3 ms·

The solution is to stop giving one antibiotic at a time. HAART for HIV [1] showed that to prevent resistance you have to give multiple drugs at the same time. T

The solution is to stop giving one antibiotic at a time. HAART for HIV [1] showed that to prevent resistance you have to give multiple drugs at the same time. The problem of course is each drug you add to the mix the more you increase the risk of bad side effects. Of course none of this will matter until we can crack down on misuse of new antibiotics in places like India and China. If each new antibiotic developed is stolen and abused then nothing will work. 1. https://en.m.wikipedia.org/wiki/Management_of_HIV/AIDS https://en.m.wikipedia.org/wiki/Management_of_HIV/AIDS

contras1970 9y ago
How about a crackdown on misuse of (new and old) antibiotics in places like the USA? http://phenomena.nationalgeographic.com/2015/12/14/you-cant-buy-antibiotics-over-the-counter-can-you-yes-you-can/ http://phenomena.nationalgeographic.com/2015/12/14/you-cant-... This is not a discussion of Indian or Chinese laws on "intellectual" "property".
- danieltillett 9y ago
  The new antibiotics are not being misused in the USA - in the main they are not being used at all in the USA which is a big problem for any company thinking of developing a new antibiotic.
freeflight 9y ago
Afaik your suggested "solution" is part of the actual cause of the problem. Too liberal use of broad-spectrum antibiotics, in everything from medicine to agriculture[0], is among the main reasons why we are in this current situation: MSRA infection rates so high, it's considered a pandemic and it's misuse being as bad in the US as it's in East Asia [1]. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/ [1] http://www.handinscan.com/global-epidemiology-of-mrsa/ http://www.handinscan.com/global-epidemiology-of-mrsa/
- jessriedel 9y ago
  No, you don't understand his comment, and appear to have boiled this technical subject down to "more antibiotics" vs. "less antibiotics". In particular, using a broad-spectrum antibiotic is very different than using multiple antibiotics.
  - freeflight 9y ago
    >boiled this technical subject down to "more antibiotics" vs. "less antibiotics" Because, once again afaik, that's one of the driving factors for the emergence of MRSA bacteria: Too liberal use of antibiotics, which especially applies in the US. The suggested solution, of using different kinds of antibiotics, feels like the sledgehammer approach that could just as well make the problem worse. By creating MRSA bacteria even faster, giving them a whole load of antibiotics to mutate resistances to at once vs one at a time. The BBC Article has a whole paragraph about this dynamic: "The most important part of this is that bacterial resistance is essentially a numbers game: the more humans try to kill bacteria with antibiotics, and the more different antibiotics they use, the more opportunities bacteria have to develop new genes to resist those antibiotics."
    - bobdole1234 9y ago
      Evolution works on fractions. Bacteria develop resistance because there's always a tiny fraction that survive the onslaught of whatever drug used, that tiny fraction survives and the remaining population is now completely resistant. This is normally not a problem because the drug kills enough of them that your immune system mops up the rest. The problem now is that the fraction has slowly become larger and larger until the point that a viable population of survivors remains to pass on their genes. The way around this is to use multiple drugs that require multiple different mutations to survive. If before each drug left a tiny fraction of population, the intersection of those drugs will leave a fraction of a fraction of a fraction. Not enough to make a viable population that passes along multiple resistances. In some cases, you can stack drugs in a way that requires bacteria to have three mutually exclusive mutations, so they're dead either way. There is an antibiotic candidate right now that is estimated to be 15,000x more effective because of smart design to require 3 different mutations to survive, but those mutations don't work together.

contras1970 9y ago

How about a crackdown on misuse of (new and old) antibiotics in places like the USA? http://phenomena.nationalgeographic.com/2015/12/14/you-cant-buy-antibiotics-over-the-counter-can-you-yes-you-can/ http://phenomena.nationalgeographic.com/2015/12/14/you-cant-... This is not a discussion of Indian or Chinese laws on "intellectual" "property".

danieltillett 9y ago
The new antibiotics are not being misused in the USA - in the main they are not being used at all in the USA which is a big problem for any company thinking of developing a new antibiotic.

freeflight 9y ago

Afaik your suggested "solution" is part of the actual cause of the problem. Too liberal use of broad-spectrum antibiotics, in everything from medicine to agriculture[0], is among the main reasons why we are in this current situation: MSRA infection rates so high, it's considered a pandemic and it's misuse being as bad in the US as it's in East Asia [1]. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/ [1] http://www.handinscan.com/global-epidemiology-of-mrsa/ http://www.handinscan.com/global-epidemiology-of-mrsa/

jessriedel 9y ago
No, you don't understand his comment, and appear to have boiled this technical subject down to "more antibiotics" vs. "less antibiotics". In particular, using a broad-spectrum antibiotic is very different than using multiple antibiotics.
- freeflight 9y ago
  >boiled this technical subject down to "more antibiotics" vs. "less antibiotics" Because, once again afaik, that's one of the driving factors for the emergence of MRSA bacteria: Too liberal use of antibiotics, which especially applies in the US. The suggested solution, of using different kinds of antibiotics, feels like the sledgehammer approach that could just as well make the problem worse. By creating MRSA bacteria even faster, giving them a whole load of antibiotics to mutate resistances to at once vs one at a time. The BBC Article has a whole paragraph about this dynamic: "The most important part of this is that bacterial resistance is essentially a numbers game: the more humans try to kill bacteria with antibiotics, and the more different antibiotics they use, the more opportunities bacteria have to develop new genes to resist those antibiotics."
  - bobdole1234 9y ago
    Evolution works on fractions. Bacteria develop resistance because there's always a tiny fraction that survive the onslaught of whatever drug used, that tiny fraction survives and the remaining population is now completely resistant. This is normally not a problem because the drug kills enough of them that your immune system mops up the rest. The problem now is that the fraction has slowly become larger and larger until the point that a viable population of survivors remains to pass on their genes. The way around this is to use multiple drugs that require multiple different mutations to survive. If before each drug left a tiny fraction of population, the intersection of those drugs will leave a fraction of a fraction of a fraction. Not enough to make a viable population that passes along multiple resistances. In some cases, you can stack drugs in a way that requires bacteria to have three mutually exclusive mutations, so they're dead either way. There is an antibiotic candidate right now that is estimated to be 15,000x more effective because of smart design to require 3 different mutations to survive, but those mutations don't work together.