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> They identified bacteria able to shrug off the drug of last resort - colistin - in patients and livestock in China. … > It is likely resistance emerged afte

by zeveb 11y ago

> They identified bacteria able to shrug off the drug of last resort - colistin - in patients and livestock in China. … > It is likely resistance emerged after colistin was overused in farm animals. What the heck? Shouldn't the antibiotic of last resort be used only as … a last resort? I can't believe that any farm animal would be worth the use of such a drug (although I suppose it's possible, were it the last of its breed or something).

th0waway 11y ago
This is an instance where capitalism (and I am a capitalist) has gone awry - someone somewhere ran a PowerPoint slideshow showing they could make 'x' more dollars if they pre-emptively dosed livestock with antibiotics, and the PHB's said 'make it so'.
j_jochem 11y ago
Here, "last resort antibiotic" means that is given only if nothing else works, because it is too nephrotoxic for normal use. This has nothing to do with the inherent effectiveness of the drug, although it has probably become more effective through the disuse that resulted from its nephratoxicity. Bad journalism again.
fredsted 11y ago
It seems like antibiotics like Colistin are uncontrolled in China, and perhaps very cheap? It seems like madness to use these last resort drugs on farm animals.
- mikeash 11y ago
  The whole problem here (as with many other things) is that actions which are "madness" when looking at the big picture come from perfectly rational actions by individuals.
  - liamconnell 11y ago
    Nah I hate that kind of thinking. Someone or some group of people have to be deemed responsible. Here's my thought process with this: So in China, and every country there are a few relevant players. Farmers, farm owners, politicians, and scientists. Farmers (laborers) have to survive and most work wages so they arent accountable. Farm owners have to compete and if they dont they go out of business and someone will take their place so they're not really accountable. But its the law that makes the rules of the game and so it is the responsibility of the political class to avoid designing "tragedy of the commons" scenarios. There are at least SOME good-willed politicians who dont want things like antibiotic-apocolypse. The problem is that they have a ton of scientists whispering different things in their ears so they dont know what issues are big threats and which are scientists trying to get funding into their own field of study. Its therefore also the responsibility of the scientific community to effectively communicate with the political class. See? At least some people out there arent perfectly rational!
    - lotyrin 11y ago
      No, it's a closed loop of externalized costs. Workers have to try to eat, businesses have to try to compete, voters have to promote their economic interests, politicians have to stay elected. Climate change and antibiotic resistance et al don't cost any of these people anything -- individually. If nobody has to pay for them, and everybody has to compete to take advantage of whatever they can to live and prosper, the rational thing is to fuck everything up. It's a massive scale prisoner's dilemma with high stakes. Government is ostensibly the system that prevents external costs, and imposes rules that skew what's rational for individuals today to be closer to what's rational for society tomorrow, but in practice it fails to do so much of the time.
      - TeMPOraL 11y ago
        Exactly. Also, per tradition, let me post a handy reference on coordination problems: http://slatestarcodex.com/2014/07/30/meditations-on-moloch/ http://slatestarcodex.com/2014/07/30/meditations-on-moloch/
    - mikeash 11y ago
  - danharaj 11y ago
    That doesn't nail it down though. This just reshuffles the terminology so that we're talking about individuals taking self-interested actions. Then we can ask of this "madness": Why do we live in a society where individuals have so little common interest with the collective good? The language of rational self-interested actors does not predict the structure of society, it just gives you a convenient way of talking about that structure at the level of individual humans. In particular, it does not explain why people perceive their self interest the way they do and it does not explain how those perceptions change. It does not explain how people come to find common interest with others and does not explain how someone's notion of self and notion of society commingle and interact. These things are the definitions that let you talk about rational behavior in the first place. This is by no means a defect of the concept. A microscope is not defective just because it is not a telescope, but it is still just a microscope. If you magnify a festering wound enough, it ceases to look so gruesome.
    - TeMPOraL 11y ago
      'mikeash nailed it down perfectly, albeit very succinctly. It's not reshuffling the terminology, it's a common phenomena - that a group of actors making decisions in their self-interest end up creating a situation that is bad for everyone and that nobody wanted in the first place, but that they can't get out of anymore. For instance, in a little simplified example, each farmer would prefer to not abuse antibiotics because they deeply care about their health and maybe even about the future of mankind. But in a competitive environment, the first farmer to use more antibiotics will gain advantage over the others, so some other farmers - maybe afraid of losing the money to feed their children - will start using more antibiotics too to stay competitive (and those who refuse on ideological grounds will simply get outcompeted). Soon, everybody is abusing antibiotics even though no one wanted it (maybe the first defector was greedy, or maybe he really needed the money). The end result is the same (competitive advantage gained by antibiotics cancels out when everyone is using them), everyone is collectively worse, and no one can break the cycle. That's why we need external actors, like governments, to enforce some coordination. But real-life governments too often fail at that. I linked to a powerful microscope in a parallel subthread.
      - 11y ago

by zeveb 11y ago

th0waway 11y ago

This is an instance where capitalism (and I am a capitalist) has gone awry - someone somewhere ran a PowerPoint slideshow showing they could make 'x' more dollars if they pre-emptively dosed livestock with antibiotics, and the PHB's said 'make it so'.

j_jochem 11y ago

Here, "last resort antibiotic" means that is given only if nothing else works, because it is too nephrotoxic for normal use. This has nothing to do with the inherent effectiveness of the drug, although it has probably become more effective through the disuse that resulted from its nephratoxicity. Bad journalism again.

fredsted 11y ago

It seems like antibiotics like Colistin are uncontrolled in China, and perhaps very cheap? It seems like madness to use these last resort drugs on farm animals.

mikeash 11y ago
The whole problem here (as with many other things) is that actions which are "madness" when looking at the big picture come from perfectly rational actions by individuals.
- liamconnell 11y ago
  Nah I hate that kind of thinking. Someone or some group of people have to be deemed responsible. Here's my thought process with this: So in China, and every country there are a few relevant players. Farmers, farm owners, politicians, and scientists. Farmers (laborers) have to survive and most work wages so they arent accountable. Farm owners have to compete and if they dont they go out of business and someone will take their place so they're not really accountable. But its the law that makes the rules of the game and so it is the responsibility of the political class to avoid designing "tragedy of the commons" scenarios. There are at least SOME good-willed politicians who dont want things like antibiotic-apocolypse. The problem is that they have a ton of scientists whispering different things in their ears so they dont know what issues are big threats and which are scientists trying to get funding into their own field of study. Its therefore also the responsibility of the scientific community to effectively communicate with the political class. See? At least some people out there arent perfectly rational!
  - lotyrin 11y ago
    No, it's a closed loop of externalized costs. Workers have to try to eat, businesses have to try to compete, voters have to promote their economic interests, politicians have to stay elected. Climate change and antibiotic resistance et al don't cost any of these people anything -- individually. If nobody has to pay for them, and everybody has to compete to take advantage of whatever they can to live and prosper, the rational thing is to fuck everything up. It's a massive scale prisoner's dilemma with high stakes. Government is ostensibly the system that prevents external costs, and imposes rules that skew what's rational for individuals today to be closer to what's rational for society tomorrow, but in practice it fails to do so much of the time.
    - TeMPOraL 11y ago
      Exactly. Also, per tradition, let me post a handy reference on coordination problems: http://slatestarcodex.com/2014/07/30/meditations-on-moloch/ http://slatestarcodex.com/2014/07/30/meditations-on-moloch/
  - mikeash 11y ago
- danharaj 11y ago
  That doesn't nail it down though. This just reshuffles the terminology so that we're talking about individuals taking self-interested actions. Then we can ask of this "madness": Why do we live in a society where individuals have so little common interest with the collective good? The language of rational self-interested actors does not predict the structure of society, it just gives you a convenient way of talking about that structure at the level of individual humans. In particular, it does not explain why people perceive their self interest the way they do and it does not explain how those perceptions change. It does not explain how people come to find common interest with others and does not explain how someone's notion of self and notion of society commingle and interact. These things are the definitions that let you talk about rational behavior in the first place. This is by no means a defect of the concept. A microscope is not defective just because it is not a telescope, but it is still just a microscope. If you magnify a festering wound enough, it ceases to look so gruesome.
  - TeMPOraL 11y ago
    'mikeash nailed it down perfectly, albeit very succinctly. It's not reshuffling the terminology, it's a common phenomena - that a group of actors making decisions in their self-interest end up creating a situation that is bad for everyone and that nobody wanted in the first place, but that they can't get out of anymore. For instance, in a little simplified example, each farmer would prefer to not abuse antibiotics because they deeply care about their health and maybe even about the future of mankind. But in a competitive environment, the first farmer to use more antibiotics will gain advantage over the others, so some other farmers - maybe afraid of losing the money to feed their children - will start using more antibiotics too to stay competitive (and those who refuse on ideological grounds will simply get outcompeted). Soon, everybody is abusing antibiotics even though no one wanted it (maybe the first defector was greedy, or maybe he really needed the money). The end result is the same (competitive advantage gained by antibiotics cancels out when everyone is using them), everyone is collectively worse, and no one can break the cycle. That's why we need external actors, like governments, to enforce some coordination. But real-life governments too often fail at that. I linked to a powerful microscope in a parallel subthread.
    - 11y ago