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Any sort of improvement over current antibiotics would be a godsend as the idea of antibiotic-resistance "superbugs" is arguably a ticking timebomb that present

by pvnick 13y ago

Any sort of improvement over current antibiotics would be a godsend as the idea of antibiotic-resistance "superbugs" is arguably a ticking timebomb that presents an existential threat to modern society. Right now the most common antibiotics we have (eg penicillin + synthetic derivatives) use a B-lactam ring to disrupt cell wall production. Now we start to see bacteria that are resistant to this attack, eg MRSA (Methicillin-resistant staphylococcus aureus), that in worst-case scenarios make even simple surgical procedures life-threatening. Then we bring in the big guns, things like Vancomycin that disrupt cell wall production using different methods. But then we start to see Vancomycin-resistant microorganisms. So governments limit Vancomycin use so as to not give bacteria the opportunity to evolve and develop resistance. Thus drug manufacturers are unwilling to research new antibiotics because they can't make a profit off of restricted-access antibiotics. So it's largely a game of cat and mouse that could very well result in a deadly worldwide epidemic. New ways of looking at the problem such as the one described in the article could, without even being hyperbolic, save billions of lives.

jamesaguilar 13y ago
Antibiotic resistance is definitely not an existential threat. Most people do not catch any bacterial diseases that would be fatal if untreated before their reproductive years. That doesn't mean it's a good situation, but existential threat is greatly overstating the problem. People would have to have an extra baby, MAYBE.
- kolinko 13y ago
  Well, don't most people catch any bacterial diseases, because we're good at healing the ones that do? With no antibiotics, the bacteria would spread more rapidly, and more people would be sick, and die, right?
  - 300bps 13y ago
    What OP said: >presents an existential threat to modern society What responders seem to be responding to: >presents an existential threat to humanity The latter one is obviously wrong. The former, I think it's more likely than not that it's wrong. Sure, globalization would make bacterial outbreaks more likely but simple things like more frequent hand washing and wearing surgical masks any time you're out in public would cut the infection rate down tremendously. There are many societal things we could do to improve society's chances of survival before antibiotic resistance would become an existential threat to society.
    - jljljl 13y ago
      This is probably true for a most infections you encounter in every day life, but the infection rate for surgical procedures is higher, despite reduction through sterilization and antiseptic. There are also a number of professions where the chances of injury, and subsequently infection, are much higher. It's possible that there would be large societal changes if the ability to undergo surgery or work in risky professions is hampered by an increased risk of lethal infections.
- pvnick 13y ago
  Considering horizontal gene transfer, I would say there most certainly is a route for stated existential threat. Bacteria trade plasmids back and fourth all the time, including those that code for antibiotic resistance. So while you are correct that the most likely outcome is a return to the pre-antibiotic era (still really bad), you underestimate the dangers in the resistance in that all sorts bacteria can become resistent, both against the medications themselves as well as against the body's own immune system. Also, notice I intentionally said an existential threat to society, not humanity. It's fair to say that no longer being able to perform surgical procedures safely would be very destabilizing to modern society.
  - eru 13y ago
    > [...] both against the medications themselves as well as against the body's own immune system. Our bodys' immune systems have been around for a while. If bacteria haven't become resistant to them by now, I don't see any immediate threat.
- swombat 13y ago
  It's an existential threat because our modern society is extremely promiscuous, not insular like the world was in the past. The disappearance of antibiotics would put a serious damper on the current trends of globalisation. It's not an existential threat to the survival of mankind, but it is an existential threat to the survival of our modern society.
  - sliverstorm 13y ago
    it is an existential threat to the survival of our modern society Forget about promiscuity vs. insularity- modern society is not built on the backs of twenty-year-olds. If humans suddenly did not survive much past their prime reproductive age, humanity would survive with absolute ease, but modern society would undergo dramatic change.
- refurb 13y ago
  I would agree. Humans survived up all the way up until the point antibiotics were discovered, so why wouldn't they survive if all antibiotics suddenly became ineffective? Sure you'd see average life expectancy drop dramatically, but I don't think you'd see humans die out as a species.
  - tsotha 13y ago
    >Sure you'd see average life expectancy drop dramatically... I wonder about that. I'll bet the drop would be pretty small if we started the aggressive public health measures they took before antibiotics.
  - salmonellaeater 13y ago
    The number of people each person comes into contact with daily has increased dramatically. Basically the R0 of most diseases is much higher: http://en.wikipedia.org/wiki/Mathematical_modelling_of_infectious_disease http://en.wikipedia.org/wiki/Mathematical_modelling_of_infec...
300bps 13y ago
>Then we bring in the big guns, things like Vancomycin Vancomycin used to be a big gun, but not really any longer. Source: https://en.wikipedia.org/wiki/Vancomycin https://en.wikipedia.org/wiki/Vancomycin From the article: For many years since its initial use, vancomycin has traditionally been reserved as a drug of "last resort"... Recently, however, vancomycin resistant organisms are becoming common. Thus, vancomycin is increasingly being displaced from this role by newer antibiotics >So governments limit Vancomycin use so as to not give bacteria the opportunity to evolve and develop resistance. Vancomycin actually has a high hurdle to use naturally. It possesses poor oral bioavailability; it must be given intravenously for most infections. It can't be abused as easily by doctors prescribing it for things like colds because you have to be hooked up to an IV to get it. Having said that, it is still a very old antibiotic (from 1953) and resistance has built up from its use. A few months ago I had Vancomycin + Ciprofloxacin administered intravenously for four days due to an infection following a severe puncture wound to my foot. It's still prescribed but it's not "the big guns" it used to be.
derleth 13y ago
> a ticking timebomb that presents an existential threat to modern society. If it gets bad enough, outpatient antibiotics use will be a thing of the past. Need antibiotics? You're staying in a facility where someone will monitor you and make sure you take the full course and don't make our resistance problems worse. It won't necessarily be a hospital and you won't necessarily be watched by doctors or nurses, but compliance will be mandatory and enforced. Society has ways of defending itself. I hope it doesn't get that bad, but needs must, when the Devil calls the tune.
- eru 13y ago
  The problem is: The bugs might be resistant to most of what we have by then.
contingencies 13y ago
http://topdocumentaryfilms.com/rise-superbugs/ http://topdocumentaryfilms.com/rise-superbugs/ is an excellent and recent Australian documentary explaining the origins of superbugs, just how scary they are, how the present scenario has evolved, and where it is likely going. Well worth a look. Despite the gravity of the subject, it's shot in a refreshingly non-scaremongering style with some apparently honest investigative journalism at its heart. (By contrast, you rarely see that if such documentaries come from the US, IMHO. Declaration of bias: I'm Australian!).
flyinRyan 13y ago
But the problem is procedural so I don't think this will help at all. The issue is that doctors proscribe antibiotics at the drop of the hat. As soon as hypochondriacs start complaining of their phantom symptoms and the strongest antibiotics aren't working they'll just get the new "super" drugs and become resistant to those too. The only solution is to get the medical profession to stop shotgunning antibiotics at every problem.

by pvnick 13y ago

jamesaguilar 13y ago

Antibiotic resistance is definitely not an existential threat. Most people do not catch any bacterial diseases that would be fatal if untreated before their reproductive years. That doesn't mean it's a good situation, but existential threat is greatly overstating the problem. People would have to have an extra baby, MAYBE.

kolinko 13y ago
Well, don't most people catch any bacterial diseases, because we're good at healing the ones that do? With no antibiotics, the bacteria would spread more rapidly, and more people would be sick, and die, right?
- 300bps 13y ago
  What OP said: >presents an existential threat to modern society What responders seem to be responding to: >presents an existential threat to humanity The latter one is obviously wrong. The former, I think it's more likely than not that it's wrong. Sure, globalization would make bacterial outbreaks more likely but simple things like more frequent hand washing and wearing surgical masks any time you're out in public would cut the infection rate down tremendously. There are many societal things we could do to improve society's chances of survival before antibiotic resistance would become an existential threat to society.
  - jljljl 13y ago
    This is probably true for a most infections you encounter in every day life, but the infection rate for surgical procedures is higher, despite reduction through sterilization and antiseptic. There are also a number of professions where the chances of injury, and subsequently infection, are much higher. It's possible that there would be large societal changes if the ability to undergo surgery or work in risky professions is hampered by an increased risk of lethal infections.
pvnick 13y ago
Considering horizontal gene transfer, I would say there most certainly is a route for stated existential threat. Bacteria trade plasmids back and fourth all the time, including those that code for antibiotic resistance. So while you are correct that the most likely outcome is a return to the pre-antibiotic era (still really bad), you underestimate the dangers in the resistance in that all sorts bacteria can become resistent, both against the medications themselves as well as against the body's own immune system. Also, notice I intentionally said an existential threat to society, not humanity. It's fair to say that no longer being able to perform surgical procedures safely would be very destabilizing to modern society.
- eru 13y ago
  > [...] both against the medications themselves as well as against the body's own immune system. Our bodys' immune systems have been around for a while. If bacteria haven't become resistant to them by now, I don't see any immediate threat.
swombat 13y ago
It's an existential threat because our modern society is extremely promiscuous, not insular like the world was in the past. The disappearance of antibiotics would put a serious damper on the current trends of globalisation. It's not an existential threat to the survival of mankind, but it is an existential threat to the survival of our modern society.
- sliverstorm 13y ago
  it is an existential threat to the survival of our modern society Forget about promiscuity vs. insularity- modern society is not built on the backs of twenty-year-olds. If humans suddenly did not survive much past their prime reproductive age, humanity would survive with absolute ease, but modern society would undergo dramatic change.
refurb 13y ago
I would agree. Humans survived up all the way up until the point antibiotics were discovered, so why wouldn't they survive if all antibiotics suddenly became ineffective? Sure you'd see average life expectancy drop dramatically, but I don't think you'd see humans die out as a species.
- tsotha 13y ago
  >Sure you'd see average life expectancy drop dramatically... I wonder about that. I'll bet the drop would be pretty small if we started the aggressive public health measures they took before antibiotics.
- salmonellaeater 13y ago
  The number of people each person comes into contact with daily has increased dramatically. Basically the R0 of most diseases is much higher: http://en.wikipedia.org/wiki/Mathematical_modelling_of_infectious_disease http://en.wikipedia.org/wiki/Mathematical_modelling_of_infec...

300bps 13y ago

>Then we bring in the big guns, things like Vancomycin Vancomycin used to be a big gun, but not really any longer. Source: https://en.wikipedia.org/wiki/Vancomycin https://en.wikipedia.org/wiki/Vancomycin From the article: For many years since its initial use, vancomycin has traditionally been reserved as a drug of "last resort"... Recently, however, vancomycin resistant organisms are becoming common. Thus, vancomycin is increasingly being displaced from this role by newer antibiotics >So governments limit Vancomycin use so as to not give bacteria the opportunity to evolve and develop resistance. Vancomycin actually has a high hurdle to use naturally. It possesses poor oral bioavailability; it must be given intravenously for most infections. It can't be abused as easily by doctors prescribing it for things like colds because you have to be hooked up to an IV to get it. Having said that, it is still a very old antibiotic (from 1953) and resistance has built up from its use. A few months ago I had Vancomycin + Ciprofloxacin administered intravenously for four days due to an infection following a severe puncture wound to my foot. It's still prescribed but it's not "the big guns" it used to be.

derleth 13y ago

> a ticking timebomb that presents an existential threat to modern society. If it gets bad enough, outpatient antibiotics use will be a thing of the past. Need antibiotics? You're staying in a facility where someone will monitor you and make sure you take the full course and don't make our resistance problems worse. It won't necessarily be a hospital and you won't necessarily be watched by doctors or nurses, but compliance will be mandatory and enforced. Society has ways of defending itself. I hope it doesn't get that bad, but needs must, when the Devil calls the tune.

eru 13y ago
The problem is: The bugs might be resistant to most of what we have by then.

contingencies 13y ago

http://topdocumentaryfilms.com/rise-superbugs/ http://topdocumentaryfilms.com/rise-superbugs/ is an excellent and recent Australian documentary explaining the origins of superbugs, just how scary they are, how the present scenario has evolved, and where it is likely going. Well worth a look. Despite the gravity of the subject, it's shot in a refreshingly non-scaremongering style with some apparently honest investigative journalism at its heart. (By contrast, you rarely see that if such documentaries come from the US, IMHO. Declaration of bias: I'm Australian!).

flyinRyan 13y ago

But the problem is procedural so I don't think this will help at all. The issue is that doctors proscribe antibiotics at the drop of the hat. As soon as hypochondriacs start complaining of their phantom symptoms and the strongest antibiotics aren't working they'll just get the new "super" drugs and become resistant to those too. The only solution is to get the medical profession to stop shotgunning antibiotics at every problem.