3 ms·

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 agricu

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.
    - freeflight 9y ago
      >The way around this is to use multiple drugs that require multiple different mutations to survive. Or it might just as well end up beeing the fastest way for creating, even more, MRSA bacteria strains because the harsher the treatment, the more sturdy the survivors we will be. >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. As corny as it might sound, we really shouldn't underestimate nature like that, it's part of the reason what got us in this mess in the first place. If we can design something requiring 3 different mutations to survive, then sooner or later nature is gonna evolve something with those 3 different mutations. Nature has played this game far longer, and far more successful than we will ever be able to. That's why imho we need a better approach than "use more types of antibiotics", as that's essentially exactly what we've been doing this whole time.
      - danieltillett 9y ago
        HIV is a far more formable resistance target than bacteria (in the short term at least). We know what we need to do - develop new antibiotics and stop giving them one at a time. Like the famous quote from Churchill about Americans we will eventually get there after we exhaust all the alternatives. Edit. When I was a science undergraduate in the early 1990s on my own I came up with HAART (not original of course) from first principles. It seems so obvious that I didn't understand why it was not standard practice (such is the arrogance of youth).

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.
  - freeflight 9y ago
    >The way around this is to use multiple drugs that require multiple different mutations to survive. Or it might just as well end up beeing the fastest way for creating, even more, MRSA bacteria strains because the harsher the treatment, the more sturdy the survivors we will be. >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. As corny as it might sound, we really shouldn't underestimate nature like that, it's part of the reason what got us in this mess in the first place. If we can design something requiring 3 different mutations to survive, then sooner or later nature is gonna evolve something with those 3 different mutations. Nature has played this game far longer, and far more successful than we will ever be able to. That's why imho we need a better approach than "use more types of antibiotics", as that's essentially exactly what we've been doing this whole time.
    - danieltillett 9y ago
      HIV is a far more formable resistance target than bacteria (in the short term at least). We know what we need to do - develop new antibiotics and stop giving them one at a time. Like the famous quote from Churchill about Americans we will eventually get there after we exhaust all the alternatives. Edit. When I was a science undergraduate in the early 1990s on my own I came up with HAART (not original of course) from first principles. It seems so obvious that I didn't understand why it was not standard practice (such is the arrogance of youth).