twitter.

Re: The antimicrobial resistance crisis needs action now

#133

Post by coldtea »

zosima wrote: post #15

I 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…

>I am quite sure, that if a sufficient bounty was given out for developing new kinds of antimicrobials, they'd be developed in no time.

It's dangerous to think such problems can just be solved by throwing money at them...

Re: The antimicrobial resistance crisis needs action now

#135

Post by nine_k »

hourago wrote: post #81
zosima wrote: post #15

I 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…

> The problem is that cost and risk of development and trials is too large for the current rewards, This kind of invesment has been traditionally done by governments. But with a reduction of taxation governments do not have animore money to do this. And for private companies it makes more sense to spend that kind of money in advertisment than in developing new products. > ensuring good prices or bounties for successf…

> big scam

If you have reasonably honest people who are not starting from scratch, and honest trials, you likely are going to get a real thing. Case in point: mRNA vaccines against COVID.

Re: The antimicrobial resistance crisis needs action now

#136

Post by unity1001 »

pmalynin wrote: post #127
unity1001 wrote: post #113

Earlier quoted context omitted.

> I don't know enough about it to know if it's a legit counterpoint. Its a gigantic counterpoint. A large swath of the technology used today was developed by NASA and then turned over to the private corporations for them to profit. Socializing the costs. Privatizing the profits. The Internet iself an argument. It was developed at DARPA with taxpayer money. Then turned over to the private corporations so that they cou…

With the Internet the government got their pound of flesh through taxation of all the new enterprises that sprung up because of their investments , so I wouldn’t make it sound so negative.

> With the Internet the government got their pound of flesh through taxation of all the new enterprises that sprung up because of their investments

Really. With all the tax breaks and ongoing lowering of the top tax bracked for corporate profit. Even as they offshore their legal entity to dodge taxes...

Even if the capital gains taxes were 90% like back in Eisenhower era and it was actually enforced, that still wouldn't justify handing over publicly funded research to private actors to profit. Publicly funded everything should be made publicly available and usable.

Re: The antimicrobial resistance crisis needs action now

#137

Post by [deleted] »

version_five wrote: post #106
unity1001 wrote: post #104

Earlier quoted context omitted.

> 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 If that is so, then that research should be done by the state. The well-being of entire human race cannot be tied to monetary incentives of profiteering.

What are examples of the state actually achieving a research objective better than free enterprise?

[deleted]

Re: The antimicrobial resistance crisis needs action now

#138

Post by mikeiz404 »

tormeh wrote: post #110
azinman2 wrote: post #75

Earlier quoted context omitted.

There’s also pharma world wide. Seems the system is broken if only massive economic upside in the US is what leads to drug discovery and successful clinical trials.

Testing requirements are as high in other rich countries. And existing antibiotics work fine atm. Nobody’s gonna pay to use new ones unless there’s no alternative, both for cost and resistance reasons. So why bother? Might as well postpone development until there’s a real market, right? I actually think this is good since it means we postpone usage of, and thereby resistance to, any new antibiotics.

Edit: Apparently broad spectrum antibiotics can actually lead to antimicrobial resistance [1][2]

—-

> I actually think this is good since it means we postpone usage of, and thereby resistance to, any new antibiotics.

This is true if you use them in isolation but I thought broad spectrum antibiotics, aka many at once, is what is typical now to slow down development of resistance? In this case you’d want to develop a few new ones and deploy them in batch.

1: https://en.m.wikipedia.org/wiki/Broad-spectrum_antibiotic

2: https://www.science.org/content/article/combining-antibiotic...

Re: The antimicrobial resistance crisis needs action now

#139

Post by mmcgaha »

Last Wednesday night, I drove a torx bit right through the first knuckle on my left index finger. Since I type all day this seemed serious enough to go to the emergency room. When I see the doctor, I am sure I sounded like a fiend looking for a hit but in this case for antibiotics. He tells me that he does not want to give them to me because if I didn't really need them that it could make it so they don't work for me later in life when I have a real need. Instead he gave me an xray, a tetanus shot and sends me on my way. Since then the swelling has gone down and my finger looks nasty but healthy and I am so far glad that I did not get the antibiotics.

Re: The antimicrobial resistance crisis needs action now

#140

Post by Fomite »

lofatdairy wrote: post #24

BTW for anyone who wants to help but thinks this is mostly wetlab/drug development work. There's quite a bit of room in the space for the computer-vision side of things to improve decision-making and time to treat. I think it's mostly based on phenotyping by imaging and identifying low-specimen cultures but I might be totally wrong. Some competitions: - https://longitudeprize.org/ - https://dpcpsi.nih.gov/AMRChalleng…

There is also a ton of room for work in modeling, simulation, data analysis, etc. The field could use computationally inclined people.
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