9 ms·

New antibiotics effective against resistant bacteria in mice

145 points by antirez 7y ago

jupp0r 7y ago
Nice, now let's please pass laws to prohibit this being given to farm animals under high penalties and international prosecution.
- darpa_escapee 7y ago
  For reference, 80% of antibiotics used in the US are used in agriculture [1]. Animals are fed antibiotics to prevent infection, but they’re also fed to animals as “growth promoters” [2]. 60% of infectious diseases in humans originate in animals, and 75% of emerging infectious diseases in humans originate in animals [3]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638249/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638249/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1804117/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1804117/ [3] https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html
  - drivebyops 7y ago
    Are the infections happening because of the close proximity that animals are kept in?
  - Pyxl101 7y ago
    It seems horrendous that we would give antibiotics to any livestock in an across-the-board way. Livestock should only get antibiotics if they come down with an infection and are diagnosed and treated by a veterinarian. If a bunch of the livestock would get sick without preemptive antibiotics then I probably don't think that method of farming should be legal, and I would be glad to pay whatever higher prices would be necessary to abolish it.
    - BurningFrog 7y ago
      Infections were not created by greedy farmers. They occur naturally among all animal populations. Some quick googling indicates that this practice both increases meat production by 10-30%, and protects animals from a lot of suffering, as they spend their lives mostly healthy. That said, yeah, we can't keep doing this, and we have to pay the cost. Let's just not pretend there is no cost.
      - Pyxl101 7y ago
        I'm not saying we should cease treating sick animals. I'm saying only treat the sick animals individually after diagnosing them. If that's not practical then let's change farming practices until it is. (I'm not a farmer. I have no idea what the impact of this practice would be. However, as a naive person I definitely would strongly prefer to reserve the medicinal powers of antibiotics for humans or individually-sick animals, not huge animal populations.)
        BurningFrog 7y ago
        I mostly agree. This is already done in many countries, and farming goes on there. My only point is that this isn't done by stupid greedy farmers for no reason. It's a practical and profitable practice that has had a lot of short term benefits both for farmers, consumers and even farm animals. But it also has to end.
  - refurb 7y ago
    There isn’t that much overlap between the antibiotics used to treat human disease and those used in livestock to promote growth. The use of human antibiotics in livestock has already been banned in the US by the FDA. https://www.thebureauinvestigates.com/stories/2018-12-19/antibiotic-use-falls-on-us-farms-after-ban-on-using-drugs-to-make-livestock-grow-faster https://www.thebureauinvestigates.com/stories/2018-12-19/ant...
  - boldlybold 7y ago
    Point (2) is no longer true as of 2017 (in the US, 2006 in the EU) [1]. I'm happy to see the FDA getting on top of this regulation. Now let's end careless spraying of antibiotics on crops. [2] [1] https://en.wikipedia.org/wiki/Antibiotic_use_in_livestock#United_States https://en.wikipedia.org/wiki/Antibiotic_use_in_livestock#Un... [2] https://www.nytimes.com/2019/05/17/health/antibiotics-oranges-florida.html https://www.nytimes.com/2019/05/17/health/antibiotics-orange...
    - hvidgaard 7y ago
      Re: Point (2), it's going in the right direction, but at least in Denmark it is very much used in a "preventative" manner in the pork industry. It took a dive when the regulation came into effect, but in the last few years not much have happened, and we still have a MRSA problem out of control. Independent sources say that more than 90% of all farms with pigs have an MRSA infection. The butcheries reported in 2014 that 88% of all pigs was infected with MRSA. Every 1 in 3 pack of pork is infected and weak and elderly people should be careful with pork in general because of this risk.
  - bayesian_horse 7y ago
    I've heard the opinion that most antibiotic resistance genes don't seem to originate in agricultural use. High AB usage is one factor in developing and spreading resistance, but it's way more complicated. For example the resistance genes also have to jump onto a bacterium that is pathogenic...
    - tempguy9999 7y ago
      > I've heard the opinion that most antibiotic resistance genes don't seem to originate in agricultural use. Maybe true but I don't see the post you're replying to saying that. If you are saying that, a reference to some research showing that would be welcome. > but it's way more complicated surely true, but it doesn't mean antibiotic overuse isn't a damn good starting point for resistance to develop.
      - bayesian_horse 7y ago
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380918/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380918/
        tempguy9999 7y ago
        This does not back up your claim. Much of it is about lack of evidence on which to draw conclusions. That's clear enough just in the abstract. I'll quote from the abstract. Selectively due to length, but I'll try to be fair: "The three mechanisms considered are as follows 1: direct infection with resistant bacteria from an animal source, 2: breaches in the species barrier followed by sustained transmission in humans of resistant strains arising in livestock, and 3: transfer of resistance genes from agriculture into human pathogens. Of these, mechanism 1 is the most readily estimated, while significant is small in comparison with the overall burden of resistant disease. Several cases of mechanism 2 are known [so it's been demonstrated to happen], and we discuss the likely livestock origins of [some bacteria] it is hard to assess in robust fashion. More difficult yet to study is the contribution of mechanism 3, which may be the most important of all." To summarise, a little, some known, and we don't know. From the summary, and again I'm quoting selectively so be warned: "The limited data available make it hard to quantify the relationship between antibiotic use in animals and the occurrence of clinical resistance. As we have shown, while there is considerable evidence associating antimicrobial use in agriculture with resistant pathogens in livestock and in the food supply, the evidence for human health risks directly attributable to agricultural antibiotics runs the gamut from speculative to scant" Summary: possible real threat, too little data to evaluate. Further, again from the conclusion: "Once these [antibiotic-resistant] strains have emerged, it might be only a matter of time before they cross the species barrier and adapt to living in humans, at which time there is very little regulation of agriculture can do to prevent their persistence in the clinical setting. The greatest value of reducing agricultural antibiotic use now may be in maintaining a status quo that, while far from ideal, is greatly preferable to the alternative." Summary: we scientists don't know but we have reason to be very concerned. These are my selective quotes and my interpretations, but I personally don't see that they support your position.
- BurningFrog 7y ago
  Could be done as a license from the manufacturer.
  - iSnow 7y ago
    Unfortunately, at least in poorer countries, people will simply disregard the license. Indian/Chinese/Russian pharma companies are quite good at synthesizing patented compounds (after all, the relevant information is in the patent claim) and selling them for cheap. And even in industrialized countries, crooked vets have abused reserve antibiotics not intended for animals.
- foobiekr 7y ago
  while we are at it, let's not give them out like candy in countries known for doing so.
  - bayesian_horse 7y ago
    Not possible, politically. Antibiotic management is an ongoing topic and effort, but you can't make independent countries comply. Also, the amount of antibiotic used is not as much of a problem for AB resistance as some people using the "as candy" metaphor may think. The epidemiology of AB resistance is way more complicated, as the spreading of resistance requires multiple factors to coincide. Like the right resistance gene, the right strain, infection chains etc
  - AngryData 7y ago
    Honestly I like that better than the US version of requiring you to pay a bunch of money for a doctor to sign off on something that a pharmacist should be able to give upon request. Something like an eye infection should be just a couple bucks to treat, but just going to a doctor to tell you "yeah your eye is infected, you need antibiotics" and then getting charged $100 or more for their signature is crazy. Maybe it would work fine in a free healthcare model. From the research ive seen there is very little risk from humans abusing antibiotics, especially in comparison to agricultural usage. I can go to the store and buy amoxicillian for fish for like 5-10 bucks, but to get a human prescription it could cost $200+.
- bayesian_horse 7y ago
  From the article we may actually want them to be used for treating animals. Apparently these molecules are very hard to build resistance against. Bacteria evolve resistances to many ABs from scratch in lab conditions. If more is discovered about the mechanism of these two drugs, one could speculate about a potential resistance gene. Is it enough to "adapt" existing genes in most microbes, like with Penicilline? Is a novel gene, traveling on a vector, required to defuse it (like with Carbapanemes)? Or is it extremely unlikely that pathogens evolve any way to counter it? The latter could be because the mechanism of action is not trivially countered. You can compare it with patching vulnerabilities. A vulnerability is sometimes not addressable without crippling a business critical feature. Then we might want to use these drugs in animals and less in Humans, because we know more about how the old drugs work and their side effects.
  - tempguy9999 7y ago
    The original post said farm animals. You're now apparently conflating that with animal testing, which will take place anyway. Anyway the OP makes a lot of sense. Resistance is known to increase when antibiotics are used. If we use them less (ie. not on farm animals) then it seems reasonable that resistance development will be lessened and the drugs' useful lifespan will be extended. Much as I hate to say it, speaking as a veggie, farm animals are a commodity and moderately expendable.
    - bayesian_horse 7y ago
      I'm saying we'd want to use them in agriculture because they seem to be harder to build resistance against. Nothing about animal testing. And I much prefer taking well known antibiotics as long as they work.
      - tempguy9999 7y ago
        > And I much prefer taking well known antibiotics as long as they work. Agreed, but you may not have that choice for much longer.
- hellofunk 7y ago
  Let's also pass laws prohibiting doctors from giving them out like candy because someone has the sniffles.
- JoeAltmaier 7y ago
  I've never been convinced of the argument that using antibiotics, causes them to be less useful. Does doubling the use frequency increase the probability of a resistant bug? How much? And how much does that reduce the useful lifetime of the drug? I'm thinking, 10X the application might reduce the useful lifetime by months out of decades. Maybe not the issue its been blown up to be.
  - tempguy9999 7y ago
    It's a valid question. > I'm thinking, 10X the application might reduce the useful lifetime by months out of decades Possibly, sure. And possibly not. Maybe 1% extra use reduces the drug's working life by 100 times. Without data either claim could be true.
    - JoeAltmaier 7y ago
      ...and without data it seems clueless to be castigating folks for using the tools we have now, to accomplish goals we have now. If our current antibiotics are becoming less useful, then create new one. There's nothing magic about the ones we're using now. They were just the first ones we came across. Like VHS vs Betamax. Lets get on with it.
      - tempguy9999 7y ago
        I castigated no-one for this. I didn't suggest not developing new antibiotics. Far from it. Merely that we use new and old ones wisely. That, and make decision based on data.
  - BurningFrog 7y ago
    Do you have an argument for this, or is it just gut feel? The argument for the standard view is simple: The more "bugs" are exposed to antibiotics, the more opportunity/reason they have to develop resistance to it.
    - JoeAltmaier 7y ago
RcouF1uZ4gsC 7y ago
This is awesome. We underestimate how much antibiotics have made our lives so much better. I hope they make billions in profits.
- sadness2 7y ago
  How much they have made our lives exist, for that matter!
- Despegar 7y ago
  Biotechs focused on antibiotics are going bankrupt actually. It has to be publicly funded. https://www.ft.com/content/4da1c6e4-603d-11e9-9300-0becfc937c37 https://www.ft.com/content/4da1c6e4-603d-11e9-9300-0becfc937...
- shpx 7y ago
  We probably underestimate how much worse the evolutionary pressure we're exerting on bacteria will make the lives of future generations.
  - roenxi 7y ago
    We're in the happy situation where it couldn't be worse than life sans-antibiotics in the first place.
  - nemo44x 7y ago
    That’s their problem I guess. Yes we should clean up after ourselves but we should also suspect that future mankind will find the will to survive.
    - jdavis703 7y ago
      I believe we have a responsibility to steward the planet for future generations. Obviously if we all die from infections because we saved all our antibiotics for the future that wouldn't be good stewardship. But the way we hand out antibiotics to prevent a potential infection or to fatten up livestock seems to be a poor use of our resources.
brohee 7y ago
Obviously it had to be public research, because big pharma is a lot more interested in managing chronic conditions... Pretty glad my taxes helped pay for that research...
- travisp 7y ago
  It's great that there are some new antibiotics, but I don't get this claim that "big pharma" won't develop new cures and only manages chronic conditions. First, it's factually false. There are now multiple Hepatitis C cures for a formerly chronic (and eventually fatal) disease, let alone all the other chronic conditions that pharmaceutical companies have cured or diminished. And "big pharma" companies have gotten to the same stage as these teams with antibiotics. Second, it doesn't even make sense unless you treat "big pharma" as a single monolithic entity. In reality, it's many many companies, including startup pharmaceutical companies, all competing against each other. I don't think of bacterial infections generally as chronic conditions in the first place, but if one company makes money on a drug that manages some chronic bacterial infection, there's no reason that another company would be worried about taking away profits from the first company.
  - jessriedel 7y ago
    Also, the government immediately put price controls on the Hepatitis C cure even though it was already going to be offered at a cost that was way below the lifetime treatment cost of the previous standard of care. This was predictable, of course, but it's weird to blame the pharma companies.
    - sidlls 7y ago
      I can easily afford $4000 per month on a mortgage for 30 years. I cannot afford a one-time cash payment of $1M to buy the same house, even though it's "way" less than the lifetime cost of the mortgage.
      - jessriedel 7y ago
        Essentially no individuals are paying this, regardless. The price controls I am talking about are for medicaid (to which many non-Medicaid prices are indexed).
tryptophan 7y ago
Seems like it has never been tested in humans. Lets hold the hype train for now. Promising drugs like this a dime a dozen. Proving that they work from this stage is the hard part. This is what big pharma specializes in.
- rolleiflex 7y ago
  Antibiotics don’t work on humans. They work on bacteria in humans. Your sentiment is generally correct for most other types of medical research, but antibiotics generally pass the human testing fairly easily, provided that they don’t also kill the human they’re tested on.
  - PunksATawnyFill 7y ago
    Which gives us products like Cipro and the other quinolones, which destroy tendons. It only took 20 years and how many degraded lives and ended careers before the FDA issued a warning: https://www.webmd.com/osteoarthritis/news/20080708/fda-warning-cipro-may-rupture-tendons https://www.webmd.com/osteoarthritis/news/20080708/fda-warni... Obviously antibiotics save lives, but let's hope the next generation is used judiciously. There are doctors out there prescribing Cipro as the first line of defense for trivial infections, and there's no excuse for it.
  - maxerickson 7y ago
    Don't be so tiresome. They obviously mean that they hope that the drugs don't kill or excessively harm the human. Antibiotics that kill cilia or kidneys or livers are doing something or other to humans, in addition to working on microorganisms.
- refurb 7y ago
  I had the exact same thought. The R&D landscape is littered with antibiotics that kill bacteria but can’t be used in humans.
  - TeMPOraL 7y ago
    Couldn't these be still used as sanitation agents?
cm2187 7y ago
So another end of the world that turns out to be not the end of the world... wake me up when there is a real wolf.
- olliej 7y ago
  It’s in mice, so no guarantee it survives being used in humans. Even if it does work in humans it’s likely at least a decade from being safely usable in humans. And finally: there are already tens of thousands of people dying from previously treatable infections. I would expect that number to be millions eventually
  - londons_explore 7y ago
    If I were one of those tens of thousands of people, I would be buying this substance from a dodgy chemical synthesis person...
    - wins32767 7y ago
      If you were one of those tens of thousands of people dying of a resistant bacterial strain you'd likely be in intensive care... =) For the chronic resistant infections, I'm not sure how many people would be willing to roll the dice.
  - dllthomas 7y ago
    And no guarantee about its durability even if it works out.
- castis 7y ago
  If your intent is to sleep, it's likely no one will bother to wake you.
capkutay 7y ago
I know there's a lot being said about super bugs...but is the expectation that we just keep developing stronger antibiotics? is this something can be sustained over the next few decades/centuries?
- ezequiel-garzon 7y ago
  Hopefully some knowledgeable can chime in. I was under the impression that in the long term antibiotics will need to be replaced by something else. I'm 42 and just this year I learned (in a mainstream newspaper) about bacteriophages [1] as a means of combating infections. Does anybody know if we are close to seeing widespread adoption of this approach? Is it too costly? Is there a risk that it may get out of control? [1] https://en.wikipedia.org/wiki/Bacteriophage https://en.wikipedia.org/wiki/Bacteriophage
  - dfeojm-zlib 7y ago
    The gist as I understand it was that Western medicine bet the farm on antibotics while Russian medicine went primarily towards phages. Because of it's Not Invented Here status, Western medicine was biased against it for ideological and political reasons.
  - boldlybold 7y ago
    Using phages to treat infections (phage therapy) has traditionally been suppressed in the West, but is making a comeback with a few high-profile case studies in recent years. Tom Patterson had an atb resistant Acinetobacter baumannii infection that was cured with phages [1]. His wife wrote a book about it (The Perfect Predator) that is a good read review of the field. More recently, a patient with cystic fibrosis was cured of a Mycobacterium abscessus infection with phage therapy [2]. These therapies are currently very expensive and time consuming, as they require custom testing of libraries of phage against the specific microbial isolate. There have not been any successful large scale clinical trials yet. For a good review of the field (but behind academic paywall), see [3] [1] https://aac.asm.org/content/61/10/e00954-17 https://aac.asm.org/content/61/10/e00954-17 [2] https://www.nature.com/articles/s41591-019-0437-z https://www.nature.com/articles/s41591-019-0437-z [3] https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(19)30052-6 https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(1...
rodgerd 7y ago
To be rendered ineffective within years as farmers start dumping them into cattle as a growth promoter.
Madmallard 7y ago
Good, now let's make sure they're actually not super toxic to humans beforehand rather than lie to people and cover up evidence until public outcry causes them to be taken off the market.

145 points by antirez 7y ago

Nice, now let's please pass laws to prohibit this being given to farm animals under high penalties and international prosecution.

darpa_escapee 7y ago
For reference, 80% of antibiotics used in the US are used in agriculture [1]. Animals are fed antibiotics to prevent infection, but they’re also fed to animals as “growth promoters” [2]. 60% of infectious diseases in humans originate in animals, and 75% of emerging infectious diseases in humans originate in animals [3]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638249/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638249/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1804117/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1804117/ [3] https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html
- drivebyops 7y ago
  Are the infections happening because of the close proximity that animals are kept in?
- Pyxl101 7y ago
  It seems horrendous that we would give antibiotics to any livestock in an across-the-board way. Livestock should only get antibiotics if they come down with an infection and are diagnosed and treated by a veterinarian. If a bunch of the livestock would get sick without preemptive antibiotics then I probably don't think that method of farming should be legal, and I would be glad to pay whatever higher prices would be necessary to abolish it.
  - BurningFrog 7y ago
    Infections were not created by greedy farmers. They occur naturally among all animal populations. Some quick googling indicates that this practice both increases meat production by 10-30%, and protects animals from a lot of suffering, as they spend their lives mostly healthy. That said, yeah, we can't keep doing this, and we have to pay the cost. Let's just not pretend there is no cost.
    - Pyxl101 7y ago
      I'm not saying we should cease treating sick animals. I'm saying only treat the sick animals individually after diagnosing them. If that's not practical then let's change farming practices until it is. (I'm not a farmer. I have no idea what the impact of this practice would be. However, as a naive person I definitely would strongly prefer to reserve the medicinal powers of antibiotics for humans or individually-sick animals, not huge animal populations.)
      - BurningFrog 7y ago
        I mostly agree. This is already done in many countries, and farming goes on there. My only point is that this isn't done by stupid greedy farmers for no reason. It's a practical and profitable practice that has had a lot of short term benefits both for farmers, consumers and even farm animals. But it also has to end.
- refurb 7y ago
  There isn’t that much overlap between the antibiotics used to treat human disease and those used in livestock to promote growth. The use of human antibiotics in livestock has already been banned in the US by the FDA. https://www.thebureauinvestigates.com/stories/2018-12-19/antibiotic-use-falls-on-us-farms-after-ban-on-using-drugs-to-make-livestock-grow-faster https://www.thebureauinvestigates.com/stories/2018-12-19/ant...
- boldlybold 7y ago
  Point (2) is no longer true as of 2017 (in the US, 2006 in the EU) [1]. I'm happy to see the FDA getting on top of this regulation. Now let's end careless spraying of antibiotics on crops. [2] [1] https://en.wikipedia.org/wiki/Antibiotic_use_in_livestock#United_States https://en.wikipedia.org/wiki/Antibiotic_use_in_livestock#Un... [2] https://www.nytimes.com/2019/05/17/health/antibiotics-oranges-florida.html https://www.nytimes.com/2019/05/17/health/antibiotics-orange...
  - hvidgaard 7y ago
    Re: Point (2), it's going in the right direction, but at least in Denmark it is very much used in a "preventative" manner in the pork industry. It took a dive when the regulation came into effect, but in the last few years not much have happened, and we still have a MRSA problem out of control. Independent sources say that more than 90% of all farms with pigs have an MRSA infection. The butcheries reported in 2014 that 88% of all pigs was infected with MRSA. Every 1 in 3 pack of pork is infected and weak and elderly people should be careful with pork in general because of this risk.
- bayesian_horse 7y ago
  I've heard the opinion that most antibiotic resistance genes don't seem to originate in agricultural use. High AB usage is one factor in developing and spreading resistance, but it's way more complicated. For example the resistance genes also have to jump onto a bacterium that is pathogenic...
  - tempguy9999 7y ago
    > I've heard the opinion that most antibiotic resistance genes don't seem to originate in agricultural use. Maybe true but I don't see the post you're replying to saying that. If you are saying that, a reference to some research showing that would be welcome. > but it's way more complicated surely true, but it doesn't mean antibiotic overuse isn't a damn good starting point for resistance to develop.
    - bayesian_horse 7y ago
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380918/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380918/
      - tempguy9999 7y ago
        This does not back up your claim. Much of it is about lack of evidence on which to draw conclusions. That's clear enough just in the abstract. I'll quote from the abstract. Selectively due to length, but I'll try to be fair: "The three mechanisms considered are as follows 1: direct infection with resistant bacteria from an animal source, 2: breaches in the species barrier followed by sustained transmission in humans of resistant strains arising in livestock, and 3: transfer of resistance genes from agriculture into human pathogens. Of these, mechanism 1 is the most readily estimated, while significant is small in comparison with the overall burden of resistant disease. Several cases of mechanism 2 are known [so it's been demonstrated to happen], and we discuss the likely livestock origins of [some bacteria] it is hard to assess in robust fashion. More difficult yet to study is the contribution of mechanism 3, which may be the most important of all." To summarise, a little, some known, and we don't know. From the summary, and again I'm quoting selectively so be warned: "The limited data available make it hard to quantify the relationship between antibiotic use in animals and the occurrence of clinical resistance. As we have shown, while there is considerable evidence associating antimicrobial use in agriculture with resistant pathogens in livestock and in the food supply, the evidence for human health risks directly attributable to agricultural antibiotics runs the gamut from speculative to scant" Summary: possible real threat, too little data to evaluate. Further, again from the conclusion: "Once these [antibiotic-resistant] strains have emerged, it might be only a matter of time before they cross the species barrier and adapt to living in humans, at which time there is very little regulation of agriculture can do to prevent their persistence in the clinical setting. The greatest value of reducing agricultural antibiotic use now may be in maintaining a status quo that, while far from ideal, is greatly preferable to the alternative." Summary: we scientists don't know but we have reason to be very concerned. These are my selective quotes and my interpretations, but I personally don't see that they support your position.
BurningFrog 7y ago
Could be done as a license from the manufacturer.
- iSnow 7y ago
  Unfortunately, at least in poorer countries, people will simply disregard the license. Indian/Chinese/Russian pharma companies are quite good at synthesizing patented compounds (after all, the relevant information is in the patent claim) and selling them for cheap. And even in industrialized countries, crooked vets have abused reserve antibiotics not intended for animals.
foobiekr 7y ago
while we are at it, let's not give them out like candy in countries known for doing so.
- bayesian_horse 7y ago
  Not possible, politically. Antibiotic management is an ongoing topic and effort, but you can't make independent countries comply. Also, the amount of antibiotic used is not as much of a problem for AB resistance as some people using the "as candy" metaphor may think. The epidemiology of AB resistance is way more complicated, as the spreading of resistance requires multiple factors to coincide. Like the right resistance gene, the right strain, infection chains etc
- AngryData 7y ago
  Honestly I like that better than the US version of requiring you to pay a bunch of money for a doctor to sign off on something that a pharmacist should be able to give upon request. Something like an eye infection should be just a couple bucks to treat, but just going to a doctor to tell you "yeah your eye is infected, you need antibiotics" and then getting charged $100 or more for their signature is crazy. Maybe it would work fine in a free healthcare model. From the research ive seen there is very little risk from humans abusing antibiotics, especially in comparison to agricultural usage. I can go to the store and buy amoxicillian for fish for like 5-10 bucks, but to get a human prescription it could cost $200+.
bayesian_horse 7y ago
From the article we may actually want them to be used for treating animals. Apparently these molecules are very hard to build resistance against. Bacteria evolve resistances to many ABs from scratch in lab conditions. If more is discovered about the mechanism of these two drugs, one could speculate about a potential resistance gene. Is it enough to "adapt" existing genes in most microbes, like with Penicilline? Is a novel gene, traveling on a vector, required to defuse it (like with Carbapanemes)? Or is it extremely unlikely that pathogens evolve any way to counter it? The latter could be because the mechanism of action is not trivially countered. You can compare it with patching vulnerabilities. A vulnerability is sometimes not addressable without crippling a business critical feature. Then we might want to use these drugs in animals and less in Humans, because we know more about how the old drugs work and their side effects.
- tempguy9999 7y ago
  The original post said farm animals. You're now apparently conflating that with animal testing, which will take place anyway. Anyway the OP makes a lot of sense. Resistance is known to increase when antibiotics are used. If we use them less (ie. not on farm animals) then it seems reasonable that resistance development will be lessened and the drugs' useful lifespan will be extended. Much as I hate to say it, speaking as a veggie, farm animals are a commodity and moderately expendable.
  - bayesian_horse 7y ago
    I'm saying we'd want to use them in agriculture because they seem to be harder to build resistance against. Nothing about animal testing. And I much prefer taking well known antibiotics as long as they work.
    - tempguy9999 7y ago
      > And I much prefer taking well known antibiotics as long as they work. Agreed, but you may not have that choice for much longer.
hellofunk 7y ago
Let's also pass laws prohibiting doctors from giving them out like candy because someone has the sniffles.
JoeAltmaier 7y ago
I've never been convinced of the argument that using antibiotics, causes them to be less useful. Does doubling the use frequency increase the probability of a resistant bug? How much? And how much does that reduce the useful lifetime of the drug? I'm thinking, 10X the application might reduce the useful lifetime by months out of decades. Maybe not the issue its been blown up to be.
- tempguy9999 7y ago
  It's a valid question. > I'm thinking, 10X the application might reduce the useful lifetime by months out of decades Possibly, sure. And possibly not. Maybe 1% extra use reduces the drug's working life by 100 times. Without data either claim could be true.
  - JoeAltmaier 7y ago
    ...and without data it seems clueless to be castigating folks for using the tools we have now, to accomplish goals we have now. If our current antibiotics are becoming less useful, then create new one. There's nothing magic about the ones we're using now. They were just the first ones we came across. Like VHS vs Betamax. Lets get on with it.
    - tempguy9999 7y ago
      I castigated no-one for this. I didn't suggest not developing new antibiotics. Far from it. Merely that we use new and old ones wisely. That, and make decision based on data.
- BurningFrog 7y ago
  Do you have an argument for this, or is it just gut feel? The argument for the standard view is simple: The more "bugs" are exposed to antibiotics, the more opportunity/reason they have to develop resistance to it.
  - JoeAltmaier 7y ago

RcouF1uZ4gsC 7y ago

This is awesome. We underestimate how much antibiotics have made our lives so much better. I hope they make billions in profits.

sadness2 7y ago
How much they have made our lives exist, for that matter!
Despegar 7y ago
Biotechs focused on antibiotics are going bankrupt actually. It has to be publicly funded. https://www.ft.com/content/4da1c6e4-603d-11e9-9300-0becfc937c37 https://www.ft.com/content/4da1c6e4-603d-11e9-9300-0becfc937...
shpx 7y ago
We probably underestimate how much worse the evolutionary pressure we're exerting on bacteria will make the lives of future generations.
- roenxi 7y ago
  We're in the happy situation where it couldn't be worse than life sans-antibiotics in the first place.
- nemo44x 7y ago
  That’s their problem I guess. Yes we should clean up after ourselves but we should also suspect that future mankind will find the will to survive.
  - jdavis703 7y ago
    I believe we have a responsibility to steward the planet for future generations. Obviously if we all die from infections because we saved all our antibiotics for the future that wouldn't be good stewardship. But the way we hand out antibiotics to prevent a potential infection or to fatten up livestock seems to be a poor use of our resources.

brohee 7y ago

Obviously it had to be public research, because big pharma is a lot more interested in managing chronic conditions... Pretty glad my taxes helped pay for that research...

travisp 7y ago
It's great that there are some new antibiotics, but I don't get this claim that "big pharma" won't develop new cures and only manages chronic conditions. First, it's factually false. There are now multiple Hepatitis C cures for a formerly chronic (and eventually fatal) disease, let alone all the other chronic conditions that pharmaceutical companies have cured or diminished. And "big pharma" companies have gotten to the same stage as these teams with antibiotics. Second, it doesn't even make sense unless you treat "big pharma" as a single monolithic entity. In reality, it's many many companies, including startup pharmaceutical companies, all competing against each other. I don't think of bacterial infections generally as chronic conditions in the first place, but if one company makes money on a drug that manages some chronic bacterial infection, there's no reason that another company would be worried about taking away profits from the first company.
- jessriedel 7y ago
  Also, the government immediately put price controls on the Hepatitis C cure even though it was already going to be offered at a cost that was way below the lifetime treatment cost of the previous standard of care. This was predictable, of course, but it's weird to blame the pharma companies.
  - sidlls 7y ago
    I can easily afford $4000 per month on a mortgage for 30 years. I cannot afford a one-time cash payment of $1M to buy the same house, even though it's "way" less than the lifetime cost of the mortgage.
    - jessriedel 7y ago
      Essentially no individuals are paying this, regardless. The price controls I am talking about are for medicaid (to which many non-Medicaid prices are indexed).

tryptophan 7y ago

Seems like it has never been tested in humans. Lets hold the hype train for now. Promising drugs like this a dime a dozen. Proving that they work from this stage is the hard part. This is what big pharma specializes in.

rolleiflex 7y ago
Antibiotics don’t work on humans. They work on bacteria in humans. Your sentiment is generally correct for most other types of medical research, but antibiotics generally pass the human testing fairly easily, provided that they don’t also kill the human they’re tested on.
- PunksATawnyFill 7y ago
  Which gives us products like Cipro and the other quinolones, which destroy tendons. It only took 20 years and how many degraded lives and ended careers before the FDA issued a warning: https://www.webmd.com/osteoarthritis/news/20080708/fda-warning-cipro-may-rupture-tendons https://www.webmd.com/osteoarthritis/news/20080708/fda-warni... Obviously antibiotics save lives, but let's hope the next generation is used judiciously. There are doctors out there prescribing Cipro as the first line of defense for trivial infections, and there's no excuse for it.
- maxerickson 7y ago
  Don't be so tiresome. They obviously mean that they hope that the drugs don't kill or excessively harm the human. Antibiotics that kill cilia or kidneys or livers are doing something or other to humans, in addition to working on microorganisms.
refurb 7y ago
I had the exact same thought. The R&D landscape is littered with antibiotics that kill bacteria but can’t be used in humans.
- TeMPOraL 7y ago
  Couldn't these be still used as sanitation agents?

cm2187 7y ago

So another end of the world that turns out to be not the end of the world... wake me up when there is a real wolf.

olliej 7y ago
It’s in mice, so no guarantee it survives being used in humans. Even if it does work in humans it’s likely at least a decade from being safely usable in humans. And finally: there are already tens of thousands of people dying from previously treatable infections. I would expect that number to be millions eventually
- londons_explore 7y ago
  If I were one of those tens of thousands of people, I would be buying this substance from a dodgy chemical synthesis person...
  - wins32767 7y ago
    If you were one of those tens of thousands of people dying of a resistant bacterial strain you'd likely be in intensive care... =) For the chronic resistant infections, I'm not sure how many people would be willing to roll the dice.
- dllthomas 7y ago
  And no guarantee about its durability even if it works out.
castis 7y ago
If your intent is to sleep, it's likely no one will bother to wake you.

capkutay 7y ago

I know there's a lot being said about super bugs...but is the expectation that we just keep developing stronger antibiotics? is this something can be sustained over the next few decades/centuries?

ezequiel-garzon 7y ago
Hopefully some knowledgeable can chime in. I was under the impression that in the long term antibiotics will need to be replaced by something else. I'm 42 and just this year I learned (in a mainstream newspaper) about bacteriophages [1] as a means of combating infections. Does anybody know if we are close to seeing widespread adoption of this approach? Is it too costly? Is there a risk that it may get out of control? [1] https://en.wikipedia.org/wiki/Bacteriophage https://en.wikipedia.org/wiki/Bacteriophage
- dfeojm-zlib 7y ago
  The gist as I understand it was that Western medicine bet the farm on antibotics while Russian medicine went primarily towards phages. Because of it's Not Invented Here status, Western medicine was biased against it for ideological and political reasons.
- boldlybold 7y ago
  Using phages to treat infections (phage therapy) has traditionally been suppressed in the West, but is making a comeback with a few high-profile case studies in recent years. Tom Patterson had an atb resistant Acinetobacter baumannii infection that was cured with phages [1]. His wife wrote a book about it (The Perfect Predator) that is a good read review of the field. More recently, a patient with cystic fibrosis was cured of a Mycobacterium abscessus infection with phage therapy [2]. These therapies are currently very expensive and time consuming, as they require custom testing of libraries of phage against the specific microbial isolate. There have not been any successful large scale clinical trials yet. For a good review of the field (but behind academic paywall), see [3] [1] https://aac.asm.org/content/61/10/e00954-17 https://aac.asm.org/content/61/10/e00954-17 [2] https://www.nature.com/articles/s41591-019-0437-z https://www.nature.com/articles/s41591-019-0437-z [3] https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(19)30052-6 https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(1...

rodgerd 7y ago

To be rendered ineffective within years as farmers start dumping them into cattle as a growth promoter.

Madmallard 7y ago

Good, now let's make sure they're actually not super toxic to humans beforehand rather than lie to people and cover up evidence until public outcry causes them to be taken off the market.