7 ms·

This was precisely addressed by Sir Alexander Fleming's 1945 Nobel Prize speech: “But I would like to sound one note of warning. Penicillin is to all intents a

This was precisely addressed by Sir Alexander Fleming's 1945 Nobel Prize speech: “But I would like to sound one note of warning. Penicillin is to all intents and purposes non-poisonous so there is no need to worry about giving an overdose and poisoning the patient. There may be a danger, though, in underdosage. It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body. The time may come when penicillin can be bought by anyone in the shops. Then 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. Here is a hypothetical illustration. Mr. X. has a sore throat. He buys some penicillin and gives himself, not enough to kill the streptococci but enough to educate them to resist penicillin. He then infects his wife. Mrs. X gets pneumonia and is treated with penicillin. As the streptococci are now resistant to penicillin the treatment fails. Mrs. X dies. Who is primarily responsible for Mrs. X’s death? Why Mr. X whose negligent use of penicillin changed the nature of the microbe. Moral: If you use penicillin, use enough.” Edit: Fleming's full Nobel lecture: http://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-lecture.pdf http://www.nobelprize.org/nobel_prizes/medicine/laureates/19...

Florin_Andrei 10y ago
It's amazing how long ago this issue was understood. And yet not much was done meanwhile, on a global scale, to address it.
- Vraxx 10y ago
  that's because it doesn't seem to be a technical hurdle, it seems like it's a social issue. We, as a species, haven't proven terribly adept at handling those yet.
  - fleitz 10y ago
    It's actually really easy to handle the problem, you have a few sets of anti-biotics and you rotate through sets every 5 years. Furthermore in Hospitals you make people wash their hands (as in you post security gaurds at the hand washing stations and none shall pass a station without washing) and you have separate wards for those with MRSA and those without MRSA. If you need an antibiotic that is not in rotation, you are hospitalized while everyone makes sure you take your full course. Doing these things eliminates about 90% of the problem.
    - Swizec 10y ago
      Doing these things is also expensive in several ways. We have collectively decided that the cost/benefit is not worth it. It's much easier to make antibiotics prescription only. Which we have. For humans at least.
      - Jedd 10y ago
        > We have collectively decided that the cost/benefit is not worth it. I don't think the decision has been conscious. More importantly the costs and benefits haven't been amortised over the life (and impact) of those decisions. Or, if you will, it hasn't been worth it yet. Unfortunately at the point where we can properly assess the enormous cost of these decisions, the opportunity will be long gone.
        jwatte 10y ago
        It is absolutely conscious. Mainly conscious by politicians and lobbyists, who are high powered but generally fail a science literacy test. And our population, we, are the ones electing them.
    - Vraxx 10y ago
      That was precisely my point. What to do isn't the problem, as you pointed out so succinctly, it's really easy to solve this problem technically. What's the issue here? People and businesses they own aren't following the "optimal" plan, thus it is more of a social issue in getting everybody on the same page.
    - Houshalter 10y ago
      There are other problems. There are doctors that give antibiotics for obviously viral infections, just to give the patients some assurance. There are third world countries that don't care and will not follow any of those rules. Also foreign prison systems, particularly in Russia, which breed TB. Then there are people that are prescribed low doses of antibiotics for things like acne. I imagine that's a huge risk more than all the other things, taking it every single day. And, as others have mentioned, agriculture uses about 50% of the world's supply of antibiotics IIRC, and that's not really safe.
- agumonkey 10y ago
  It's not even blurry or doubtful. Sometimes pioneers have hints that something may or may not... Here, it's crystal clear from the start.
- caf 10y ago
  Every time I've filled a script for antibiotics, they have been accompanied by very prominent written warnings that you must complete the full prescribed course. Often reiterated verbally by the pharmacist.
  - cloudjacker 10y ago
    yeahhhh I thought it was just because although you feel better you could still be in part of the infection cycle, not because the remaining germs were probably now resistant.
  - mei0Iesh 10y ago
    But they don't explain why, and warnings are overdone due to litigation fears, so people will often use their own judgment, and without understanding the concept behind why, they may choose unwisely. "Take all of the prescribed medication" : "They're just greedy and want to make me buy more" vs. "Take all or you'll breed antibiotic-resistant bacteria that cannot be treated and you will die and kill the human race" : "I better follow this prescription"
    - caf 10y ago
      If you're the sort to believe it's just a conspiracy to make you buy unnecessary quantities of drugs, then why wouldn't you also presume that the story about antibiotic-resistant bacteria is also part of the conspiracy?
      - mrob 10y ago
        "What doesn't kill you makes you stronger" is a well known saying. It makes sense that it would apply to bacteria.
        Kristine1975 10y ago
        >"What doesn't kill you makes you stronger" is a well known saying. It's from Friedrich Nietzsche's "Twilight of the Idols": "What does not kill me, makes me stronger."
- chatmasta 10y ago
  For a long time since 1945, many humans have believed a supernatural being created the human race thousands of years ago. Understanding the process that leads to antibacterial resistance requires understanding evolution. So it's no surprise that much of the world fails to understand it.
  - industriousthou 10y ago
    Even creationists usually understand that microevolution happens.
    - jussij 10y ago
      Surely they believe the microbes were created by god or is that something god left to evolution?
      - reitanqild 10y ago
        A lot of us just don't care. I am happy to base my work on the currently best working scientific models. My faith is also based on "best practices": what worked well for my parents, grandparents and me and which also happened to help create the western culture we enjoy today. "Render therefore to Caesar the things which are Caesar's; and to God the things that are God's."
        Symbiote 10y ago
        But you have no evidence that your ancestor's faith worked well. Probably the opposite, if you look at any conflicts they were involved in, or what social advances were blocked.
        reitanqild 10y ago
        > But you have no evidence that your ancestor's faith worked well. I am, to a certain degree, that evidence. (Edit: this holds true to some degree even if you look at it from a purely techical POV which makes me smile : ) > Probably the opposite, if you look at any conflicts they were involved in, or what social advances were blocked. This is meaningless unless you also take into account the advances brought forward because of it. And, FWIW, you have to cast your net wide and far to find anything real horrific. This is not to say we are better people than other, but trying to say our faith made us worse than the alternative (warrior tribes as they existed some hundred years ago) seems very wrong.
- iamcreasy 10y ago
  Reminds me of the climate change warning made by one of the researchers from ExxonMobil back in 1981. When I see something like this I start to question our governing system. Its way to slow and sluggish to react to these kind of events that requires immediate attention.
  - seren 10y ago
    The problem is the signal to noise ratio. Every day you have catastrophic predictions from asteroids, super volcanoes, big earthquakes, new ice age, peak oil, loss of ozone layer, loss of biodiversity, solar storms, ... All with dire consequences. Each of these events would cost a few (hundreds of?) billions to address or mitigate. It requires a super human intelligence to separate the chaff from the wheat. And this is hard to know what is scaremongering, and what is really dangerous.
    - iamcreasy 10y ago
      > And this is hard to know what is scaremongering, and what is really dangerous. Indeed. Also there are increasing evidence that many scientific studies aren't reproducable. We need a better System to identify 'useful signals' among noises. But in our current socio-economic structure, this topic never comes up as the most important issue. Abraham Lincoln founded National Science Foundation that laid out a solid ground work for this movement, but nobody(correct me if I am wrong) picked it up where he left of and pushed Scientific inquiry as one of our top agenda.

Florin_Andrei 10y ago

It's amazing how long ago this issue was understood. And yet not much was done meanwhile, on a global scale, to address it.

Vraxx 10y ago
that's because it doesn't seem to be a technical hurdle, it seems like it's a social issue. We, as a species, haven't proven terribly adept at handling those yet.
- fleitz 10y ago
  It's actually really easy to handle the problem, you have a few sets of anti-biotics and you rotate through sets every 5 years. Furthermore in Hospitals you make people wash their hands (as in you post security gaurds at the hand washing stations and none shall pass a station without washing) and you have separate wards for those with MRSA and those without MRSA. If you need an antibiotic that is not in rotation, you are hospitalized while everyone makes sure you take your full course. Doing these things eliminates about 90% of the problem.
  - Swizec 10y ago
    Doing these things is also expensive in several ways. We have collectively decided that the cost/benefit is not worth it. It's much easier to make antibiotics prescription only. Which we have. For humans at least.
    - Jedd 10y ago
      > We have collectively decided that the cost/benefit is not worth it. I don't think the decision has been conscious. More importantly the costs and benefits haven't been amortised over the life (and impact) of those decisions. Or, if you will, it hasn't been worth it yet. Unfortunately at the point where we can properly assess the enormous cost of these decisions, the opportunity will be long gone.
      - jwatte 10y ago
        It is absolutely conscious. Mainly conscious by politicians and lobbyists, who are high powered but generally fail a science literacy test. And our population, we, are the ones electing them.
  - Vraxx 10y ago
    That was precisely my point. What to do isn't the problem, as you pointed out so succinctly, it's really easy to solve this problem technically. What's the issue here? People and businesses they own aren't following the "optimal" plan, thus it is more of a social issue in getting everybody on the same page.
  - Houshalter 10y ago
    There are other problems. There are doctors that give antibiotics for obviously viral infections, just to give the patients some assurance. There are third world countries that don't care and will not follow any of those rules. Also foreign prison systems, particularly in Russia, which breed TB. Then there are people that are prescribed low doses of antibiotics for things like acne. I imagine that's a huge risk more than all the other things, taking it every single day. And, as others have mentioned, agriculture uses about 50% of the world's supply of antibiotics IIRC, and that's not really safe.
agumonkey 10y ago
It's not even blurry or doubtful. Sometimes pioneers have hints that something may or may not... Here, it's crystal clear from the start.
caf 10y ago
Every time I've filled a script for antibiotics, they have been accompanied by very prominent written warnings that you must complete the full prescribed course. Often reiterated verbally by the pharmacist.
- cloudjacker 10y ago
  yeahhhh I thought it was just because although you feel better you could still be in part of the infection cycle, not because the remaining germs were probably now resistant.
- mei0Iesh 10y ago
  But they don't explain why, and warnings are overdone due to litigation fears, so people will often use their own judgment, and without understanding the concept behind why, they may choose unwisely. "Take all of the prescribed medication" : "They're just greedy and want to make me buy more" vs. "Take all or you'll breed antibiotic-resistant bacteria that cannot be treated and you will die and kill the human race" : "I better follow this prescription"
  - caf 10y ago
    If you're the sort to believe it's just a conspiracy to make you buy unnecessary quantities of drugs, then why wouldn't you also presume that the story about antibiotic-resistant bacteria is also part of the conspiracy?
    - mrob 10y ago
      "What doesn't kill you makes you stronger" is a well known saying. It makes sense that it would apply to bacteria.
      - Kristine1975 10y ago
        >"What doesn't kill you makes you stronger" is a well known saying. It's from Friedrich Nietzsche's "Twilight of the Idols": "What does not kill me, makes me stronger."
chatmasta 10y ago
For a long time since 1945, many humans have believed a supernatural being created the human race thousands of years ago. Understanding the process that leads to antibacterial resistance requires understanding evolution. So it's no surprise that much of the world fails to understand it.
- industriousthou 10y ago
  Even creationists usually understand that microevolution happens.
  - jussij 10y ago
    Surely they believe the microbes were created by god or is that something god left to evolution?
    - reitanqild 10y ago
      A lot of us just don't care. I am happy to base my work on the currently best working scientific models. My faith is also based on "best practices": what worked well for my parents, grandparents and me and which also happened to help create the western culture we enjoy today. "Render therefore to Caesar the things which are Caesar's; and to God the things that are God's."
      - Symbiote 10y ago
        But you have no evidence that your ancestor's faith worked well. Probably the opposite, if you look at any conflicts they were involved in, or what social advances were blocked.
        reitanqild 10y ago
        > But you have no evidence that your ancestor's faith worked well. I am, to a certain degree, that evidence. (Edit: this holds true to some degree even if you look at it from a purely techical POV which makes me smile : ) > Probably the opposite, if you look at any conflicts they were involved in, or what social advances were blocked. This is meaningless unless you also take into account the advances brought forward because of it. And, FWIW, you have to cast your net wide and far to find anything real horrific. This is not to say we are better people than other, but trying to say our faith made us worse than the alternative (warrior tribes as they existed some hundred years ago) seems very wrong.
iamcreasy 10y ago
Reminds me of the climate change warning made by one of the researchers from ExxonMobil back in 1981. When I see something like this I start to question our governing system. Its way to slow and sluggish to react to these kind of events that requires immediate attention.
- seren 10y ago
  The problem is the signal to noise ratio. Every day you have catastrophic predictions from asteroids, super volcanoes, big earthquakes, new ice age, peak oil, loss of ozone layer, loss of biodiversity, solar storms, ... All with dire consequences. Each of these events would cost a few (hundreds of?) billions to address or mitigate. It requires a super human intelligence to separate the chaff from the wheat. And this is hard to know what is scaremongering, and what is really dangerous.
  - iamcreasy 10y ago
    > And this is hard to know what is scaremongering, and what is really dangerous. Indeed. Also there are increasing evidence that many scientific studies aren't reproducable. We need a better System to identify 'useful signals' among noises. But in our current socio-economic structure, this topic never comes up as the most important issue. Abraham Lincoln founded National Science Foundation that laid out a solid ground work for this movement, but nobody(correct me if I am wrong) picked it up where he left of and pushed Scientific inquiry as one of our top agenda.