Imagining the Post-Antibiotic Future 453
Hugh Pickens DOT Com writes "Health authorities have been struggling to convince the public that the threat of totally drug-resistant bacteria is a crisis. Earlier this year, British chief medical officer Sally Davies described resistance to antibiotics as a 'catastrophic global threat' that should be ranked alongside terrorism. In September, Dr. Thomas Frieden, the director of the U.S. Centers for Disease Control and Prevention, issued a blunt warning: 'If we're not careful, we will soon be in a post-antibiotic era. For some patients and some microbes, we are already there.' Now Maryn McKenna writes that we are on the verge of entering a new era in history and asks us to imagine what our lives would be like if we really lost antibiotics to advancing drug resistance. We'll not just lose the ability to treat infectious disease; that's obvious. But also: The ability to treat cancer, and to transplant organs, because doing those successfully relies on suppressing the immune system and willingly making ourselves vulnerable to infection. We'll lose any treatment that relies on a permanent port into the bloodstream — for instance, kidney dialysis. We'd lose any major open-cavity surgery, on the heart, the lungs, the abdomen. We'd lose implantable devices: new hips, new knees, new heart valves. We'd lose the ability to treat people after traumatic accidents, as major as crashing your car and as minor as your kid falling out of a tree. We'd lose the safety of modern childbirth. We'd lose a good portion of our cheap modern food supply because most of the meat we eat in the industrialized world is raised with the routine use of antibiotics, to fatten livestock and protect them from the conditions in which the animals are raised. 'And it wouldn't be just meat. Antibiotics are used in plant agriculture as well, especially on fruit. Right now, a drug-resistant version of the bacterial disease fire blight is attacking American apple crops,' writes McKenna. 'There's currently one drug left to fight it.'"
Oh nos, terrorists! (Score:0, Insightful)
Saying something is as scary as terrorism is like saying it's as dangerous as marijuana.
What will researchers do next (Score:4, Insightful)
They just want money, so they say there will be some sort of catastrophe so they can get funding for their so-called studies. They even managed to throw in think of the children on top of their other hyperbole. I, for one, want absolute iron-clad proof that something disastrous will happen before we lift a finger to prevent it.
The above post may contain toxic doses of sarcasm.
Hypocritical (Score:5, Insightful)
Too many antibiotics in the food supply is a major part of what's causing this problem in the first place!
Terror (Score:3, Insightful)
"British chief medical officer Sally Davies described resistance to antibiotics as a 'catastrophic global threat' that should be ranked alongside terrorism."
So it's just a minor concern? Good to hear, I was starting to get worried here.
Why did we become so dependant? (Score:4, Insightful)
It's not that Origin of Species is exactly a new book. By the time we developed the antibiotics evolutionary biology was well understood.
I guess as usual , no-one was thinking about long-term consequences.....also I wonder how did my grandparents managed to be successful farmers - earning the most money in the whole family while supporting themselves and the families of their sons with agricultural products (I don't remember my family buying much flour, cheese, meat , fruits and vegetables for decades) without antibiotics. I mean they hardly used machines let alone chemistry...
Sorry for the provocation, but is there anyone who still thinks that free market capitalism is any good in anticipating (let alone solving) global long-term issues?
Alongside Terrorism? (Score:5, Insightful)
Do we blame politicians for not treating this as important and instead pissing billions away on 'the war on terror' or do we blame ourselves for being so ignorant that we (on average) don't care about this major issue but throw our support behind whoever promises to spend most on protecting us from often imaginary bogeymen.
Easy fix would be... (Score:5, Insightful)
Easy solution (Score:5, Insightful)
Easy solution: Ban the use of antibiotics in the meat industry.
Of course then people wouldn't get their insanely cheap meat anymore.
Boohoo - what a disaster.
self made tragedy (Score:5, Insightful)
This is going to be a self made tragedy.
How many times have people gone to the doctor for a cold but the doctor gave them antibiotics almost as a placebo. How many times have people not used the entire bottle of antibiotics? Some ranchers give antibiotics to their live stock as a matter of course so that they can get fatter faster.
Then of course after the Ronald Reagan/Margret Thatcher revolution everything has to be about profits. Well there isn't much profit in antibiotics. If you have a really good antibiotic then the medical comunity will be likely not to perscribe it. They would want to save it for the really nasty bugs. Even if it is perscribed a lot people will only get one bottle and then stop taking it after their infection goes away. The drug industry would rather come up with something like statins; that is something they can put rich people on for the rest of their lives (I am sure there are some in the industry that would rather keep giving out statins than to cure heart disease.) Don't even get me started on creationsits' heads exploding because their bacterial infections are actually evolving.
We already have kids basically getting killed off because they picked their scabs on a minor cut and then got the wrong type of bug. Before antibiotics any little cut was a possible death sentence. Looks like if something isn't done (and I am not holding my breath) we are going to get back there sooner rather than later.
Re:terrorism! ha! (Score:5, Insightful)
If this is a threat that "should be ranked alongside terrorism" then I'm not even going to waste my time reading about it.
It's an idiotic comparison; but only because it's a threat that should be ranked far ahead of terrorism. 'Terrorists' are barely a rounding error compared to the existing morbidity and mortality caused by drug resistant pathogens (I include in this category ones that aren't resistant to literally everything; but are now much harder, more expensive, and potentially more dangerous to treat because they resist most or all of the cheap, common, non-ghastly-side-effects drugs, leaving you with only the options you didn't want to be stuck with).
Re:Be Afraid, be very very afraid. (Score:5, Insightful)
The market is partially causing this; in India there are antibiotics plants that spew waste into gutters and that waste has plenty of punch to make the local bacteria resistant. Also in India (and other places where drugs are available without prescription) it's not uncommon that people treat infections with a single pill because they don't know any better.
What we need to do is educate people on how antibiotics work and stop unnecessary usage of antibiotics right now. It's counterproductive to feed lifestock antibiotics by the bulk when the problems are treatable otherwise (I'm looking at you corn subsidies and packed to brim handling facilities among other things). Also would be really interesting to see what happened if we phased out some of our antibiotics for a decade; would the resistance still be there in enough scale?
Re:terrorism! ha! (Score:5, Insightful)
I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.
Plus how the hell is falling out of a tree any less dangerous than being in a car crash? I'd rather be surrounded by steel and air-bags if something hard is going to be slammed into my body.. uh, well, that sounded a bit wrong, but whatever.
Maybe the author's point was that they don't love their kids, because having your kid get hurt isn't as bad as risking yourself..?
The author's point was that falling out of a tree usually causes a minimum of a cut or abrasion in the skin. Likewise a car accident. No antibiotics means even a minor break in the skin could become life threatening.
Re:terrorism! ha! (Score:3, Insightful)
I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.
Not in the US. Here in the land of the "free to lobby and oppose just because" any politician that comes out in favor of dealing with this situation will be attacked by the opposition for doing so (anti-business, anti-health, anti-patriotic, anti-think_about_the_children, anti-etc). They will face the war chests of some anti-politician's_name_here group and their pro-anti-anything_the_opposition_wants lobbyists. Gaining public understanding and support is essential to defend themselves against this type of attack.
It's because we don't try to cure much at all (Score:0, Insightful)
Companies make more money by creating drugs that make you feel better only while continuing to purchase their drugs. Cure a disease and you lose a customer; lesson their symptoms and you have a customer for life.
No one wanted to listen or change (Score:5, Insightful)
The prophylactic use of antibiotics has long been identified as a problem and yet people couldn't manage to stop their ridiculous fear of "getting sick." You know, getting sick once in a while isn't so bad. Keep your immune system strong and healthy and getting sick is a minor inconvenience. Instead we've got a system of marketing driven by ridiculous fears. Sure, wash your hands. But with anti-bacterial soaps all the time? What could possibly go wrong? Certainly not a weakened immune system resulting from a decreased demand load right?
And the crap they allow in the livestock industry? Holy crap. How is that NOT supposed to get into our water and our food?
"Before antibiotics any little cut was a possible death sentence." Really? I wouldn't go quite that far. Conventional remedies took care of the vast majority of such things when I was a child. Iodine, mercurochrome, hydrogen-peroxide and all manner of antiseptics seem to do the job nicely. Of course things needed near-immediate attention and all that but so what? Why do we have to believe "give me a shot and I'll be just fine!" and continue on as if there would be no other effects?
One of the real kickers for me is the scares we've had over the past what? 20 years now? Talking about superbugs and MRSA and all that? Name one thing that has been done to really combat the trend? I know what *I* have done -- I have ensured my practices are nearly opposite of what ever soccer mom does. You won't find "anti-bacterial soap" in my home. There is only the standards like Irish Spring and Ivory. I will not feed into the unrealistic fear pushed onto the public to sell more product. And when I do take medications, I will be sure that (1) I actually need it and (2) it will be far more effective on me because I don't have any acquired resistance.
Re:Oh nos, terrorists! (Score:5, Insightful)
If marijuana were legal, drug cartels would not be interested in it because anyone could grow his own with little effort. How many criminal alcohol cartels exist currently? And how many existed during prohibition?
Re:terrorism! ha! (Score:5, Insightful)
I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.
Plus how the hell is falling out of a tree any less dangerous than being in a car crash? I'd rather be surrounded by steel and air-bags if something hard is going to be slammed into my body.. uh, well, that sounded a bit wrong, but whatever.
Maybe the author's point was that they don't love their kids, because having your kid get hurt isn't as bad as risking yourself..?
The author's point was that falling out of a tree usually causes a minimum of a cut or abrasion in the skin. Likewise a car accident. No antibiotics means even a minor break in the skin could become life threatening.
This is where they lost me. How often are scrapes and cuts (or even car accidents) treated with antibiotics? Sure, major lesions will warrant a general antibiotic, but in my first three decades of life i can count on one hand the number of times I took antibiotics, and almost all of them were preventative (meaning even without them, the risk to life was statistically indistinguishable from 0). Trying to rally the public with "if you get a scrape you will die" is pretty much fear mongering. And fear mongers can fuck right off.
Re:Oh nos, terrorists! (Score:4, Insightful)
Wasn't alcohol about as dangerous during the prohibition? I distinctively remember some mobsters and some shooting.
Re:Alongside Terrorism? (Score:5, Insightful)
The loss of effective antibiotics is a genuinely 'catastrophic global threat'; terrorism is a largely imaginary risk for most people with considerably less chance of negatively affecting their life than going near a road. If terrorism was a single fire ant on your leg then widespread drug resistant bacterias would be a pissed off Hippo stomping you into the ground.
Do we blame politicians for not treating this as important and instead pissing billions away on 'the war on terror' or do we blame ourselves for being so ignorant that we (on average) don't care about this major issue but throw our support behind whoever promises to spend most on protecting us from often imaginary bogeymen.
Never underestimate the capacity of the human race to obsess on trivialities at the expense of their overall welfare.
Re:What will researchers do next (Score:5, Insightful)
The sad part is there are people out there that think this very thing. That you're "playing with god's will" if you use antibiotics in such manners.
It's amazing the way someone can believe in an absolutely omniscient, allmighty God Who completely knows the past, present, and future, Who endowed mankind with intellect and reason ... and then think this God had no idea mankind might use and apply that intellect and reason. How do people rationalize such beliefs?
Re:terrorism! ha! (Score:4, Insightful)
Plus the meat industry would donate heavily to their opponent.
Re:terrorism! ha! (Score:5, Insightful)
They didn't say "if you get a scrape you will die." They said "if you get a scrape you could potentially die," which is a factual statement if we have no effective antibiotics.
This is a common strawman argument. Restate a scientists' position so that it is extreme, then chide the scientists for taking such an extreme position. It seems to be remarkably effective with a significant percentage of the population, but it seems transparent enough to me.
Re:Why did we become so dependant? (Score:5, Insightful)
The trouble is that antibiotics and livestock seems to have allowed the industry to be completely negligent of conditions and the health of their animals. I have no doubt that your grandparents will have treated theirs such better than hormone pumped, antibiotic loaded factory farm livestock we have today. Then again, antibiotics can also save herds from infectious diseases.
In the same way you can't compete with Walmart on price using a hand loom, it seems you can't compete with agri-business without using some of these techniques.
The only solution seems to be to regulate it, and I believe some countries are already doing so in part. That and advances in synthetic or vat grown meat would go towards solving a lot of problems and help remove anti-biotics from the food chain.
Re:What will researchers do next (Score:3, Insightful)
They just want money, so they say there will be some sort of catastrophe ... I, for one, want absolute iron-clad proof
Dude, I can't believe that actually got modded insightful. Science is all about extrapolating a "best guess" prediction based on the data you have at hand. There are no "ironclad" guarantees about anything. If I have a room full of scientists telling me sh#t is going to hit the fan unless something is done, always give them the benefit of the doubt. They are much more educated in the topic.
Solutions are simple, executing them is hard (Score:5, Insightful)
Those of us who have been in and around the industry have seen this developing for a long time. The solutions are straightforward but face enormous resistance from those currently benefiting from how antibiotics are currently misused.
1) Ban the use of antibiotics in livestock except to actually treat disease. As the article notes, >60% of all antibiotics by volume are used to fatten livestock in the absence of disease. Because the USDA regulates livestock production rather than the FDA it becomes a jurisdictional quagmire to try to limit use in livestock. While there isn't much antibiotic left in meat when it goes to market, the runoff from stockyards provides the perfect mixture of bacteria and diluted antibiotic (and metabolites) to create resistant strains.
2) Stop prescribing antibiotics in novel classes for routine things like ear infections and sinus infections. Studies show that most of those will clear up on their own without antibiotic treatment, but nobody wants to be the guy who feels miserable but doesn't get a Z-Pak or some fluroquinolones as treatment.
3) Ban these ridiculous anti-bacterial soaps and things that contain triclosan. It's creating cross-antibiotic resistance and isn't even that effective at killing bacteria during primary use because people don't leave it on long enough.
4) An earlier poster asked if the lack of corporate investment to find new antibiotics is a market failure, and the answer is yes. Besides the enormous dysfunction that permeates big pharma in general, the reality is that antibiotics are generally not nearly as profitable as once-a-day drugs that last a lifetime. Either provide regulatory incentives for antibiotic development or do more of the research at the government level or both.
5) In the long run, we need a completely different approach to managing bacterial infection. An earlier poster mentioned phages, and there are multiple different research avenues that show some promise if we can get them going.
Re:terrorism! ha! (Score:4, Insightful)
Exactly. If this were to happen it would kill more people in a month then what we have lost to terrorism* in all time. It is far more important then terrorism.
*bombers, suicide planes etc, not despots
Anecdotes aren't statistics (Score:5, Insightful)
So, your anecdote is that you've never had your life save by antibiotics. So what? Are you suggesting that the scientists are saying that 100% of the population will die without antibiotics? No, they are saying that many more people will die without them than with them. This seems self-evident to me, but apparently people like you are more difficult to convince. You do seem easily convinced by anecdotes, however, so, I'll see your anecdote with a couple of my own.
When he was about 5, my son was running on the deck and tripped. As he slid along the desk, a very then (willow) tree branch got shoved up into his leg about 4 inches or so. I pulled out as much as a could, but a good inch or so of tree branch broke off and got left behind. Our choices were to treat the infection and let his body gradually dispose of the foreign substance or cut his leg open and remove the branch. Either way, without antibiotics he would have been quite unlikely to survive.
As a child my mother got strep throat. Her family could not easily afford a doctor and so that waited to see if she would just get better. Instead, it developed into scarlet fever. She had to spend a year of her childhood confined inside and on heavy antibiotics or she would have died.
I myself have had numerous infections: strep throat (many times, mostly as a child), bronchitis, etc. At least one of these would have been fatal without antibiotics.
So, by these anecdotes, three of every four people will die without antibiotics, right? Wrong. Anecdotes aren't statistics, so stop trying to marginalize real issues with "well it's never happened to me" bullshit, OK? We are all very impressed that you've lived 50 years and never needed antibiotics except for preventative purposes, but you are not the norm.
Re:terrorism! ha! (Score:4, Insightful)
This is where they lost me.
Um, no. That is where you actively decided to get lost.
Trying to rally the public with "if you get a scrape you will die" is pretty much fear mongering.
I really loathe people (like you) who pretend to be quoting something, when that something was actually never said. The real quote was (my emphasis added, otherwise verbatim):
Note how it doesn't say "you will die" that you pretended?
And fear mongers can fuck right off.
No, that would be you who can fuck off. Preferably to a different planet. The earth, and everyone on/in it, would be better off if you just left, permanently.
Stop buying factory farmed Produce and Meat (Score:4, Insightful)
"We'd lose a good portion of our cheap modern food supply because most of the meat we eat in the industrialized world is raised with the routine use of antibiotics, to fatten livestock and protect them from the conditions in which the animals are raised."
Stop buying factory farmed Produce and Meat. Buy from small farmers that don't feed antibiotics to livestock and don't use antibiotics on plants. Yes, it is a little bit more expensive than the government subsidized industrial farmed cheap food but how cheap is your life? How expensive is cancer? What is the cost of antibiotic resistance.
You make choices.
Re:What will researchers do next (Score:2, Insightful)
It's called free will.
What really is puzzling is all these science fanbois who constantly throw out strawmen and red herrings about religion but in reality they have no idea what religion is nor do they know anything about the 'solutions' to all the 'problems' their 'great' minds thought of that they think nobody in the past millenia ever thought of.
The problem is that the solutions usually take the form of a black box with a name tag attached that's supposed to solve the problem. I personally am a big fan of classic philosophy and advanced theological thinking, they're simply awesome. But the solutions they arrive at always rely on some bit of mystery that you must take at face value, otherwise things don't work.
Free will is a prime example. Whenever you try to crack it open and figure out how it works you end up with a deterministic formulation. So you only have two options really: either you assume there is this free will attribute no matter how nonsensical it looks when observed under the cognitive equivalent of a tunneling microscope, or you give up and assume that free will is a perceptual error, and then moves to the much simpler problem of figuring out why we instinctively believe there is such a thing when it makes no sense.
Another good example is the classic theist concept of the prime mover as God, which in turn is a pure one without moving parts, that somehow is at the same time will, and goodness, and power, and law, and knowledge, and action, and planning, and outside of time and space, and containing time and space, and ourselves etc., all of this more or less just because. It all sounds amazing, and it indeed is, but when you stop, take a step back and look at it critically you're really left only with a big question mark, and a question mark, no matter how incredible is the sentence that comes before it, isn't an answer.
So it isn't that those thinkers didn't arrive at solutions. It's just that they're bad solutions. But I agree that most science fanbois would benefit immensely from actually knowing those answers so as to at least not go around reinventing the wheel again and again and again...
Re:terrorism! ha! (Score:5, Insightful)
They didn't say "if you get a scrape you will die." They said "if you get a scrape you could potentially die," which is a factual statement if we have no effective antibiotics.
Yes, but they've deliberately and carefully worded it in such a way that people will think the extreme "if you get a scrape you will die" upon reading it. They could have said: "Wounds of all types will carry a greater risk of untreatable infection." But they worded the sentence to include the least severe cause and the worst case effect.
That, IMHO is scaremongering.
Re:terrorism! ha! (Score:2, Insightful)
I conclude you're an idiot.
Fact 1. You mention vaccination, colds and flu. Those are 100% viral, no bacteria involved.
Fact 2. It's not popular antibiotics, it's effective without nasty side effects.
Fact 3. Some are left, very few new antibiotics are being researched or developed, as it is not profitable
About the only sensible thing you've said is about the overuse of antibacterial soaps, hand sanitizers would be a much better choice if you were doing work where sterility is important, otherwise plain soap and water will do an excellent job.
Re:What will researchers do next (Score:5, Insightful)
Of course if the medical profession wants to get the public to take note, just tell them that we won't be able to treat syphilis anymore. If common STDs become untreatable and declared an epidemic, then the public will take notice.
Getting close with gonorrhea already.
Re:terrorism! ha! (Score:4, Insightful)
You aren't successful because there is no evidence to back you idea
How about, before you put life changing drugs inside animal fodder, YOU prove that it's REALLY harmless. Why should the burden of proof be upon me ?!? And you know what, I've been following this for a long time, and there are more and more studies that prove that it is indeed a root cause of resistance buildup. 50% of all chicken meat produced in the US has some form of germs with antibiotics resistance, and (from memory) 30% of ground beef. Look it up, it's in the articles above.
As for being a douche for shortening a word, are you grasping at straws or what ?