Potential Cure For Antibiotic Resistant Infections 127
kpw10 writes to let us know about research to be published this week that offers hope in the battle against multi-drug-resistant bacteria. "Researchers at the University of North Carolina at Chapel Hill have discovered that two drugs used to treat bone loss in old folks can both kill and short-circuit the 'sex life' of antibiotic-resistant bacteria blamed for nearly 100,000 hospital deaths across the country each year."
Existing drugs are GOOD things (Score:2, Interesting)
Re:Unnatural Selection (Score:5, Interesting)
Patients are part of the problem too, since there is a tendency (cultural in some cases, personal in others) to demand that a doctor "do something" to fix the problem. Antibiotics were perceived for a long time as something harmless to give in those circumstances, but that perception is fading fast. If anything, the trend now is to err on the side of letting things play out a little more to see if antibiotic therapy is really needed.
This has also caused physicians to have to explain the situation better. I know for myself that when I am explaining to a suspicious parent the reason that I'm not going to give their child an antibiotic for their viral infection, I don't waste a lot of time explaining resistance. If they already understand resistance, they're not asking for antibiotics. If they don't, it just sounds like I'm making things up. I focus instead on side effects and cost, and my typical (true) statement is "about all I can do with antibiotics would be to give your child diarrhea to go with her cold." This is surprisingly effective, especially in the parents of non-potty-trained toddlers.
None of which stops me from pulling out the stops when I'm faced with a septic kid or a real infection that needs to be nuked. In those cases, though, I'm very careful to make sure that the regimen I use is appropriate, considering the resistance patterns and the risk of making them worse.
Now if we could only get the idiots who lace animal feed with antibiotics to do the same. Ever wonder where resistant strains start? Hint: it ain't just in the hospitals.
Re:Unnatural Selection (Score:3, Interesting)
Don't trivialise this (Score:4, Interesting)
Hopefully this won't be used promiscuously, and I hope they'll work out the interactions with other treatments, as quite often treatment is multi-modal.
I wouldn't wish what I go through due to MRSA on anyone (except my stepfather, but that's another story altogether.
Evolutionary Cost (Score:0, Interesting)
You can expect, the moment we stop using beta-lactam antibiotics, resistance to them will disappear from the population. So combining multiple vectors of antibiotics is useful, both in eliminating the bacteria (for now) and in making them weaker (in the future).
In an ideal situation, multiple drugs would attack systems that are so critical that evolving around them would make the bacteria so weak as to be unable to defend against the host immune system.
Re:Unnatural Selection (Score:3, Interesting)
Re:Unnatural Selection (Score:4, Interesting)
This gets me into the whole doctor-as-gatekeeper-for-pills thing that drives me nuts. I challenge colleagues once in a while: in an environment where all medications were available at retail, could they still justify their fees? Could they market themselves well enough to avoid starvation? I think I could, because of the kind of medicine I practice (and because I can sometimes go a dozen patients between giving a prescription), but it's definitely something honest physicians should be asking themselves.
In the no-Rx-required environment, though, there's no question that resistance emerges rapidly. Fortunately, the antibiotics available in Mexico are a small subset of the ones we use here, and most of the ones that patients can buy OTC have broad therapeutic indices (overdose doesn't hurt you much) and are from antibiotic classes (penicillins, macrolides) where we have later-generation alternatives that avoid the common resistances. It's a fluid situation, though, and one that has infectious disease specialists always a little on edge.
Re:Unnatural Selection (Score:3, Interesting)
Re:You missed the obvious (Score:2, Interesting)