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Antibiotic 'apocalypse' warning
- verelo 14y agoThis has been one of the things that scares me the most about the future. I really don't want to end up in medieval times, i fear something like this would lead to a weird high tech medieval world.
- maxerickson 14y agoThe good news is that it is 'merely' a public health crisis. We still have hygiene and sanitation and the germ theory of disease (that latter makes the others far more effective and has only been widely accepted for ~100 years).
- cstross 14y agoThat may be so, but they had antisepsis, vaccination and the germ theory of disease in the 1920s and 1930s ... and it still didn't save them from losing as many people to fulminating bacterial infections as we lose to cancer today.
- maxerickson 14y agoI'm not eager to be without antibiotics or anything. I'm glad (at least some) people are taking the problem seriously. I guess I just think about it from the angle that the public health system has to run around drumming up popular support to get anything new done, even though all the boring old stuff they do has such a huge impact.
- cstross 14y agoHere's a thought: out-sourcing hospital cleaning services to the lowest bidder is a really bad idea. Because the other term for "hospital cleaning services" is "infection control". Similarly, elderly patients frequently end up suffering from malnutrition in hospitals because of poor food and/or not enough staff to feed people with difficulty eating. And malnutrition leads to immunological depression. Again: shaving margins on this stuff costs lives. New drugs actually come some way down the checklist of things we need to be doing to contain infectious diseases.
- mikecane 14y ago>>>We still have hygiene and sanitation Those are the first things abandoned by the homeless. Who have also been the breeding pool for resistant TB.
- fsck0ff 14y agoI am not sure if this helps in any way, but it just popped up in my newsfeed http://mashable.com/2013/01/24/ibm-hydrogel/ http://mashable.com/2013/01/24/ibm-hydrogel/ [edit: typo]
- atlantic 14y agoIt's interesting that governments are aware of the threat, but they don't take any action against the root cause, which is inappropriate, nonmedical antibiotic uses, particularly with livestock and poultry. http://www.nytimes.com/2012/12/17/opinion/antibiotics-in-livestock.html?_r=0 http://www.nytimes.com/2012/12/17/opinion/antibiotics-in-liv...
- Nux 14y agoCramming loads of animals together and pumping them with antibiotics is probably widespread farming procedure by now. I would imagine changing this will require some effort. Not to mention this will prolly raise the price of your favourite horse, errm.. beef burger at the local supermarket. :-)
- tomwalker 14y agoThere are always neigh-sayers (sorry)
- freyr 14y agoOne of the best things about HN is the lack of idiotic pun threads. Leave that to reddit.
- TechNewb 14y agoWe vote with every purchase, we can help by not buying meat that uses antibiotics (natural/organic/etc), and by not taking antibiotics unless the doctor strongly recommends. I tell my doctor straight up that I do not want meds unless necessary for my health and safety. I do not trust the pharmaceutical industry one bit, I personally believe that they create as many problems as they solve.
- evilduck 14y agoMy understanding is that antibiotic usage in cows is that it significantly increases their growth rate given the livestock feed we use by altering their gut flora to utilize the nutrients better. If MRSA became resistant to whatever antibiotic they use, I don't think it would alter agricultural practice since that's not what they're using it for. I could be wrong since this is way out of my areas of interest, but AFAIK it has nothing to do with fighting off infections.
- minikites 14y agoI wonder if phage therapy will be the best future treatment of bacterial infections. https://en.wikipedia.org/wiki/Phage_therapy https://en.wikipedia.org/wiki/Phage_therapy
- Nux 14y agoSaw this recently, and apparently there are people working on it: http://www.bbc.co.uk/programmes/b01ms5c6 http://www.bbc.co.uk/programmes/b01ms5c6 (or on everyone's favourite torrent site)
- knowaveragejoe 14y agoIt makes complete sense. We are essentially exposing bacteria in the wild to extremely efficient natural selection.
- maeon3 14y agoCongressmen don't believe in evolution, ergo natural selection is a lie because of jesus. On the plus side, natural selection will kick in for humans as well when getting infections removes you from the gene pool, thus making humans more naturally resistant to infection.
- aroberge 14y agoA lot of religious folks, who do not believe in natural science, are procreating much more(and at an earlier age) than the average population. With this in mind, I don't think natural selection will be beneficial for civilization...
- roc 14y agoWas there ever a time when that was not the case? If it were impossible for the children of anti-science fundamentalists to constitute a sufficient and sane majority to protect science, we'd have almost certainly never gotten to where we are. That America, a country populated largely by those whose primary intent was the pursuit of religious fundamentalism, was ever the world lead in science and technology puts rather large holes in the "fundamentalists breeding will be the downfall of us all" argument. Similarly goes the concern about "dumb people breeding more/faster" necessarily leading to the dystopic future of IDIOCRACY. We can absolutely suffer a reversion to fundamentalism and/or a rise of proudly celebrated ignorance. There are plenty of historical examples of civilizations falling to those threats. I'm just saying that we also have plenty of data that it needn't necessarily go that way.
- driverdan 14y agoEvolution and natural selection only apply to the long term over many, many generations. Your short term observations mean very little.
- FollowSteph3 14y agoThe biggest cause IMHO is the rampant use of antibiotics in farm feed. It's been proven NOT to be effective. And worse, it's given everyday with no infection. And the amount is multiples of human consumption!! Why focus on human consumption when antibiotics in farm food is rampant and on a much much bigger scale of consumption.
- m_eiman 14y agoThat's one of the reasons I prefer organic meat, where such behavior isn't allowed.
- falcolas 14y agoReally? Here's a whole list of synthetic medicines that can be used on organically raised livestock (US Law): http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=0bc0fb14bb1cdd2a20a584274b0887cf&rgn=div8&view=text&node=7:3.1.1.9.32.7.354.4&idno=7 http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=0bc0fb14... And if it's considered to be non-synthetic, the only restriction is strychnine.
- cobrausn 14y agoAs mentioned by tocomment in another thread, the rules are apparently changing. http://news.ycombinator.com/item?id=5110144 http://news.ycombinator.com/item?id=5110144
- falcolas 14y agoThis is for Organic certified livestock, not general livestock.
- m_eiman 14y agoAt least that's the KRAV rules, but that's mostly a Swedish organisation/set of rules. They explicitly forbid pre-emptive use of medication (but require swift treatment of ill animals).
- 14y ago
- wcoenen 14y agoTime to step up the research into the therapeutic use of bacteriophages. If the bacteria evolve, then let's create cures that evolve along with them. https://en.wikipedia.org/wiki/Bacteriophage https://en.wikipedia.org/wiki/Bacteriophage https://en.wikipedia.org/wiki/Phage_therapy https://en.wikipedia.org/wiki/Phage_therapy
- fghh45sdfhr3 14y agoThe problem is you can't talk to your immune system to explain why it should leave those particular viruses alone.
- astrodust 14y agoThey're bacterial viruses. They have zero interest in your cells.
- aplusbi 14y agoRight, I think the point is that your immune system doesn't know that and will attack them.
- Dylan16807 14y agoConsidering how often they'll be glued to the bacteria they're fighting, sounds fine to me.
- astrodust 14y agoI'm not even sure that they're recognized by the immune system as a threat. They won't be causing any infections that would trigger a response.
- fghh45sdfhr3 14y agoResponse is triggered by any foreign protein. It does not matter it is not infecting your cells. Anything that is not known to be you is attacked. And the more and longer you have of it inside of you, the bigger the immune response gets.
- spo81rty 14y agoWe should also try to cure common illnesses with other home remedies if possible. How did people get over sinus infections 1,000 years ago? Or did everyone just die? I don't know the answer, but these days antibiotics are handed out to cure everything as a precaution.
- davidw 14y agoI'd love to know the answer to that, because I get those things with some frequency, and antibiotics clear them up very quickly and effectively: after 10/15 days of feeling shitty, I get immediately better within 24 hours. It's hard to know beforehand, though, whether it's really an infection or just a draggy cold. All the 'alternative' type remedies I've tried have been completely ineffective.
- sammyo 14y agoWell one answer is that they didn't. Infection was a major cause of death. When you see a brutal dentist scene in a historical film it gives shivers, the missing context is that the patients life was probably being saved.
- LatvjuAvs 14y agoWhenever my old relatives talk about how they grandparents lived up to 120 years old in remote Russian villages without any doctors, it gives shivers. Last relative died at age 98, so much for modern civilization. And not like they were on life support when hitting over 100, they were out in the fucking field working. But yeah, eventually this will disappear and all we have is a book saying that 100 years ago average life span was 30 years so we are doing great increasing it to 60 :D
- driverdan 14y agoThat's bullshit. Scientists are actively studying populations with high longevity to find exactly why they live so long. No one is trying to hide it.
- benpbenp 14y agoI'm imagining a completely modular hospital composed of detachable rooms and corridors made of fabric, such that each room can be torn down, hard boiled, and replaced after every patient/procedure/day. The same for corridors every week, entire wings every month. (For example). Is this anything approaching a workable idea?
- Retric 14y agoMuch better option is just to add high intensity UV lighting to sterilize the AIR and most surfaces. For deep cleaning there are plenty of more or less mechanical solutions that are next to impossible to evolve around.
- btilly 14y agoI've read interesting research that suggests that subjecting surfaces to ultrasound discourages the development of biofilms. This also helps cleaning.
- tomwalker 14y agoIn some hospitals they have rolling columns of UV lights that they leave in rooms after chemically cleaning them to provide an extra cleansing effect and also reduce airborne transmission of disease.
- shabble 14y agoSwitching standard fixtures over to copper based alloys (which have antimicrobial properties[1]) might be a good place to start. I'm not sure to what extent the physical plant (walls, floors, etc) is the primary source of transmission compared with the staff/patients/visitors. The stats on something as basic and fundamental as hand-washing are often quite shocking. [1] https://en.wikipedia.org/wiki/Antimicrobial_properties_of_copper#Efficacy_on_copper_surfaces https://en.wikipedia.org/wiki/Antimicrobial_properties_of_co...
- tomwalker 14y agoA great problem is partial treatment of disease in developing countries. For example, India, Russia and China have a large amount of TB. Some patients start treatment regimes but do not complete them. The bacteria develops resistance and then spreads. Allow this to happen over millions of individuals then throw in international travel, bringing the infection to areas that do not suspect it quite as often. London is having a TB boom due to immigration. (disclosure: I am a doctor, partner specialises in infectious disease)
- ars 14y ago> is partial treatment I've never understood this, maybe you can answer me. Doesn't the immune system also kill bacteria? By using antibiotics you kill most of the bacteria, and then the immune system finishes them off. After all, if any bacteria were left wouldn't they just get the person sick again? An infection starts with just a few bacteria, a reinfection would be the same - unless the immune system keeps them in check, in which case there are no bacteria left to build resistance. If a bacteria is resistant then giving the full does wouldn't help anyway, it's resistant after all. It won't do anything except remove all competition so the resistant will be the only bacteria left. It seems to me it's better to try to kill only some of the bacteria so you don't isolate the resistant one so well, and rely on the immune system to kill most of the bacteria.
- shabble 14y ago'resistant' isn't the same as 'totally unaffected by' - it's a spectrum, and the duration of treatment is one of the factors which determines how much of that spectrum is killed. At the 'I feel better now' stage, there could still be quite a large population that would still be killed by completing the course of treatment. One function of the immune system is killing bacteria, but it can also quarantine and reject (e.g: Phlegm, vomiting, etc) them, which is one source of transmission.
- ars 14y ago> there could still be quite a large population that would still be killed by completing the course of treatment. That's perfect! That means if you stop there then what you have left is un-resistant bacteria. That's excellent, you avoided breeding resistance. So why do you want to keep taking antibiotics that narrows down the bacteria till only resistant ones are left?
- Tloewald 14y agoAuggesting that "we might not ever see global warming" is a foolish way to raise awareness of this issue. To begin with -- we are seeing it just as we are seeing increasing drug reistance in bacteria.
- ryusage 14y agoI think the point she was trying to make was that, while global warming gets a lot of attention from governments and media, it won't matter much if we're all killed by drug resistant infections in the next 10 years. In other words, she's saying that our priorities right now are not in line with the timeframes of the threats we're facing. Of course, there's no reason we can't address both at the same time.
- Millennium 14y agoTo claim that two threats are equal, only to then turn around and deny one of those threats, is not a very good way to argue that the other threat is a grave concern.
- mistercow 14y agoSo I'm not an evolutionary biologist or a doctor, and this is a heavily studied problem, so I am not going to say "they're doing it wrong." There's probably just something I'm missing, and I want to know what it is. But the problem with drug resistance is that these bacteria strains evolve when exposed to a drug, so that the mechanism of action for the drug stops being effective. What I want to know is: why aren't we treating new infections by giving patients a drug with every (still working) mechanism of action at once, attacking the infection on multiple fronts? Essentially you'd be massively constraining the optimization problem that evolution has to solve, and making it way more unlikely that the bacteria in the patient could acquire all of the necessary mutations before being wiped out. So what is it about this strategy that wouldn't work? Why are doctors still just prescribing amoxicillin alone?
- zatara 14y agoIn two words: side effects. Some powerful antibiotics are very toxic (e.g. liver, etc) and thus less used.
- lobster_johnson 14y agoI'm not an expert either, but combinations are apparently used. For example, you mention amoxicillin, which is often combined with something called clavulanic acid [1]. Another combination drug is Trimethoprim/sulfamethoxazole [2]. Some diseases, like resistant tuberculosis, are sometimes treated with antibiotic "cocktails". The problem is that combinations of antibiotics may have cytotoxic effects even at doses lower than normally harmful. Those two combinations above are used because they are known to work in synergy, with few side effects. Some antibiotics are not used except as a last resort precisely because they are so toxic to the human body that they might kill the host in the process of eradicating the target bacteria. In fact, antibiotics are found in nature all the time, but they tend to be too toxic to use. [1] http://en.wikipedia.org/wiki/Amoxicillin/clavulanic_acid http://en.wikipedia.org/wiki/Amoxicillin/clavulanic_acid [2] http://en.wikipedia.org/wiki/Trimethoprim/sulfamethoxazole http://en.wikipedia.org/wiki/Trimethoprim/sulfamethoxazole
- robbiep 14y ago
- tomkin 14y agoSomewhat slanting the topic here, but what happened to Tetracycline (non-synthetic)? One of the oldest, inexpensive treatments available – discontinued for, what appears to be, no tangible reason. It was highly effective for all sorts of infections and was involved in some groundbreaking studies that tested its use as a cancer treatment, as well, was found to slow angiogenesis, treat rheumatoid arthritis, aging, depletion of collegen, acne, prostate cancer and treatment of fibromyalgia just to name a few. It's also a pretty reliable anti-inflammatory. For whatever reason, it is now hard to get or not available at all. Any insight into this?
- phormula 14y agoI think it has lost favor versus other drugs in the same family such as doxycycline and minocycline are still available, but have less adverse effects
- tomkin 14y agoThanks :) I personally found that mino/doxycycline were not as good as tetracycline for treatment of acne and I don't know why. I'm concerned that the same is true of the other potential applications.
- hhuio 14y agoYou want to co-exist with bacteria, not wipe them out. Diplomacy versus war. Se probiotics.