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.'"
terrorism! ha! (Score:5, Interesting)
If this is a threat that "should be ranked alongside terrorism" then I'm not even going to waste my time reading about it.
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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.
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: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: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.
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Barely a few years ago there was a violent discussion on
Re:terrorism! ha! (Score:4, Informative)
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You aren't successful because there is no evidence to back you idea. It's been looked at, many times. Fact is, there is no scientific evidence that any antibiotic resistance is coming from give antibiotics to cows.
Yes, I know it's counter intuitive, but when you look at the data it's clearly coming from too places:
People not finishing the regime, and hospitals.
People disagreeing with you doesn't make them a shill. Shills get paid to promote an idea or activity.
" I wish /. would implement a better search alg
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" I wish /. would implement a better search algo so that we can for instance search our own past posts."
agreed, but abbreviating 'algorithm' to 'algo' make you sound like a douche.
Wouldn't a douche more or less sound like Squirtle?
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 ?
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How about, before you put life changing drugs inside animal fodder, YOU prove that it's REALLY harmless.
Because proving a negative like that is a bitch. The number of subcases to prove is arbitrarily large and the political opponent can always claim (again without effort or proof) that there are more (unidentified) subcases that haven't been addressed.
There's also the comparison of risks: Does failing to knock back the parasite load of the food animals lead to more infections in humans that then get treat
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:4, Interesting)
> They said "if you get a scrape you could potentially die," which is a factual statement if we have no effective antibiotics.
This is factual even with antibiotics.
In fact we tend to forget the only actual fact of life: you will eventually die.
That's true but the number two cause of death from the time we created agriculture and cities until just recently was infection from cuts.
Number one was disease, killing off more than half our babies.
Antibiotics is the number one reason there are so many people alive right now in the world. Seven billion humans is an incredibly large portion of the amount of life on the planet. Losing antibiotics would put a check on the human population. A serious big check. Perhaps big enough to deal with global warming but that's not 'why' it happened.
Evolution is basic biology. In fact, there is a theory that sexual reproduction was "invented" by multicellular organisms in order to stay ahead of the much faster evolution of the single-celled bacteria that preyed on them.
That war continues today and will never stop. Only the individuals fighting on both sides stop. Always.
But the basic impetus for us is to try to stay alive at least long enough to have babies.
That's what the war is all about.
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Antibiotics is the number one reason there are so many people alive right now in the world
I absolutely agree with your assessment of how enormous the burden of infectious disease once was. But speaking as a medical student, water and sewage systems have saved more lives than doctors ever have.
I'd put antibiotics third place, behind vaccines.
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Re:terrorism! ha! (Score:5, Informative)
How often are scrapes and cuts (or even car accidents) treated with antibiotics?
All the time. What do you think Neosporin has in it?
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.
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You don't understand the effect of marketing, do you? Words that people say or type evoke a response far in excess of their actual importance.
If someone tells a mother in an emergency room that her son's injuries "could become life threatening", no amount of downplaying that will matter. She will hear "Your son will die if we don't ...." That is what humans do. How do you not know that?
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>Reminds me of Douglas Adams' telephone sanitizers.
You seem to forget the part where the parent populations planet died because of a disease spread by unsanitary telephone handsets.
Re:terrorism! ha! (Score:4, Informative)
The problem isn't that if you don't treat scrapes or cuts with antibiotics that they will get infected and you will die.
The problem is that if a scrape or cut gets a serious infection you won't be able to treat it with antibiotics.
Obligatory car analogy:
Car Airbags. If they all suddenly vanished, most people probably wouldn't have a problem, many car accidents don't trigger them. But when you need them, they will save your life.
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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.
You say you " can count on one hand the number of times I took antibiotics, and almost all of them were preventative," meaning you took them to prevent infection, so you don't know how many times you could have actually gotten an infection. I did an informal survey of my friends to find out how many have taken antibiotics to fight an actual infection, and the response was 100%. If those infections were antibiotic-resistant, that means 100% of them would have died. I think you're misunderstanding the risk an
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.
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Re:Anecdotes aren't statistics (Score:4, Informative)
Careful with anecdotes, they aren't data.
Holy shit did you miss the point.
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I'm in my 50's and have taken antibiotics twice and in both cases the doctor at the emergency room said I could have easily died without them -- once with pneumonia which I thought I could "tough out" at home and once when a cat bite swelled up my hand to twice its normal size, with red lines going up my arm. I'm glad the antibiotics were there and worked both times!
Re:terrorism! ha! (Score:5, Informative)
Ah, yes, since you've never needed it, nobody else will. MRSA is already killing more people in the US than AIDS.
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Re:terrorism! ha! (Score:4, Informative)
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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
Re:terrorism! ha! (Score:4, Insightful)
Plus the meat industry would donate heavily to their opponent.
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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:terrorism! ha! (Score:4, Funny)
Well, it's your fault for not being effective anymore, fuzzyfuzzyfungus.
Re:terrorism! ha! (Score:5, Funny)
Some of us have been running a largely successful antibiotic R&D program for much of our ~1.5 billion year history, while occasionally taking time out of our busy schedules to help keep those lazy 'plants' alive [nih.gov] and produce the bread that gives you the energy to sustain life and the ethanol that allows you to endure it.
Others, who I am too tactful to name, spent almost a decade trying to copy our homework, between 1928 and 1938, and after a whole 75 years are on the verge of totally fucking up at antibiotic R&D and regressing to 19th century bacterial morbidity and mortality levels.
But no, I get it, I'm the ineffective one. Sorry about that, all my fault.
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Don't start being passive-aggressive with me. There's plenty of others who haven't lost their teeth in the fight against microorganisms. How come fire still works, huh? Fire doesn't make any of your lousy excuses about being overused, and it's been working with us for much longer than you. Mostly on corpses, since it lacks your sense of moderation, but hey, it works really well. In fact, I'd say fire is somewhat like a flame, still burning bright after all these years, while your skills seem to be decomposi
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There is more money to be made on terrorism, and government is in the business of making money. In prioritizing funding, government will always direct the cash flow towards the opportunity which (1) cost the most, and (2) is the most easily exploited for personal gain.
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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
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Which is a bit ironic since on the other end all sorts of relatively minor things with small effects get hyped up into 'OMG' deals, like terrorism.
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It would probably help if agencies like the CDC and HHS used sentences like "This would likely kill a few hundred people worldwide, so don't panic" in their press conferences and speeches instead of phrases like "with potential to harm millions of people around the world" (citation [hhs.gov]), not to mention the obligatory references to how many tens of millions were killed by the 1918 flu (no mention, of course, of the fact that this was largely do to a world war, and very primitive sanitation and medical treatment
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.
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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?
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Surely you aren't arguing that the clash between omnipotence and free will hasn't been contentious? It's hardly something that was ever settled to everyone's satisfaction. I've never seen a convincing argument that omnipotence is even possible: "Can God make a stone so heavy that even he cannot lift it?" The concept of omnipotence creates a paradox IMHO. The typical (and most accepted response) is to argue that "omnipotence" is not defined as "can do anything", but rather "can do anything that God can do"..
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I'd like to think so, but I'm not a xenobiologist.
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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.
Proof? Look at mortality rates from simple wounds prior to antibiotics. Read the reports about drug resistant bacteria that already is prevalent in the hospitals and the dangers involved. To clean the hospitals, they use strong chemicals and UV light, both known to be detrimental to human beings. You want proof? All you need to do is look at mortality rates about 100 years ago.
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Not to say that anti-biotic resistant bacteria aren't a significant problem, but 100 years ago we had poor nutrition and poor sanitation and poor hygiene. Most of the reason those scrapes and bruises and for that matter surgeries resulted in such appallingly high mortality is that people didn't clean wounds or their hands, including surgeons.
To compare those days to today is really rather ridiculous. Even if a significant number of bacteria strains became totally anti-biotic immune we'd still not have anyth
Re:What will researchers do next (Score:4, Interesting)
Not to say that anti-biotic resistant bacteria aren't a significant problem, but 100 years ago we had poor nutrition and poor sanitation and poor hygiene. Most of the reason those scrapes and bruises and for that matter surgeries resulted in such appallingly high mortality is that people didn't clean wounds or their hands, including surgeons.
To compare those days to today is really rather ridiculous. Even if a significant number of bacteria strains became totally anti-biotic immune we'd still not have anything close to the death tolls experienced 100 years ago. It's a serious issue, but we don't have a black death coming any more than H1N1 resulted in the kind of death tolls we saw in the early 20th century.
Of course, a lot of the improvements you mention are related specifically to the introduction of antibiotics. Cleaning wounds with soap and water only goes so far and can't be down with deep wounds. MRSA is already a very real problem for hospitals, which is why they are taking such precautions already. But even in 2nd world countries where there is decent sanitation and the like, bacterial infections are a real problem because of the lack of antibiotics. It is easy to extrapolate that to 1st world countries if antibiotics became ineffective.
Even going back to the 1950s, people died from staph infections all the time. During the Korean War, wounded soldiers often had successful surgeries but died from infection. That occurred whether in a MASH or at a real hospital. Sulfa powder, while more effective than nothing wasn't very effective compared to antibiotics.
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.
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:What will researchers do next (Score:5, Informative)
A likely cause of this drug resistance is use of antibiotics to increase growth rate in livestock. It has been recently shown that for certain livestock simple sanitation methods can be superior to the use of antibiotics. It is also likely that there are superior methods to antibiotics for all livestock,
To follow your profit motive, most of the antibiotics in the US, 80%, are sold for agriculture. While we can assume that antibiotics for agriculture are sold for less than human use, and so the pharmaceuticals firms will not go immediately bankrupt if agricultural uses are outlawed, we can assume the shock to the sector will be significant.
Given that antibiotics in humans has become a minor part of the business, it is not unreasonable to assume that researchers must find an alternative.
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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.
Comment removed (Score:5, Informative)
Re:What will researchers do next (Score:4, Funny)
Nobody is as cynical about scientists and scientific institutions and their desire to frighten government into giving them money than I am.
I agree, the tendency to exaggerate problems by scientists has reached the state of a crisis. Soon we won't know what to believe anymore!!
This is why I am applying for an urgent grant to study the effect of made up crises on academic research.
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!
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You mean McDonald's would have to raise the price of a burger by $0.20?
All is lost.
Re:Hypocritical (Score:5, Funny)
No, McDonald's has no meat or plant matter in their food, so it doesn't apply.
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.
Be Afraid, be very very afraid. (Score:3, Interesting)
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?
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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?
Well, in China and India, lots of stuff gets spewed into the gutters. And rivers. Not that the USA has a sterling record in that department.
Speaking of which. The USA hardly has a pristine environment even now. Even when direct effluents are missing, the lakes, waters, and streams of the USA - including groundwater - contain numerous antibiotics in various degrees of metabolism just because kidneys don't screen them all.
Re:Be Afraid, be very very afraid. (Score:5, Interesting)
The market is definitely causing this. True story:
I know a guy who is a MD and worked most of his career as an antibiotic researcher. His team came up with a new antibiotic that killed everything they tested it on. When he brought the research to the VPs and the CEO, the CEO told him, "You expect me to spend millions of dollars to bring this drug to market only to have the damn doctors keep it in reserve so they can use it as a last resort?"
So, yeah this is a market epic fail. ROI > life. To the morons running these companies, the equation is as simple as that.
Re:Be Afraid, be very very afraid. (Score:5, Interesting)
Will the market save us by producing something be it at a price, or, is this too big and needs to be done by government money and research?
Antibiotics are arguably an example of a situation that (while not meeting the classic definition of 'market failure') is not a market victory.
If the price of an antibiotic is relatively low, it becomes economically viable as a growth enhancer/mortality reducer in high-density agricultural applications, likely burning through its effectiveness relatively quickly (with some help from being handed out to treat patients whining about the sniffles and being reflexively used on basically anybody admitted to a hospital; but veterinary uses are the big one). If the price is relatively high, you see a strong incentive for poorer users (especially in the 'developing' world) to try to make do by 'stretching' inadequate supplies across longer times or more patients than the supplies can provide adequate doses for. You also have more incentive for diluted and fraudulently labelled, or outright faked, versions to make it into the supply chain.
On the supply side, I don't know why it isn't working; whether biology is just being a stubborn bastard and we'd need to throw ten times as many scientists at the problem, or whether the ROI on penis pills and hair loss and pimping minor rebadges of old drugs is better than doing research; but the steady advances in increasingly resistant bacteria have not caused the invisible hand to keep pace with new drugs (particularly new drugs with novel mechanisms, which would get us further ahead in the arms race than incremental tweaks on resistance-threatened mechanisms.)
Re:Be Afraid, be very very afraid. (Score:5, Interesting)
With antibiotics in industry, it is in any individual company's best interest to have everyone else move away from it. If a company uses lots of antibiotics while others do not, not only does it make their own product cheaper and fattier, but they will get more time out of the antibiotics. So no company (outside luxury brands) has an interest in being the one or group of ones to stop the practice since all it will do is help some competitor who does not play along. Same goes in health care unfortunately.
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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?
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:Why did we become so dependant? (Score:5, Informative)
It's not that Origin of Species is exactly a new book. By the time we developed the antibiotics evolutionary biology was well understood.
Market forces vs. scientists sounding the alarm: “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” -- Fleming while accepting his Nobel prize in 1945
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.
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: (Score:2)
Re: (Score:3)
If only there were some historical event which could be traced to improper treatment of bacterial infection, which could illustrate the threat of loss of antibiotics to human civilization and how it is so much worse than terrorism ever was or could be.
Oh wait, there is... the Black Death. I mean, when you can not figuratively, but literally attribute the threat of something to what caused the Black Death, why opt for something as mundane as terrorism.
(and for those who don't like the use of the term lite
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.
The problem (Score:5, Interesting)
The summary says:
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
This the source of the problem, not the effect.
Yes, it does turn out that dosing meat animals with antibiotics even when they are not sick will increase their weight (and hence production) by about 10%, This is a small increase-- but the margin on meat production is low enough that it makes a difference in profitability, and hence if some of the farms do it, pretty much all of them follow.
So, we're losing the ability to use antibiotics because we're spraying them across the landscape, not to cure sickness, but as a fattening agent for cattle.
and protect them from the conditions in which the animals are raised.
This is actually a much smaller use of antibiotics. But, yes, the idea is that we can save money by not bothering with sanitation and health in cattle, but instead just dose them with antibiotics.
Anonymous wrote:
As ranching employs a significant number of people in some states, and agrobusiness has great clout with Congress, this just isn't going to happen. Plus, the average American is not going to accept such a sudden stop to his high meat intake.
Actually, it's a very small effect-- eliminating antibiotic use on cattle would have only a trivial effect on price. The problem is that the low margin on meat production means that if one cattle-production factory does it, everybody has to do so to keep up.
Re:The problem (Score:4, Interesting)
They make the cow fatter because cows are not meant to eat corn, corn gives them stomach ulcers, the antibiotics make sure the ulcers do not cause them health issues, so the increased calorie density of corn feed means the cows gain weight more consistently.
Solving 80 percent of the problem (Score:4, Informative)
What is it with the livestock, that would do nothing to solve the problem, doctors give out antibiotics like there f'in candy to anyone and everyone.
It would do something to solve the largest part of the problem
Amount of antibiotics sold by manufacturers for use by food-producing animals: 13.1 million kilograms
Sold for use by people: 3.3 million kilograms
80 percent of antibiotics sold in the US go to increasing meat production from farm animals.
http://www.nytimes.com/2013/03/28/opinion/antibiotics-and-the-meat-we-eat.html [nytimes.com]
http://www.politifact.com/truth-o-meter/statements/2013/oct/15/louise-slaughter/rep-louise-slaughter-says-80-antibiotics-are-fed-l/ [politifact.com]
http://www.rodalenews.com/antibiotics [rodalenews.com]
Just because you are a vegan doesn't mean you should peddle some false information.
Just because you are an Anonymous Coward doesn't mean you should peddle some false information. There, fixed it for you.
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: (Score:3)
(I am sure there are some in the industry that would rather keep giving out statins than to cure heart disease.)
I do disagree with that: a cure would be MUCH more profitable than treatments for CVD, even if statins were still under patent. Consider this: to be cheaper for your insurance company, a cure for heart disease could charge $1 less than the combined sum they pay for hospitalizations, surgeries, stents, blood pre
Replicators (Score:2)
If the natural food supply is in danger, it's time to build food replicators.
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.
Phages will have to be a part of the answer (Score:5, Interesting)
Hopefully our biotech is starting to get to the point where we can tailor viruses to specific targets, at least some of the time. Things like this [codagenix.com] give me some hope. If we can do that, we can do at least some of that kind of tailoring.
Cheap food is not actually cheap (Score:2)
Beef is cheap in the US because they feed cattle corn instead of grass. Cattle are not designed to eat corn, so they get bloated and sick. They're also kept confined in small areas in conditions that promote the spread of disease, so they need antibiotics.
The environmental and humanitarian catastrophe of large-scale factory-farming is a major culprit in the abuse of antibiotics and the rise of antibiotic-resistant organisms. Sometime down the line, we're going to pay the true cost of the "cheap" food.
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.
This is ridiculous (Score:3)
Antibiotic resistance is a serious issue, but a lot of the summary is hysterical nonsense.
Dialysis patients are more susceptible to infections, but dialysis doesn't require antibiotics. Even if all antibiotics disappeared tomorrow, they would still go on having dialysis. The possibility that they might get an infection that kills them is far less than the absolute certainty that they would die without dialysis.
In the same vein, surgery, implanted devices and treatment for accidents also don't require antibiotics, even though they are usually given proactively to prevent infection. Nobody is going to let someone bleed to death rather than risk causing an infection by suturing a wound.
Yes, antibiotic resistance means more people dying from infections, but it's not some enormous apocalypse that prevents all medical treatment and automatically infects and kills everyone in the hospital.
Re:This is ridiculous (Score:4, Informative)
"Godsend" was the word I heard often used to describe them.
Sure, apocalypse now it ain't, but the way things are going, society as a whole will change drastically as a result of anti-biotics being superseded by evolution.
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.
Antiserums (Score:4, Interesting)
With antibiotics becoming less effective, and molecular biology making such advances, perhaps medicine will stop relying so exclusively on antibiotics (selective poisons) and increase the use and development of antiseurms (mixes of antibodies specific to small regions of the pathogen's surface).
Indeed: When antibiotics were the new "magic bullets", some diseases still responded far better to antiserum treatment than the antibiotics the doctors switched to treating with.
In those days making antiserums was a matter of injecting the pathogen into an animal (typically a horse), then (after a few days) extracting some antibodies (to EVERY pathogen the horse had experienced) and injecting the lot into the patients.
Now we can identify the "conserved regions" that the bug can't change without becoming non-pathogenic, making human antibodies to those regions, sorting out the most effective ones, transplanting the DNA into suitable cell cultures, and making exactly the desired antibody by the bucketload.
With a library of antibiodies to test against we have automated mechanisms - based on silicon chip technology - to assay a pathogen against thousands of them and identify the effective ones within minutes.
Antiseurm the body's own, very effective, way to prevent a recurrence of a disease or infection that one has already survived. But the body's own R&D and deployment takes about three days. Like doctors giving antibiotics, it relies on more general approaches to fight off the initial infection. Giving it assistance with the better-tuned countermeasure in the early stages should be at least as effective as antibiotics were before the development of resistance.
Antibodies can be made to just about any molecular shape the bug exposes to its surroundings. (The hard part is avoiding making one that also appears on normal tissue.) The antibody works, not just by jamming up some necessary machinery in the pathogen, but also by marking the pathogen for destruction by the rest of the patient's immune system. So this approach should work on just about any bug that isn't avoiding the immune system by hiding inside cells or other places it can't reach, or has already devastated the body's clean-up crew.
Re:Oh nos, terrorists! (Score:5, Funny)
Saying something is as scary as terrorism is like saying it's as dangerous as marijuana.
Marihuana? The Mexican devil-loco-weed? Assassin of youth? A cause of homicidal mania in our formerly upstanding young men of good character, and most widely used by the Negro, to stoke its lust for depraved violation of White Womanhood?
Truly a terrifying threat, sir!
(This post brought to you by the 1930s)
Re: (Score:2)
Saying something is as scary as terrorism is like saying it's as dangerous as marijuana.
Marijuana is dangerous. Maybe not to smoke it, but ask the drug agents about the drug cartels sometime.
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:Oh nos, terrorists! (Score:4, Insightful)
Wasn't alcohol about as dangerous during the prohibition? I distinctively remember some mobsters and some shooting.
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Re:Oh nos, terrorists! (Score:5, Funny)
That is pretty dangerous. I knew this guy who had some marijuana. People came to his house with guns, took it from him, made him cut off his dread locks, and then he had to pay some guy in a suit to negotiate for him so they wouldn't put him in a cage.
Marijuana is really dangerous. Stay away from that stuff.
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By breeding faster than we could die.