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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”

#351

Post by scythe »

waps wrote: post #270
tokenadult wrote: post #228

Earlier quoted context omitted.

General reply to express thanks for and respond to the several replies my first comment here received. First of all, I wrote in the original reply, "his warnings should be taken seriously," so I am by no means disagreeing with the quoted CDC expert about his general policy recommendations. Indeed, I am on record here on HN[1] saying that I'd like to see the United States follow the lead of the EU immediately in banni…

So much wrong with this post: > There is a testable prediction here of course: either bacteria outrun human antibiotic development or they do not. I'm confident that more bacterial lineages will be wiped out before human medicine is seriously compromised by natural selection of bacteria that are resistant to most antibiotics used in human medicine. Do a dumb test. Walk into your nearest hospital, I don't even want to…

>We lost the fight with viruses a decade ago. If you get infected with a deadly viral disease, like rabies, it's curtains. There's nothing any hospital can do for you except sedate you until you're dead.

What? We never had effective antivirals. We have a few useful drugs (oseltamivir, protease inhibitors, etc) for particular viruses, but there has never been a point in human history when rabies was a treatable disease. The Milwaukee protocol, which is the only effective[1] non-vaccine treatment for rabies, isn't even drug-based!

You may of course be confused. The major antiviral used in replications of the Giese case, amantadine, was also an anti-flu drug, resistance to which is now widespread in influenza (see http://en.wikipedia.org/wiki/Amantadine#Veterinary_misuse ). However, I do not believe amantadine resistance has ever been described in rabies, which in any case is usually treated with vaccination -- the challenge is to get the immune system to respond to the virus before the host dies! Giese herself was treated with both amantadine and ribavirin. In any case, your claim is confusing at best, misleading at worst.

[1]: controversial, see http://www.medscape.com/viewarticle/712839_7

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

#352

Post by Houshalter »

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.

The bacteria is acting purposefully I guess in the same sense that a hammer acts purposefully to drive down a nail. I don't know if that's a correct usage of language or not but it's essentially the same thing. But it is correct to say the hammer's purpose is to drive down the nail, and the bacteria's purpose is to survive and reproduce successfully.

So what if a species goes extinct? That doesn't mean it can't evolve, only that it didn't adapt quickly enough.

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

#353

Post by nate_meurer »

mtdewcmu wrote: post #337
tokenadult wrote: post #228

Earlier quoted context omitted.

General reply to express thanks for and respond to the several replies my first comment here received. First of all, I wrote in the original reply, "his warnings should be taken seriously," so I am by no means disagreeing with the quoted CDC expert about his general policy recommendations. Indeed, I am on record here on HN[1] saying that I'd like to see the United States follow the lead of the EU immediately in banni…

There is a bit of hubris here borne of ignorance. If you study this problem in any depth, you start to appreciate how pernicious it is. I'm not an doctor or epidemiologist, but I learned quite a bit by reading an excellent book[1] on the subject: > Indeed, I am on record here on HN[1] saying that I'd like to see the United States follow the lead of the EU immediately in banning antibiotics used in human medicine (esp…

Well said. However...

> "Agriculture only uses a few antibiotics, ones that are cheap in bulk, nontoxic to livestock, and can be mixed with feed..."

The reality is much worse. Factory meat producers will abuse any antibiotic if they are allowed, even the most powerful last-resort antibiotics. For example, many poultry producers were routinely mixing fluoroquinolones into their feed until very recently. The practice was outlawed in 2005, but there is good evidence that some poultry producers continue to do it in violation of the law:

http://www.sciencedaily.com/releases/2012/04/120405131431.ht...

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

#354

Post by [deleted] »

tokenadult wrote: post #228
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…

General reply to express thanks for and respond to the several replies my first comment here received. First of all, I wrote in the original reply, "his warnings should be taken seriously," so I am by no means disagreeing with the quoted CDC expert about his general policy recommendations. Indeed, I am on record here on HN[1] saying that I'd like to see the United States follow the lead of the EU immediately in banni…

[deleted]

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

#355

Post by robomartin »

I'm out of my depth here, but it seems to me one idea could be to help bacteria evolve rather than aim to kill them all. What I mean by this is that perhaps using bacteria against themselves could be an interesting approach. Much like over decades people bred dogs to encourage certain traits perhaps we can coax bacteria into developing traits that help us rather than help them when they come into our bodies. Maybe your run a fever for five or ten days and feel crummy but rather than have bacteria trying to destroy you they are, effectively, fighting and destroying themselves.

In other words, Aikido not Karate. Use their own energy against them.

Just a thought. Probably nonsense. Not a biologist.

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

#356

Post by kamaal »

artsrc wrote: post #330
waps wrote: post #270

Earlier quoted context omitted.

So much wrong with this post: > There is a testable prediction here of course: either bacteria outrun human antibiotic development or they do not. I'm confident that more bacterial lineages will be wiped out before human medicine is seriously compromised by natural selection of bacteria that are resistant to most antibiotics used in human medicine. Do a dumb test. Walk into your nearest hospital, I don't even want to…

> We lost the fight with viruses a decade ago. If you get infected with a deadly viral disease, like rabies, it's curtains. There's nothing any hospital can do for you except sedate you until you're dead. The fight we have not yet one is the fight against poverty. Not many wealthy people die of rabies. AIDS which was once fatal, is no longer, provided you can afford the treatment.

Keeping you alive is not the same as living. A few would like to stay in situation where you can't do 99% of the things other humans do.

Its very common in a lot of of places in the world to ask for euthanasia in case of such diseases.

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

#357

Post by kamaal »

gnaritas wrote: post #346
jasonshen wrote: post #90

Earlier quoted context omitted.

You are completely right in that bacteria don't have the ability to "want" things since they don't have any kind of brain. However, desire is a useful way for the general public to understand what is happening. It's like saying "Water wants to flow to the lowest point of a room" or "The arrow wants to follow the path of least air resistance"

> However, desire is a useful way for the general public to understand what is happening. No it isn't, it's misleading. > It's like saying "Water wants to flow to the lowest point of a room" Equally unnecessarily misleading. Water doesn't want anything, and before you claim people understand that let me tell you, they don't. It's a common belief that water has memory, there's an entire industry based on the concept a…

This is basically debating semantics.

Bacteria don't 'want' anything in a purely technical sense. But they will eventually develop/are developing resistance to antibiotics anyway. You seem to be stuck in debating about the right sentences to describe that.

That should be least of our worries.

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

#358

Post by robbiep »

waps wrote: post #270
tokenadult wrote: post #228

Earlier quoted context omitted.

General reply to express thanks for and respond to the several replies my first comment here received. First of all, I wrote in the original reply, "his warnings should be taken seriously," so I am by no means disagreeing with the quoted CDC expert about his general policy recommendations. Indeed, I am on record here on HN[1] saying that I'd like to see the United States follow the lead of the EU immediately in banni…

So much wrong with this post: > There is a testable prediction here of course: either bacteria outrun human antibiotic development or they do not. I'm confident that more bacterial lineages will be wiped out before human medicine is seriously compromised by natural selection of bacteria that are resistant to most antibiotics used in human medicine. Do a dumb test. Walk into your nearest hospital, I don't even want to…

Firstly, there's a real difference between rates of MRSA colonisation and rates of MRSA infection, which implies a pathological process at work.

Secondly, what on earth do you mean when you say we lost the fight against viruses a decade ago'?

We have only got better at treating viruses; we had almost no treatment for viruses a decade ago and we have some treatments now; for example we are now much better at treating chronic hepatitis c infection which is a leading cause of liver failure and cancer; we have good HIV drugs which can lead to long term management without significant comorbidities (although many of the pieces were in place a decade ago), and your illustrated case, rabies, has long been a problem child like many significant viral illnesses that are discovered close to the end of their course, has caused so much pathology by tr time they present that the course is terminal.

But there have only been a handful of cases of fulminant rabies in the developed world in the last decade, so it's hardly a thing that we are getting experience in treating.

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

#359

Post by kamaal »

Houshalter wrote: post #350
resu_nimda wrote: post #197

Earlier quoted context omitted.

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 e…

It's still an incredibly stupid process. Sure it made it's way to the complex life forms we have today, but only after unfathomably huge amounts of time, and trillions and trillions of attempts.

>>but only after unfathomably huge amounts of time, and trillions and trillions of attempts.

What's really huge and what no is really a limit and perception of our brains, no?

For a evolutionary process that has started at the earliest stars after the Big Bang. Those species are currently so powerful, that we are very likely to them the same as bacteria are to us. Might as well perceive that to be a very reasonably efficient process.

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

#360

Post by elangoc »

I'm genuinely interested to know whether garlic can be safe and effective replacement. I ask in all seriousness since garlic is said to have antibacterial properties (and was used topically as an antiseptic for wounds in WW 1 & WW 2). The thing about garlic is that our body never develops a tolerance for it. Is it true that bacteria can never develop resistance to the active compounds in garlic (ex: allicin) ?
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