Existing Drugs Fight Antibiotic-Resistant Bugs

sciencehabit writes "Medical experts have been powerless to stop the rise of antibiotic-resistant bacteria and are increasingly desperate to develop novel drugs. But a new study finds that smarter use of current antibiotics could offer a solution. Researchers were able to keep resistant bacteria from thriving by alternating antibiotics to specifically exploit the vulnerabilities that come along with resistance—a strategy that could extend the lifespan of existing drugs to continue fighting even the most persistent pathogens."

As an Australian

[Anonymous Coward]

I was expecting to see the article saying heroin and cocain fight pathogens .

Perhaps if

[Anonymous Coward]

I was thinking somewhat along the idea, written in summary. We could battle resistance with somekind of phasing of antibiotics in and out of use.. For example we could phase out one type of antibiotic for say decade, then bring it back and phase out another. Could this work?

Copper cladded work surfaces and fittings

[flyingfsck]

Probably the biggest mistake we made the last century was to change away from using copper and brass in hospitals, to stainless steel and chrome - turns out that copper cladded work surfaces is a very effective way to control bugs in hospitals and they don't get resistant to it.

Asia is out of control

[nickserv]

Over prescription of antibiotics is a huge problem here in Asia mostly due to cultural face saving practices. In the West when you go see a doctor you are sometimes, probably not often enough, told to just go home, stay hydrated, rest and that you don't need any medication because there's no medication that can really help.

In Asia however, when someone sees a doctor they expect to go home with something. Even though the doctor's advice is 'respected' it would be a loss of face for a patient seeking treatment to be told to just to go home and rest, no medication is needed. It's hard for Westerners to understand, and IMHO serves very little purpose in today's society, but Asians would view coming home from a doctor without medication as the doctor not doing their job. Also, by not providing some kind of medication the doctor is basically, in the Asian mind, telling the patient "you are wrong, there's nothing wrong with you" which would be a big loss of face for the patient.

There's also a cultural service and purchasing custom that applies but it's much more esoteric and difficult to describe. Briefly, there's an expression "buy 10 buns, get 11 bags" because everyone is conditioned that a transaction is not complete until the goods or services are delivered well and completely packaged. It's a nice polite custom and all but you should see the dumbfounded look on many vendors' faces when I tell them I do not want a plastic bag for my purchase(s). It may sound irrelevant but it comes into play at the doctor's office in terms of, the service transaction is not complete until medicine is delivered.

So, doctors here are not able to go against the cultural grain, even though they know medically and scientifically that antibiotics will do more harm (in the long run) than good, the cultural conditioning is too strong so they always prescribe and 9 times out of 10 it's antibiotics. I was a paramedic in the US for years and I know treatments are highly relative to cultures. I've got no problem with cupping or coining or other 'treatments' that appear to be absurd when viewed through the filter of my culture but, none of those practices have an international impact.

Over prescription of antibiotics is a very significant international problem and Asia is doing the world a huge disservice by allowing it's cultural customs to influence medicine to such a degree in this matter.

Re:Perhaps if

[muridae]

10 years seems too long to me, actually. The problem is, a patient has an infection that's resistant to 'cillins or 'mycins or 'floaxins or 'sporins or what ever. Instead of throwing the biggest drug available at it (say it's resistant to all 'cillins) then throw something weak from another family (keflex or something on those lines). Don't throw Vanc/Gent at it, or Rocephin. But make sure the infection is dead dead. Not just in hiding and building a resistance to that new antibiotic too, treat with the full regimen and retest afterwards! And for gods sakes, drill it into the patients heads to take all X days worth, don't skip just because 'you feel better'!

Having just gone through this over 3 years, it's easy to say and harder to do. Bacteria hide (UTIs are bad about this, so are cysts), and when they do they can build up resistance and patients want the strong stuff so it kills it fast. But, and this is a bit of pt side talking, I wish I got the weaker meds first so the later infections weren't resistant to everything but Vanc/Gent/Strepto+Linazolid. Having on two drugs types available post-surgery (both 'of last resort' types) was a pain in the ass.

Second thing to do is for hospitals to be a little more cautious. Every antibiotic flavor for two years left my gut bacteria resistant to nearly everything. So, post surgery, and abscess appeared. Guess how many it was resistant to? Linazolid is the first antibiotic I've met that was more expensive, by weight, than gold. And that was the active drug weight, not the horse pill the crammed it in to!

For the curious, psuedomonas a started it and several idiot docs didn't call infectious disease to learn that omnicef and ampicillin wouldn't work; but they made everything else resistant. Then 4 PICC (well, 3 PICC and one PIC that got a little misplaced) for 3rd gen cefs' which are anti-psudo drugs. All the while, entero was getting resistant to all of those (lucky they killed all the e. coli or I'd have been toast).

Re:phaser ... done in days

[muridae]

That assumes that chronic UTIs have a few days to do a 'reset'. I've had one recurrent for 2 years (psuedo a, it's resistance to 'cillins is a bit different) and would go from not knowing it's active to being near septic in hours (we thought it was a different infection for the first year, til someone put 2 and 2 together to wonder how the same strange bacteria was sticking around). Cipro isn't too bad used right, though I find they push it too fast through small IVs and blow veins. And the expensive stuff . . . I dunno, Linazolid had fewer side effects than dying, but the effect on my family's wallet till insurance decided that 5 days wasn't enough and the Dr was right about 10 was painful; somewhere between 300 and 500 a day for pills...had a bloody PICC, should have gotten the cheaper liquid but I think the docs forgot about it. (linazolid was for what was left after the anti-psuedos and a idiot hospitalist (didn't call infectious disease for 6 days to figure out that omnicef or recephen or gent weren't going to work) made everything else resistant. When you sneak a look at a culture resistance check and see only drugs of last resort listed, and only 4 of them will work, you get a little panic-y.

Re:The bacteria are like the Borg.

[TheCarp]

Actually it is a bit messier than that: http://en.wikipedia.org/wiki/Horizontal_gene_transfer [wikipedia.org]

So the genes for antibiotic resistance don't even have to be evolved by the same organism, nor must they remain there, they can spread separately from the pathogen. The germs you fight may not even be the main resevoir for those genes.

I actually wonder how long it will be before someone engineers a slutty bacterium that is very successful at gene transfer with its own kind and load it up with genes for antibiotic vulnerability. Hell it wouldn't even need to be a traditional antibiotic.... anything you can program it to recognize and trigger cell death should do the trick.

It would be kind of like air dropping syphlitic hookers on the enemy.

Re:Perhaps if

[sjames]

New law, if you get an infection from the hospital, your stay is free. Just watch how fast they find the resources to sanitize everything.