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The antimicrobial resistance crisis needs action now

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Re: The antimicrobial resistance crisis needs action now

#81

Post by hourago »

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 successful development would likely create a plethora of antimicrobials in a quite short time frame.

If one woman has a child in 9 months. How many months takes to 9 women? More money may accelerate development, but there is a limit on how much faster one can go. Give a big enough reward and you will find more corporations cheating and lobbyng to get that money without delivering any actual antimicrobials.

Public research institutions seem a very good middle ground. Give pasionate scientist funding and they will come with solutions. Give passionate CEOs money and you get the next big scam.

Re: The antimicrobial resistance crisis needs action now

#82

Post by s1artibartfast »

connicpu wrote: post #72
prox wrote: post #44

Earlier quoted context omitted.

Not only third world, I have read several articles over the years that it is (was?) prevalent in the US as well.

Yeah, many urgent care doctors here will prescribe antibiotics just to get the patient out of there as fast as they can even when they almost certainly have a viral infection

Not my experience. Many doctors seem very hesitant to prescribe antibiotics. Even 10 years ago I was in the ER for a deep flush wound from shop accident, almost killed myself. Had a large open wound from a dirty saw. They made sure I was up my my tentis shot but no antibiotics. When I asked about them, they said they would treat if an infection presented itself but not before

Re: The antimicrobial resistance crisis needs action now

#83

Post by acdha »

Thorentis wrote: post #61
retrac wrote: post #39

Earlier quoted context omitted.

Like many slow moving disasters, it doesn't feel like one while you live through it. An example: gonorrhea has no golden standard cure anymore. 40 years ago a single large dose of oral antibiotics was an effective cure. It made controlling it relatively easy. In the 90s, resistance to most of the common oral antibiotics became prevalent. Through the 2010s, a single dose of an intramuscular cephalosporin was effective…

[flagged]

Good thing nobody gets cheated on, lied to, or raped.

As advice, this is like saying we don’t need airbags because people should drive safely. Provably millions of people will have adverse effects due to this and moralizing won’t shift that rate anywhere near enough.

Re: The antimicrobial resistance crisis needs action now

#84

Post by headsoup »

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…

Just need some governments to mandate them, then no worries

Re: The antimicrobial resistance crisis needs action now

#85

Post by matthewmacleod »

Thorentis wrote: post #61
retrac wrote: post #39

Earlier quoted context omitted.

Like many slow moving disasters, it doesn't feel like one while you live through it. An example: gonorrhea has no golden standard cure anymore. 40 years ago a single large dose of oral antibiotics was an effective cure. It made controlling it relatively easy. In the 90s, resistance to most of the common oral antibiotics became prevalent. Through the 2010s, a single dose of an intramuscular cephalosporin was effective…

[flagged]

It is difficult to understand what you are trying to say with this comment. What are you trying to communicate with it? Could you express your intent in some other way which might make it clearer?

Re: The antimicrobial resistance crisis needs action now

#86

Post by krisoft »

rdedev wrote: post #40
nextos wrote: post #8

We need more research in bacteriophages. They can be engineered to avoid any resistance, and they can replace antibiotics in all use cases. Besides, they are much more selective. Getting antibiotics when needed is OK, but they can lead to other health complications down the road.

The problem with phages is that our immune system can recognize them easily and flush them out of the body. It doesn't stick around long enough to do the work. It could work if the dose is massive or if the infection is localized to one specific area. Btw this is what I learnt from reading a blog from someone who has worked with this stuff. I'm not a biologist and it's been a long time since I read that article so I…

> The problem with phages is that our immune system can recognize them easily and flush them out of the body.

The problem with phages is that they are finicky to administer. There is no "get this phage and it will kill all bacteria in and around you" treatment. They are specific. This of course has its own benefits too, but makes the process of administering harder.

With antibiotics the doctor comes to the conclusion that it is a bacterial infection. Then they write a prescription. And then you can buy the drug from any drug store. Antibiotics are largely shelf-stable and there is only a handful of different ones, so any drug store can keep all the major ones.

With phages the pipeline is more complicated.

You need to take a sample from the patient, you need to cultivate it, and then you need to check which phage or phage cocktail gets rid of that specific bacteria the best. That is a lot of lab work. Won't work at scale unless we automate it. And then there are questions like: How do they keep the phages healthy and happy? Are they working with a fixed selection of phages (a phage library if you will) or do they try phages based on the symptoms? Once they know which phage is the right one how does the patient get them? Can we stock them in our existing drug stores? Are they shelf-stable / can they be made shelf-stable? Which phages should the drug stores stock?

All of this can be of course answered and the problems ironed out. We put a man on the moon after all. We can do hard things if we want to. It is just a lot of faff.

Re: The antimicrobial resistance crisis needs action now

#87

Post by Animats »

An antibiotic is something that kills something you don't like while not killing things you do like. The survival strategy for hostile bacteria is to evolve towards not having vulnerabilities to things which have that antibiotic property. A century of antibiotics has pushed evolution in that direction. Antibiotics thus get harder to find. There may be a fundamental limit here.

The golden age of simple, broad-spectrum antibiotics is behind us.

Re: The antimicrobial resistance crisis needs action now

#88

Post by stevespang »

rdedev wrote: post #40
nextos wrote: post #8

We need more research in bacteriophages. They can be engineered to avoid any resistance, and they can replace antibiotics in all use cases. Besides, they are much more selective. Getting antibiotics when needed is OK, but they can lead to other health complications down the road.

The problem with phages is that our immune system can recognize them easily and flush them out of the body. It doesn't stick around long enough to do the work. It could work if the dose is massive or if the infection is localized to one specific area. Btw this is what I learnt from reading a blog from someone who has worked with this stuff. I'm not a biologist and it's been a long time since I read that article so I…

[dead]

Re: The antimicrobial resistance crisis needs action now

#89

Post by Salgat »

Animats wrote: post #87

An antibiotic is something that kills something you don't like while not killing things you do like. The survival strategy for hostile bacteria is to evolve towards not having vulnerabilities to things which have that antibiotic property. A century of antibiotics has pushed evolution in that direction. Antibiotics thus get harder to find. There may be a fundamental limit here. The golden age of simple, broad-spectrum…

On the plus side, this forces bacteria to compromise in other ways in order to incorporate antibiotic resistance.

Re: The antimicrobial resistance crisis needs action now

#90

Post by bell-cot »

therusskiy wrote: post #3

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.

There anti-pneumonia vaccines, though the effectiveness is iffy. (For starters, many species of bacteria can cause pneumonia. The species not covered by the vaccine she got will not magically avoid infecting her.) If your wife hasn't gotten one recently, and has no contra-indicating medical conditions or...

Best wishes to your wife and you in any case.

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