6 ms·

this whole fear "antibiotic super resistance bug" doomsday fear is narrative is totally out of control, where now doctors are resisting prescribing totally safe

by delbel 8y ago

this whole fear "antibiotic super resistance bug" doomsday fear is narrative is totally out of control, where now doctors are resisting prescribing totally safe and proven penicillin based drugs, which is causing more damage then good. The "super bug" threat is not from penicillin based resistance, but this clarification is nowhere to be found in the mainstream media. This article and the researchers are totally out of character with what the problem is. It's gotten so bad that the WHO has now put out an advisory to say it is OK to prescribe amoxicillin because people are getting really really sick from doctors worried about this irrational fear because they believe in these lies.

Fomite 8y ago
I work in hospital infection control. Extended-spectrum beta-lactamases are a major problem with several emerging infections, mostly Enterobacteriaceae.
- delbel 8y ago
  You would think somebody like yourself would be the first person these reporters would reach out and contact to ask for information. Have you ever been contacted? Instead, they focus on farm animals. Somehow regular family doctors read this -- fear the most, and hesitant to prescribe basic antibiotics for conditions that could turn serious, where these people later on could end up in your care because of these mistakes. The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts and therefore, kill itself rendering no vector to transfer between hosts. This is why I think ebola outbreaks always die down.
  - buvanshak 8y ago
    >The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts.. That is not what a super bug means. It just means that it is resistant to antibiotics. Not that it has a MR of 100. It is possible for people to survive infections without antibiotics. I am surprised that I have to say this aloud. It seems that we are living in a time where people are born convinced that human beings cannot survive without medicines...
  - Fomite 8y ago
    "You would think somebody like yourself would be the first person these reporters would reach out and contact to ask for information. Have you ever been contacted?" - Yep. "Instead, they focus on farm animals." - While the focus on farm animals occasionally irritates me because it lets doctors off the hook by pretending they're not part of the problem, ESBLs - as an example - are relatively common in livestock. "...hesitant to prescribe basic antibiotics for conditions that could turn serious, where these people later on could end up in your care because of these mistakes." Of the problems we have, the inappropriate non-use of antibiotics pales in comparison to the inappropriate use of antibiotics, either using an overly broad spectrum agent (like penicillin or ampicillin...), the wrong agent, or treating a viral infection with antibiotics. Antibiotic stewardship, in both the inpatient and outpatient settings, is not pretty much the standard of care, and supported by major medical societies like the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. "The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts and therefore, kill itself rendering no vector to transfer between hosts. This is why I think ebola outbreaks always die down." Relying on the concept of susceptible depletion is a really bad idea. It's one of those "just so" stories that seems to make sense, but doesn't work in practice (Ebola doesn't actually die down due to susceptible depletion either...) The issue is not "OH MY GOD IT WILL KILL EVERYONE" but that there are activities today that are relatively risk free because if you do get an infection it's treatable. Things like surgery and childbirth. Absent effective treatments, the concern is that the mortality rate from infections will rise. Not to 100%, but it also doesn't need to be 100% to be a major public health problem.
    - delbel 8y ago
      Thanks, I really enjoy and respect your perspective and facts.
    - candiodari 8y ago
      I think if one looks at relatively recent incidents of diseases spreading, and take the Spanish flu as precedent, that provides a good framework for what one can expect once we fully lose antibiotics. Suddenly losing 10, 20, probably up to 60% of certain popluation groups (usually age based, but definitely not race-blind) is to be expected, with some groups more likely than others to be affected. The poor obviously, but beyond that children and elderly, sometimes with a large preference for one sex over another, or one race over another ... I'm pretty sure that's pretty accurately described as "OH MY GOD EVERYBODY DIES", because ... that's certainly what it'll feel like for at least 6 months.
  - maxxxxx 8y ago
    The black death didn't kill all of its hosts but wiping out a third of the population is still pretty bad in my book.
    - jryan49 8y ago
      But it increased the quality of life for those who did survive, and has had many positive effects on all humans born afterwards [0]. So it's not all bad :D 0: https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the_Italian_Renaissance_possible%3F https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the...
      - maxxxxx 8y ago
        In Britain peasants also suddenly had bargaining power when land owners need workers and there were not many workers left.
      - saiya-jin 8y ago
        so called Thanos argument
  - hexane360 8y ago
    You've likely played too much Pandemic. Take a step back and wonder whether it's likelier that all the scientists are wrong or that you don't know as much about epidemiology (or, looking at your post history: geology, chemistry, climate science, GMOs) as you may about programming. https://xkcd.com/675/ https://xkcd.com/675/
  - TeMPOraL 8y ago
    To reiterate the point brought by others so that it stands in the clear: the problem with superbugs isn't the imagined risk of creating a super-pathogen that will wipe out large parts of the population. The problem is that the routine procedures you don't think about as unsafe - like childbirth, patching up cuts, minor surgeries - could suddenly become life-threatening conditions.
    - Fomite 8y ago
      The one I often pick is battlefield medicine. Soldiers don't die of gangrene and sepsis in field hospitals anymore.
pokemongoaway 8y ago
Not to mention low dose antibiotics are sometimes very therapeutic. When the effective medicines become widespread big pharma has incentive to spend as much money marketing against them as it does to actually develop better stuff. Antibiotics never worked against biofilms anyway - and many of the cases of so-called evil bacteria are actually just full fledged biofilms.
- delbel 8y ago
  I have noticed that there is absolute zero coverage of biofilm based infections and very little research. A simple dose of doxycycline before the bacteria is able to create a biofilm would prevent years of suffering, doctors flat out refuse to do it until it is to late because of the irrational fear of super bacteria cooked up by the media. This is happening at a huge scale.
  - Fomite 8y ago
    This will come as a surprise to the various people I see working on biofilms at conferences. Also, non-biofilm resistance to Tetracyclines (of which Doxy* is a member) are widespread, and primarily involve the ribosomal subunits.
    - delbel 8y ago
      Oh no, I meant in the context of the news media. I think its great that you see people working on the problem at conferences and I hope they find breakthroughs. My knowledge is very limited and this isn't my area of expertise obviously. I am into small farming. But it interest me and recently I discovered Nitazoxanide and read about how scientist and doctors found out it cures Hep-B and almost cures Hep-C, and the flu -- all viruses, which is pretty amazing to me because it is an antibiotic not a antivirus. It also prevents the creation of biofilm of lyme. Apparently the Hep-B/C discovery lead to a whole new class of treatments that are about to come out or will be. My problem is journalist blaming farmers. Two of my products are THC and CBD based. If I made outrageous medical claims or concerns like these journalist, I would lose my livelyhood by regulators. It just grinds my gears that we get the blame for all of this when we want good positive solutions to real problems as well. If the journalist were halfway decent they would figure out that the antibiotics are all about crop/livestock insurance. Farmers are smart people to, just yesterday I got a request to isolate THCV for apparently its neurogensis properties. They wanted a strain that has zero delta-9 THC, the illegal one, for medical purposes. We want good things as well and you can bet your buttons if I login, and see farmers getting blamed for some supposed crisis like creating super bugs that are going to wipe out humanity, I'll look into it-- and call them out on it.

by delbel 8y ago

Fomite 8y ago

I work in hospital infection control. Extended-spectrum beta-lactamases are a major problem with several emerging infections, mostly Enterobacteriaceae.

delbel 8y ago
You would think somebody like yourself would be the first person these reporters would reach out and contact to ask for information. Have you ever been contacted? Instead, they focus on farm animals. Somehow regular family doctors read this -- fear the most, and hesitant to prescribe basic antibiotics for conditions that could turn serious, where these people later on could end up in your care because of these mistakes. The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts and therefore, kill itself rendering no vector to transfer between hosts. This is why I think ebola outbreaks always die down.
- buvanshak 8y ago
  >The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts.. That is not what a super bug means. It just means that it is resistant to antibiotics. Not that it has a MR of 100. It is possible for people to survive infections without antibiotics. I am surprised that I have to say this aloud. It seems that we are living in a time where people are born convinced that human beings cannot survive without medicines...
- Fomite 8y ago
  "You would think somebody like yourself would be the first person these reporters would reach out and contact to ask for information. Have you ever been contacted?" - Yep. "Instead, they focus on farm animals." - While the focus on farm animals occasionally irritates me because it lets doctors off the hook by pretending they're not part of the problem, ESBLs - as an example - are relatively common in livestock. "...hesitant to prescribe basic antibiotics for conditions that could turn serious, where these people later on could end up in your care because of these mistakes." Of the problems we have, the inappropriate non-use of antibiotics pales in comparison to the inappropriate use of antibiotics, either using an overly broad spectrum agent (like penicillin or ampicillin...), the wrong agent, or treating a viral infection with antibiotics. Antibiotic stewardship, in both the inpatient and outpatient settings, is not pretty much the standard of care, and supported by major medical societies like the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. "The idea that a super bug could get out of control in the general population is not scientifically sound because it would kill all of its hosts and therefore, kill itself rendering no vector to transfer between hosts. This is why I think ebola outbreaks always die down." Relying on the concept of susceptible depletion is a really bad idea. It's one of those "just so" stories that seems to make sense, but doesn't work in practice (Ebola doesn't actually die down due to susceptible depletion either...) The issue is not "OH MY GOD IT WILL KILL EVERYONE" but that there are activities today that are relatively risk free because if you do get an infection it's treatable. Things like surgery and childbirth. Absent effective treatments, the concern is that the mortality rate from infections will rise. Not to 100%, but it also doesn't need to be 100% to be a major public health problem.
  - delbel 8y ago
    Thanks, I really enjoy and respect your perspective and facts.
  - candiodari 8y ago
    I think if one looks at relatively recent incidents of diseases spreading, and take the Spanish flu as precedent, that provides a good framework for what one can expect once we fully lose antibiotics. Suddenly losing 10, 20, probably up to 60% of certain popluation groups (usually age based, but definitely not race-blind) is to be expected, with some groups more likely than others to be affected. The poor obviously, but beyond that children and elderly, sometimes with a large preference for one sex over another, or one race over another ... I'm pretty sure that's pretty accurately described as "OH MY GOD EVERYBODY DIES", because ... that's certainly what it'll feel like for at least 6 months.
- maxxxxx 8y ago
  The black death didn't kill all of its hosts but wiping out a third of the population is still pretty bad in my book.
  - jryan49 8y ago
    But it increased the quality of life for those who did survive, and has had many positive effects on all humans born afterwards [0]. So it's not all bad :D 0: https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the_Italian_Renaissance_possible%3F https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the...
    - maxxxxx 8y ago
      In Britain peasants also suddenly had bargaining power when land owners need workers and there were not many workers left.
    - saiya-jin 8y ago
      so called Thanos argument
- hexane360 8y ago
  You've likely played too much Pandemic. Take a step back and wonder whether it's likelier that all the scientists are wrong or that you don't know as much about epidemiology (or, looking at your post history: geology, chemistry, climate science, GMOs) as you may about programming. https://xkcd.com/675/ https://xkcd.com/675/
- TeMPOraL 8y ago
  To reiterate the point brought by others so that it stands in the clear: the problem with superbugs isn't the imagined risk of creating a super-pathogen that will wipe out large parts of the population. The problem is that the routine procedures you don't think about as unsafe - like childbirth, patching up cuts, minor surgeries - could suddenly become life-threatening conditions.
  - Fomite 8y ago
    The one I often pick is battlefield medicine. Soldiers don't die of gangrene and sepsis in field hospitals anymore.

pokemongoaway 8y ago

Not to mention low dose antibiotics are sometimes very therapeutic. When the effective medicines become widespread big pharma has incentive to spend as much money marketing against them as it does to actually develop better stuff. Antibiotics never worked against biofilms anyway - and many of the cases of so-called evil bacteria are actually just full fledged biofilms.

delbel 8y ago
I have noticed that there is absolute zero coverage of biofilm based infections and very little research. A simple dose of doxycycline before the bacteria is able to create a biofilm would prevent years of suffering, doctors flat out refuse to do it until it is to late because of the irrational fear of super bacteria cooked up by the media. This is happening at a huge scale.
- Fomite 8y ago
  This will come as a surprise to the various people I see working on biofilms at conferences. Also, non-biofilm resistance to Tetracyclines (of which Doxy* is a member) are widespread, and primarily involve the ribosomal subunits.
  - delbel 8y ago
    Oh no, I meant in the context of the news media. I think its great that you see people working on the problem at conferences and I hope they find breakthroughs. My knowledge is very limited and this isn't my area of expertise obviously. I am into small farming. But it interest me and recently I discovered Nitazoxanide and read about how scientist and doctors found out it cures Hep-B and almost cures Hep-C, and the flu -- all viruses, which is pretty amazing to me because it is an antibiotic not a antivirus. It also prevents the creation of biofilm of lyme. Apparently the Hep-B/C discovery lead to a whole new class of treatments that are about to come out or will be. My problem is journalist blaming farmers. Two of my products are THC and CBD based. If I made outrageous medical claims or concerns like these journalist, I would lose my livelyhood by regulators. It just grinds my gears that we get the blame for all of this when we want good positive solutions to real problems as well. If the journalist were halfway decent they would figure out that the antibiotics are all about crop/livestock insurance. Farmers are smart people to, just yesterday I got a request to isolate THCV for apparently its neurogensis properties. They wanted a strain that has zero delta-9 THC, the illegal one, for medical purposes. We want good things as well and you can bet your buttons if I login, and see farmers getting blamed for some supposed crisis like creating super bugs that are going to wipe out humanity, I'll look into it-- and call them out on it.