11 ms·

CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

161 points by colmvp 13y ago

colmvp 13y ago
Has there been any research to indicate that antibiotics in livestock gets passed to humans (and if so, to what degree)? I know that there was testimony by Dr. Lance B. Price to the House Committee for greater transparency on "why, how and in what animals these vital drugs are used." http://democrats.energycommerce.house.gov/sites/default/files/documents/Testimony-Price-Health-ADUFA-AGDUFA-2013-4-9.pdf http://democrats.energycommerce.house.gov/sites/default/file...
- iwwr 13y ago
  It's more about bacteria getting antibiotic resistence in animals and those get eventually passed to humans. Antibiotics are pretty much a non-renewable resource, the more they're used, the lesser their effectiveness. Using them on livestock, or even excessively on humans would leave humans with a dangerous lack of medical defence against harmful bacteria.
  - andyjohnson0 13y ago
    "It's more about bacteria getting antibiotic resistence in animals and those get eventually passed to humans." This can happen, but most of the bacteria found in animals are species-specific and don't get "passed" to us in the sense that you could "catch" flu or TB from another human. The real danger is "horizontal gene transfer" [1], where different kinds of bacteria exchange genes - including those for antibiotic resistance. This is the main mechanism for the spread of resistance to antibiotics. [1] http://en.wikipedia.org/wiki/Horizontal_gene_transfer http://en.wikipedia.org/wiki/Horizontal_gene_transfer
    - Tichy 13y ago
      A lot of epidemic diseases that plague us come from animal farming. Ever wondered why diseases have names like "chicken pox" or "pig flu"? That effect might even have helped in conquering the Americas, because the conquerors where used to such diseases and the natives where not.
      - andyjohnson0 13y ago
        Direct transmission of diseases (such as flu) from animals to humans certainly can happen: thats why I wrote "this can happen" in my comment. However, its not a significant vector in the spread of antibiotic resistance. BTW, Chicken Pox affects only humans and some other primates. The virus that causes it, varicella zoster, doesn't infect chickens or other fowl. And, being a virus, it has nothing to do with antibiotic resistance either.
- route66 13y ago
  As a challenge a Dutch research: http://www.vwa.nl/onderwerpen/risicobeoordelingen/bestand/2200068/antibioticaresistentie-effect-van-antibiotica-versleping-via-diervoeder http://www.vwa.nl/onderwerpen/risicobeoordelingen/bestand/22... From the abstract (freely translated): "... guessed is that a third to half of resistance encountered in germs within humans is of agricultural origin." Important is that not the antibiotics are transferred from animals to humans but the already resistant bacteria. A short summary is here: http://www.upi.com/Science_News/2012/08/31/Antibiotic-resistance-seen-growing-in-soil/UPI-35091346452976/?spt=hs&or=sn http://www.upi.com/Science_News/2012/08/31/Antibiotic-resist...
  - colmvp 13y ago
    Awesome, thank you.
- anon1385 13y ago
  http://www.motherjones.com/tom-philpott/2013/04/study-confirms-antibiotic-resistant-bugs-jump-animals-humans http://www.motherjones.com/tom-philpott/2013/04/study-confir... After analyzing the mutations of the MRSA strains in the women and the animals, the researchers concluded that it had been circulating among the livestock before jumping to the people. The researchers' analysis is "so fine-grained," McKenna writes, that it "seems to me to be difficult to challenge." The Danish study comes on the heels a 2012 paper by a consortium of US and European researchers, which used gene sequencing to show that another common strain of MRSA originated in humans as a common staph infection, jumped to livestock, where it evolved resistance to the common antibiotics tetracycline and methicillin, and then jumped back to humans. Of course, you can also contract antibiotic-resistant pathogens through contact with raw meat—as, for example, more than 100 people did when the agribusiness giant Cargill sent out tens of millions of pounds of ground turkey tainted with antibiotic-resistant salmonella in 2011.
velodrome 13y ago
People need stop using antibiotics for everything and use it only when necessary. When Drugs Stop Working-Norway's Answer: http://www.cbsnews.com/2100-205_162-6014559.html http://www.cbsnews.com/2100-205_162-6014559.html
- stingraycharles 13y ago
  People aren't the problem; it's the food industry that abuses antibiotics the most. When a pig gets ill, it's way cheaper to give her a dose of antibiotics instead of getting a vet.
  - andyjohnson0 13y ago
    Antibiotics are sometimes given to sick animals, but their main use is as growth promoters [1]. Animals that are regularly fed low doses of antibiotics grow faster, meaning that they can be slaughtered earlier and the overall cost of rearing the animal is therefore reduced. "The effectiveness of synercid, a drug of last resort for the treatment of vancomycin-resistant infections, is threatened because of the use of virginiamycin as a growth promoter in chickens and pigs in the United States. Virginiamycin is chemically related to synercid, and bacteria resistant to the one drug also appear to be resistant to the other." [2] [1] http://www.omafra.gov.on.ca/english/livestock/animalcare/amr/facts/05-041.htm http://www.omafra.gov.on.ca/english/livestock/animalcare/amr... [2] http://www.ucsusa.org/food_and_agriculture/our-failing-food-system/industrial-agriculture/prescription-for-trouble.html http://www.ucsusa.org/food_and_agriculture/our-failing-food-...
    - InclinedPlane 13y ago
      Many people will point out that the antibiotics given to animals are mostly different from those used on humans. However, as your example points out there are actually only a small number of families of antibiotics each of which share a specific method of attack on bacteria. And bacteria that become resistant to a cheap antibiotic, like virginiamycin, will do so in a way that also renders them resistant to their more expensive cousins that have been reserved for human use.
ktd 13y ago
Terrible, sensationalist title. The actual quote from the article is "If we are not careful, we will soon be in a post-antibiotic era," which paints a very different picture.
- rurounijones 13y ago
  Given the fact that the "If we are careful" bit is not going to happen (Without some drastic societal changes around the globe) I think we can pretty much ignore that part of the sentence.
  - droopyEyelids 13y ago
    Yep. I'd like to see a detailed analysis of how the future will develop regarding this. America and most European countries already exercise care with antibiotics. However, South American countries and India etc sell almost all of them OTC where they can be incorporated into folklore style medicine. Will drug resistant diseases stay within the boarders of the countries that incubate them? Or will the cases that slip across borders be enough to negate any benefit more careful countries cultivate?
    - rurounijones 13y ago
      > America and most European countries already exercise care with antibiotics Warning: Generalisations ahead And even in the countries you include as exercising care, we still have a significant number of people who do not finish their antibiotic courses. Tis a bit of a quandry, people tend not to be altruistic if they cannot observe the effect of their altruism.
- colmvp 13y ago
  FWIW, my original title was: "If we are not careful, we will soon be in a post-antibiotic era" and then my title was changed to the sensationalist title.
- toddmorey 13y ago
  But you truncated the quote for impact. It ends with: “And for some patients and for some microbes, we are already there.”
rurounijones 13y ago
while post anti-biotic sucks for humans directly. What about post-antibiotic for livestock which forms our food sources. If we can no longer raise as many cattle, pigs, sheep etc. then what are the global implications.
- smackay 13y ago
  Quite simple: healthier humans and more sustainable agriculture. From Yahoo Answers: it takes 17 kilos of corn, beans, grains, etc, to produce one kilo of beef in feedlot cattle. Having a large proportion of meat in one's diet is not the most efficient use of the available (limited) resources we have.
  - freshhawk 13y ago
    > Quite simple: healthier humans and more sustainable agriculture After a significant number of humans die, quite probably yes.
  - czottmann 13y ago
    100% ACK.
  - rurounijones 13y ago
    That is the simple answer in a perfect world. I was more thinking of the political and economic effects, especially if there is a post-antibiotic problem which quickly decimates existing stocks.
    - smackay 13y ago
      Unless there is some kind of apocalypse (rinderpest making it to the USA due to global warming) then the decline in meat production might be (relatively) gradual. The main use of antibiotics in agriculture (AFAIK) is simply to aid fattening animals as they are sick for fewer days of the year and so can put on more weight. Reduce antibiotic use and the market weight of animals will decline and either prices will have to rise or demand will fall as people move to other sources of protein - assuming there are reasonable/viable alternatives. I'm not sure there will be many political effects - unless of course people are going hungry, however the economic effects might be interesting. If intensive meat production stopped then perhaps there would be more free-range or extensive meat available (certainly at a higher price). Environmentally this might not be a bad thing, for example, the integrated olive/chestnut, goat/pig agriculture we have here in Portugal is pretty good for wildlife. More animals wandering over a wider area would be good for vultures as well (which are in rapid decline globally). Admittedly this is probably a limited scenario but it illustrates that there are desirable alternatives to highly intensive agriculture. Aside: The economics of meat production seem pretty crazy to me. I can go to my local supermarket and purchase several meals worth of fatty pork for less than the price of a couple of heads of broccoli and and few carrots. Given it takes a lot more resources to produce the pork that suggests that the system we have is seriously out of whack. Caveat: Off course, we might not be able to carpet the globe in goats to make this all work. It's just not going to be possible (or at least very difficult) to do this with a population well in excess of 10 billion.
jackgavigan 13y ago
I, for one, welcome our new antibiotic-resistant bacterial overlords. <mutter>Might finally put a stop to rampant population growth...</mutter>
jacquesm 13y ago
Antibiotics are now so widespread in use that you can detect them in the ground water and in the oceans. http://sustainability.formas.se/en/Issues/Issue-3-November-2012/Content/Focus-articles/Residues-from-antibiotics-in-the-ocean-affect-the-whole-food-chain/ http://sustainability.formas.se/en/Issues/Issue-3-November-2... http://www.sciencedaily.com/releases/2007/08/070821153926.htm http://www.sciencedaily.com/releases/2007/08/070821153926.ht... MRSA is just one small example of what the future holds if we don't manage this carefully, we're actually exerting evolutionary pressure on the one adversary that holds a serious trump card over us, an 8 hour reproductive cycle.
- jessriedel 13y ago
  > Antibiotics are now so widespread in use that you can detect them in the ground water and in the oceans. "Detectability" is a silly metric which tells you nothing about this issue. Molecules are really, really, ridiculously small. Most of the breaths you take contain atoms from Caesar's last gasp, but that doesn't tell you anything useful about the prevalence of Caesar.
  - sehugg 13y ago
    The articles linked talk about antibiotic-resistant genes being passed from organisms in hog waste lagoons (and hospitals) to organisms in groundwater. DNA is a molecule, yes, but a molecule with the will to survive.
  - MartinCron 13y ago
    It's the same kind if silly metric that is sticky, resonant, and evocative. If you want people to care about what you have to say, it's a smart strategy, especially if you back it up with meaningful analysis.
    - jessriedel 13y ago
      I use to come to HN because people argued intelligently. Now people want to justify dumb pandering comments. What a bummer.
alan_cx 13y ago
Why is it that some apocalyptic scientific predictions are accepted, while others gain a culture of denial? Strikes me that one could construct a counter argument against this prediction which is as strong as the arguments, for example, climate change deniers use. Yet, no one has done so. I'm struggling to imagine why. Is there profit for the current big players in solving this issue, where as climate change solutions are not so good for current energy supplier? Or something like that?
- _delirium 13y ago
  There is quite a bit of pushback at times on this issue as well, especially when agricultural use of antibiotics is mentioned as a potential contributing factor. Suggestions to regulate that usage tend to provoke contrary claims that the risk is overblown and contrary studies showing no significant danger.
- harshreality 13y ago
  How much profit is there in current antibiotics? Only a few of the newer ones are still patented. Aren't the bulk of prescribed antibiotics generics? I don't think it's because of a difference in the profit to be made by solutions (green energy vs antibiotic alternatives), but rather because of a difference in the profit to be made by the status quo (hydrocarbon-based energy companies stand to make huge profits if they can delay the development of green alternatives until there's a major energy crunch). Antibiotic resistance is more obviously traceable to antibiotics use. The greenhouse gasses link to global warming exists, but the skeptics have leverage against it: Western countries contribute more to global warming per capita (right?), but China and India are contributing more overall; anything we try to do is going to be very expensive and cause a modest slow-down of warming at best; the Earth has been warmer than it is now; global warming models are incomplete; the Earth is a very complex dynamic system that might buffer global warming in unknown ways before we get to a crisis. It's more difficult to argue against antibiotic resistance in bacteria being a problem when we can see resistance develop in a lab, and when we've seen the dire consequences of plagues in documented history.
  - anon1385 13y ago
aluhut 13y ago
I grew up in a former East Block country. Back then we had medical centers. If you were sick, you went there and they gave you something. Most of the time the solution was: Antibiotics. Because I was sick quite often, I can say I grew up on Antibiotics. When we moved to West Europe my mother made the mistake of chosing a doctor from our country (so she could uderstand what she says). So I continued to get antibiotics until I got an bronchitis. Two weeks had passed until the doctor decided it was a bronchitis and not "just" one of my usual sick-phases (that she also treated with antibiotics). I spend additional two weeks getting more of the same antibiotic. It got worse. Finaly she decided that it may be useful to make an radiographic examination. Lucily the doctor there realised that I had pneumonia and changed my medication. I have not been to a doctor for over 20 years since. I did not take anything besides some aspirine when I hit my head skiing 8 years ago. I don't know how this is possible after my very hard childhood but I just don't get sick anymore. I am very sure that I'll not make the same mistake of letting the doctors solve everything with the hammer when my children get sick.
- elmuchoprez 13y ago
  While I can appreciate your situation, those last two paragraphs read with the same kind of anecdotal logic that lead people to the conclusion that vaccinations do more harm than good.
  - aluhut 13y ago
    It wasn't ment that way. The vaccination conspiracy theorists are the opposite evil here. They are even worse. I didn't want to say that I would not give my kid antibiotics. This is bullshit. But I will change the doctor if his only solution is antibiotics. I had that situation already with my girlfriend. She is ill pretty often. She works in a kindergarden and parents tent to get rid of their sick kids by sending them there. She had to change her doctor because it just did not work out and sometimes the solution is simply to stay home for a few days and drink some warm tea. There is no easy solution here. You can't say that you refuse all kinds of medication but you have to find out which doctor is really trying to help you out here and this can be only done through experience. I for myself am just lucky. I can't say how but it works. If I ever get really sick and the 3 days on tea won't help, I will go to the doctor I trust and get some medication to cure it.
stephnexus 13y ago
Agree that antibiotics need to be withheld from livestock unless they are actually sick. Our conventional food system practices are a disgusting joke. On the innovative side, I wish more research were ongoing with regard to bacteriophages: http://en.wikipedia.org/wiki/Phage_therapy http://en.wikipedia.org/wiki/Phage_therapy This therapy pre-dates antibiotics but is harder to target to the pathogen. Russia has been using phages for decades. Other options include natural antibiotics, like manuka honey, which is already being used (as "MediHoney") by hospitals in the U.S. when other antibiotics fail. My main question is: Why is this end-of-line therapy, when it has few to no side effects and it's more difficult for bacteria to develop resistance to it (since it's a multifaceted natural compound, instead of a single-strategy synthetic compound)? Answer: profit. But it's time for us to evolve. And evolution in this case doesn't necessarily mean more high-tech -- we're low-tech organisms, it's quite possible that the solution is also low-tech.
- leoedin 13y ago
  The issue isn't just that antibiotics are used routinely for animals. The issue is that high volume (and low cost) animal rearing techniques require extensive antibiotic use to compensate for the awful conditions and diet of the animals. Legislating against antibiotic use in animals would definitely help though.
- haldujai 13y ago
  Actually you're quite mistaken. The reason no one uses phage therapy is because for it to be effective it has to be given in a cocktail, i.e. you're given 20 different phages at a time. The FDA/CDC strongly discourage cocktail usage as it promotes the development of resistance more than antibiotic abuse. MediHoney is used mainly as a wound dressing to prevent infection, not to treat current infections (maybe infections at the wound site). The answer is not profit as you may believe.
  - Blahah 13y ago
    That's not the only reason no-one uses phage therapy - there's also a strong cultural resistance in the west. I've worked on phage targeting various Salmonella serovars, and while you do require cocktails for the most effective treatment, but phage evolve along with the pathogen. There's no inherent limit on the availability of phage like there is with our current suite of antibiotics. With extensive sequencing-based environmental monitoring, as we're starting to see in many western countries, we can detect the evolution of new bacterial and phage strains in near real-time and isolate the phage to treat the pathogens. We can keep up with pathogen evolution. There's no equivalent system for generating new antibiotics. I reckon this kind of tech is only a few years away - all the pieces are coming into place.
Tichy 13y ago
Is the problem really hospitals, or is it industrial animal farming? Because I suspect it is mostly the latter. It is of course more convenient to rant against sick people than to give up the daily junk food burger.
coldcode 13y ago
Once we all die, then people will change. Which makes as much sense as giving pigs antibiotics.
jtheory 13y ago
Evolution is such an important concept for people in general to understand. Bacteria evolve based on environmental factors (like varying levels of antibiotics), and that's eventually a very bad thing. Viruses evolve as well, and the nasty viruses that we could eradicate entirely if we had good global vaccination coverage instead -- for a host of often-silly reasons -- get to explode in numbers in various outbreaks. Even if a measles outbreak kills no one, it is still a huge increase in the amount of virus in the wild, and that means faster evolution. I hate to imagine a parent who has been against vaccines (due to being duped by the anti-vaxxers) finding that their own local outbreak was the source for the super-measles virus, which isn't reliably stopped by vaccines and spreads like wildfire, or is more deadly than current strains.
- route66 13y ago
  Careful though, antibiotics are not directed against viruses but bacteria. These in turn are not being "preempted" by vaccination, to use a threading term for a threat. http://health.howstuffworks.com/medicine/medication/question88.htm http://health.howstuffworks.com/medicine/medication/question...
  - throwaway812 13y ago
    GP made no claims about antibiotics and viruses. (S)he was simply going on a tangent about the problems with the anti-vaxx folks.
- astrodust 13y ago
  What we need is more research into bacteriophages, viruses that prey exclusively on bacteria, to combat the bacteria we don't want. The enemy of our enemy is our friend.
cvshepherd 13y ago
all the articles i've come across regarding this topic, fail to mention that there are well studied plant extracts / phytochemicals capable of dealing with antibiotic-resistant bacteria[1]. are these really not considered a viable option for treatment in the near future, or are there other reasons for neglecting to mention them in such articles? [1] http://www.scielo.br/scielo.php?pid=S1517-83822000000400003&script=sci_arttext http://www.scielo.br/scielo.php?pid=S1517-83822000000400003&...
cantankerous 13y ago
Since new anti-biotic development is so critical, I don't get why the feds don't in-source it to the CDC or provide massive incentives already. This is an infuriating problem that should've been dealt with decades ago on the R&D-funding front.
- snowwrestler 13y ago
  As I understand it, the problem is more fundamental than that. Antibiotics were originally discovered accidentally, and a lot of subsequent antibiotics were discovered/created by investigating and extending the mechanisms of the original discoveries. We're now running out of those implications to chase down. To get the "next breakthrough" in antibiotics will require another surprise discovery, or some other fundamental breakthrough in basic biological understanding.
  - bbatchelder 13y ago
    Last I heard, the next breakthrough is expected to be the exploitation of quorum sensing. Tricking the bacteria into thinking there are already more than enough of them so they at least stop reproducing.
    - DerpObvious 13y ago
      Another use of interfering with quorum sensing is keeping bacteria docile, even when they've multiplied to levels where they could be threatening to the host.
- protomyth 13y ago
  At one point[1], I heard that there were 3 new anti-biotics in development at various drug companies. It was my understanding that, like the lyme disease vaccine, they would probably not bring them to production given the current regulatory environment. I would imagine if it all goes to heck, then they would probably move forward. 1) its been a number of years so this might not be accurate anymore if it once was
NovemberWest 13y ago
Yay. This is what our current healthcare system is giving us. And it is impossible to talk about alternatives. You morons are going to die of hubris. Basically.

161 points by colmvp 13y ago

Has there been any research to indicate that antibiotics in livestock gets passed to humans (and if so, to what degree)? I know that there was testimony by Dr. Lance B. Price to the House Committee for greater transparency on "why, how and in what animals these vital drugs are used." http://democrats.energycommerce.house.gov/sites/default/files/documents/Testimony-Price-Health-ADUFA-AGDUFA-2013-4-9.pdf http://democrats.energycommerce.house.gov/sites/default/file...

iwwr 13y ago
It's more about bacteria getting antibiotic resistence in animals and those get eventually passed to humans. Antibiotics are pretty much a non-renewable resource, the more they're used, the lesser their effectiveness. Using them on livestock, or even excessively on humans would leave humans with a dangerous lack of medical defence against harmful bacteria.
- andyjohnson0 13y ago
  "It's more about bacteria getting antibiotic resistence in animals and those get eventually passed to humans." This can happen, but most of the bacteria found in animals are species-specific and don't get "passed" to us in the sense that you could "catch" flu or TB from another human. The real danger is "horizontal gene transfer" [1], where different kinds of bacteria exchange genes - including those for antibiotic resistance. This is the main mechanism for the spread of resistance to antibiotics. [1] http://en.wikipedia.org/wiki/Horizontal_gene_transfer http://en.wikipedia.org/wiki/Horizontal_gene_transfer
  - Tichy 13y ago
    A lot of epidemic diseases that plague us come from animal farming. Ever wondered why diseases have names like "chicken pox" or "pig flu"? That effect might even have helped in conquering the Americas, because the conquerors where used to such diseases and the natives where not.
    - andyjohnson0 13y ago
      Direct transmission of diseases (such as flu) from animals to humans certainly can happen: thats why I wrote "this can happen" in my comment. However, its not a significant vector in the spread of antibiotic resistance. BTW, Chicken Pox affects only humans and some other primates. The virus that causes it, varicella zoster, doesn't infect chickens or other fowl. And, being a virus, it has nothing to do with antibiotic resistance either.
route66 13y ago
As a challenge a Dutch research: http://www.vwa.nl/onderwerpen/risicobeoordelingen/bestand/2200068/antibioticaresistentie-effect-van-antibiotica-versleping-via-diervoeder http://www.vwa.nl/onderwerpen/risicobeoordelingen/bestand/22... From the abstract (freely translated): "... guessed is that a third to half of resistance encountered in germs within humans is of agricultural origin." Important is that not the antibiotics are transferred from animals to humans but the already resistant bacteria. A short summary is here: http://www.upi.com/Science_News/2012/08/31/Antibiotic-resistance-seen-growing-in-soil/UPI-35091346452976/?spt=hs&or=sn http://www.upi.com/Science_News/2012/08/31/Antibiotic-resist...
- colmvp 13y ago
  Awesome, thank you.
anon1385 13y ago
http://www.motherjones.com/tom-philpott/2013/04/study-confirms-antibiotic-resistant-bugs-jump-animals-humans http://www.motherjones.com/tom-philpott/2013/04/study-confir... After analyzing the mutations of the MRSA strains in the women and the animals, the researchers concluded that it had been circulating among the livestock before jumping to the people. The researchers' analysis is "so fine-grained," McKenna writes, that it "seems to me to be difficult to challenge." The Danish study comes on the heels a 2012 paper by a consortium of US and European researchers, which used gene sequencing to show that another common strain of MRSA originated in humans as a common staph infection, jumped to livestock, where it evolved resistance to the common antibiotics tetracycline and methicillin, and then jumped back to humans. Of course, you can also contract antibiotic-resistant pathogens through contact with raw meat—as, for example, more than 100 people did when the agribusiness giant Cargill sent out tens of millions of pounds of ground turkey tainted with antibiotic-resistant salmonella in 2011.

velodrome 13y ago

People need stop using antibiotics for everything and use it only when necessary. When Drugs Stop Working-Norway's Answer: http://www.cbsnews.com/2100-205_162-6014559.html http://www.cbsnews.com/2100-205_162-6014559.html

stingraycharles 13y ago
People aren't the problem; it's the food industry that abuses antibiotics the most. When a pig gets ill, it's way cheaper to give her a dose of antibiotics instead of getting a vet.
- andyjohnson0 13y ago
  Antibiotics are sometimes given to sick animals, but their main use is as growth promoters [1]. Animals that are regularly fed low doses of antibiotics grow faster, meaning that they can be slaughtered earlier and the overall cost of rearing the animal is therefore reduced. "The effectiveness of synercid, a drug of last resort for the treatment of vancomycin-resistant infections, is threatened because of the use of virginiamycin as a growth promoter in chickens and pigs in the United States. Virginiamycin is chemically related to synercid, and bacteria resistant to the one drug also appear to be resistant to the other." [2] [1] http://www.omafra.gov.on.ca/english/livestock/animalcare/amr/facts/05-041.htm http://www.omafra.gov.on.ca/english/livestock/animalcare/amr... [2] http://www.ucsusa.org/food_and_agriculture/our-failing-food-system/industrial-agriculture/prescription-for-trouble.html http://www.ucsusa.org/food_and_agriculture/our-failing-food-...
  - InclinedPlane 13y ago
    Many people will point out that the antibiotics given to animals are mostly different from those used on humans. However, as your example points out there are actually only a small number of families of antibiotics each of which share a specific method of attack on bacteria. And bacteria that become resistant to a cheap antibiotic, like virginiamycin, will do so in a way that also renders them resistant to their more expensive cousins that have been reserved for human use.

ktd 13y ago

Terrible, sensationalist title. The actual quote from the article is "If we are not careful, we will soon be in a post-antibiotic era," which paints a very different picture.

rurounijones 13y ago
Given the fact that the "If we are careful" bit is not going to happen (Without some drastic societal changes around the globe) I think we can pretty much ignore that part of the sentence.
- droopyEyelids 13y ago
  Yep. I'd like to see a detailed analysis of how the future will develop regarding this. America and most European countries already exercise care with antibiotics. However, South American countries and India etc sell almost all of them OTC where they can be incorporated into folklore style medicine. Will drug resistant diseases stay within the boarders of the countries that incubate them? Or will the cases that slip across borders be enough to negate any benefit more careful countries cultivate?
  - rurounijones 13y ago
    > America and most European countries already exercise care with antibiotics Warning: Generalisations ahead And even in the countries you include as exercising care, we still have a significant number of people who do not finish their antibiotic courses. Tis a bit of a quandry, people tend not to be altruistic if they cannot observe the effect of their altruism.
colmvp 13y ago
FWIW, my original title was: "If we are not careful, we will soon be in a post-antibiotic era" and then my title was changed to the sensationalist title.
toddmorey 13y ago
But you truncated the quote for impact. It ends with: “And for some patients and for some microbes, we are already there.”

rurounijones 13y ago

while post anti-biotic sucks for humans directly. What about post-antibiotic for livestock which forms our food sources. If we can no longer raise as many cattle, pigs, sheep etc. then what are the global implications.

smackay 13y ago
Quite simple: healthier humans and more sustainable agriculture. From Yahoo Answers: it takes 17 kilos of corn, beans, grains, etc, to produce one kilo of beef in feedlot cattle. Having a large proportion of meat in one's diet is not the most efficient use of the available (limited) resources we have.
- freshhawk 13y ago
  > Quite simple: healthier humans and more sustainable agriculture After a significant number of humans die, quite probably yes.
- czottmann 13y ago
  100% ACK.
- rurounijones 13y ago
  That is the simple answer in a perfect world. I was more thinking of the political and economic effects, especially if there is a post-antibiotic problem which quickly decimates existing stocks.
  - smackay 13y ago
    Unless there is some kind of apocalypse (rinderpest making it to the USA due to global warming) then the decline in meat production might be (relatively) gradual. The main use of antibiotics in agriculture (AFAIK) is simply to aid fattening animals as they are sick for fewer days of the year and so can put on more weight. Reduce antibiotic use and the market weight of animals will decline and either prices will have to rise or demand will fall as people move to other sources of protein - assuming there are reasonable/viable alternatives. I'm not sure there will be many political effects - unless of course people are going hungry, however the economic effects might be interesting. If intensive meat production stopped then perhaps there would be more free-range or extensive meat available (certainly at a higher price). Environmentally this might not be a bad thing, for example, the integrated olive/chestnut, goat/pig agriculture we have here in Portugal is pretty good for wildlife. More animals wandering over a wider area would be good for vultures as well (which are in rapid decline globally). Admittedly this is probably a limited scenario but it illustrates that there are desirable alternatives to highly intensive agriculture. Aside: The economics of meat production seem pretty crazy to me. I can go to my local supermarket and purchase several meals worth of fatty pork for less than the price of a couple of heads of broccoli and and few carrots. Given it takes a lot more resources to produce the pork that suggests that the system we have is seriously out of whack. Caveat: Off course, we might not be able to carpet the globe in goats to make this all work. It's just not going to be possible (or at least very difficult) to do this with a population well in excess of 10 billion.

jackgavigan 13y ago

I, for one, welcome our new antibiotic-resistant bacterial overlords. <mutter>Might finally put a stop to rampant population growth...</mutter>

jacquesm 13y ago

Antibiotics are now so widespread in use that you can detect them in the ground water and in the oceans. http://sustainability.formas.se/en/Issues/Issue-3-November-2012/Content/Focus-articles/Residues-from-antibiotics-in-the-ocean-affect-the-whole-food-chain/ http://sustainability.formas.se/en/Issues/Issue-3-November-2... http://www.sciencedaily.com/releases/2007/08/070821153926.htm http://www.sciencedaily.com/releases/2007/08/070821153926.ht... MRSA is just one small example of what the future holds if we don't manage this carefully, we're actually exerting evolutionary pressure on the one adversary that holds a serious trump card over us, an 8 hour reproductive cycle.

jessriedel 13y ago
> Antibiotics are now so widespread in use that you can detect them in the ground water and in the oceans. "Detectability" is a silly metric which tells you nothing about this issue. Molecules are really, really, ridiculously small. Most of the breaths you take contain atoms from Caesar's last gasp, but that doesn't tell you anything useful about the prevalence of Caesar.
- sehugg 13y ago
  The articles linked talk about antibiotic-resistant genes being passed from organisms in hog waste lagoons (and hospitals) to organisms in groundwater. DNA is a molecule, yes, but a molecule with the will to survive.
- MartinCron 13y ago
  It's the same kind if silly metric that is sticky, resonant, and evocative. If you want people to care about what you have to say, it's a smart strategy, especially if you back it up with meaningful analysis.
  - jessriedel 13y ago
    I use to come to HN because people argued intelligently. Now people want to justify dumb pandering comments. What a bummer.

alan_cx 13y ago

Why is it that some apocalyptic scientific predictions are accepted, while others gain a culture of denial? Strikes me that one could construct a counter argument against this prediction which is as strong as the arguments, for example, climate change deniers use. Yet, no one has done so. I'm struggling to imagine why. Is there profit for the current big players in solving this issue, where as climate change solutions are not so good for current energy supplier? Or something like that?

_delirium 13y ago
There is quite a bit of pushback at times on this issue as well, especially when agricultural use of antibiotics is mentioned as a potential contributing factor. Suggestions to regulate that usage tend to provoke contrary claims that the risk is overblown and contrary studies showing no significant danger.
harshreality 13y ago
How much profit is there in current antibiotics? Only a few of the newer ones are still patented. Aren't the bulk of prescribed antibiotics generics? I don't think it's because of a difference in the profit to be made by solutions (green energy vs antibiotic alternatives), but rather because of a difference in the profit to be made by the status quo (hydrocarbon-based energy companies stand to make huge profits if they can delay the development of green alternatives until there's a major energy crunch). Antibiotic resistance is more obviously traceable to antibiotics use. The greenhouse gasses link to global warming exists, but the skeptics have leverage against it: Western countries contribute more to global warming per capita (right?), but China and India are contributing more overall; anything we try to do is going to be very expensive and cause a modest slow-down of warming at best; the Earth has been warmer than it is now; global warming models are incomplete; the Earth is a very complex dynamic system that might buffer global warming in unknown ways before we get to a crisis. It's more difficult to argue against antibiotic resistance in bacteria being a problem when we can see resistance develop in a lab, and when we've seen the dire consequences of plagues in documented history.
- anon1385 13y ago

aluhut 13y ago

I grew up in a former East Block country. Back then we had medical centers. If you were sick, you went there and they gave you something. Most of the time the solution was: Antibiotics. Because I was sick quite often, I can say I grew up on Antibiotics. When we moved to West Europe my mother made the mistake of chosing a doctor from our country (so she could uderstand what she says). So I continued to get antibiotics until I got an bronchitis. Two weeks had passed until the doctor decided it was a bronchitis and not "just" one of my usual sick-phases (that she also treated with antibiotics). I spend additional two weeks getting more of the same antibiotic. It got worse. Finaly she decided that it may be useful to make an radiographic examination. Lucily the doctor there realised that I had pneumonia and changed my medication. I have not been to a doctor for over 20 years since. I did not take anything besides some aspirine when I hit my head skiing 8 years ago. I don't know how this is possible after my very hard childhood but I just don't get sick anymore. I am very sure that I'll not make the same mistake of letting the doctors solve everything with the hammer when my children get sick.

elmuchoprez 13y ago
While I can appreciate your situation, those last two paragraphs read with the same kind of anecdotal logic that lead people to the conclusion that vaccinations do more harm than good.
- aluhut 13y ago
  It wasn't ment that way. The vaccination conspiracy theorists are the opposite evil here. They are even worse. I didn't want to say that I would not give my kid antibiotics. This is bullshit. But I will change the doctor if his only solution is antibiotics. I had that situation already with my girlfriend. She is ill pretty often. She works in a kindergarden and parents tent to get rid of their sick kids by sending them there. She had to change her doctor because it just did not work out and sometimes the solution is simply to stay home for a few days and drink some warm tea. There is no easy solution here. You can't say that you refuse all kinds of medication but you have to find out which doctor is really trying to help you out here and this can be only done through experience. I for myself am just lucky. I can't say how but it works. If I ever get really sick and the 3 days on tea won't help, I will go to the doctor I trust and get some medication to cure it.

stephnexus 13y ago

Agree that antibiotics need to be withheld from livestock unless they are actually sick. Our conventional food system practices are a disgusting joke. On the innovative side, I wish more research were ongoing with regard to bacteriophages: http://en.wikipedia.org/wiki/Phage_therapy http://en.wikipedia.org/wiki/Phage_therapy This therapy pre-dates antibiotics but is harder to target to the pathogen. Russia has been using phages for decades. Other options include natural antibiotics, like manuka honey, which is already being used (as "MediHoney") by hospitals in the U.S. when other antibiotics fail. My main question is: Why is this end-of-line therapy, when it has few to no side effects and it's more difficult for bacteria to develop resistance to it (since it's a multifaceted natural compound, instead of a single-strategy synthetic compound)? Answer: profit. But it's time for us to evolve. And evolution in this case doesn't necessarily mean more high-tech -- we're low-tech organisms, it's quite possible that the solution is also low-tech.

leoedin 13y ago
The issue isn't just that antibiotics are used routinely for animals. The issue is that high volume (and low cost) animal rearing techniques require extensive antibiotic use to compensate for the awful conditions and diet of the animals. Legislating against antibiotic use in animals would definitely help though.
haldujai 13y ago
Actually you're quite mistaken. The reason no one uses phage therapy is because for it to be effective it has to be given in a cocktail, i.e. you're given 20 different phages at a time. The FDA/CDC strongly discourage cocktail usage as it promotes the development of resistance more than antibiotic abuse. MediHoney is used mainly as a wound dressing to prevent infection, not to treat current infections (maybe infections at the wound site). The answer is not profit as you may believe.
- Blahah 13y ago
  That's not the only reason no-one uses phage therapy - there's also a strong cultural resistance in the west. I've worked on phage targeting various Salmonella serovars, and while you do require cocktails for the most effective treatment, but phage evolve along with the pathogen. There's no inherent limit on the availability of phage like there is with our current suite of antibiotics. With extensive sequencing-based environmental monitoring, as we're starting to see in many western countries, we can detect the evolution of new bacterial and phage strains in near real-time and isolate the phage to treat the pathogens. We can keep up with pathogen evolution. There's no equivalent system for generating new antibiotics. I reckon this kind of tech is only a few years away - all the pieces are coming into place.

Tichy 13y ago

Is the problem really hospitals, or is it industrial animal farming? Because I suspect it is mostly the latter. It is of course more convenient to rant against sick people than to give up the daily junk food burger.

coldcode 13y ago

Once we all die, then people will change. Which makes as much sense as giving pigs antibiotics.

jtheory 13y ago

Evolution is such an important concept for people in general to understand. Bacteria evolve based on environmental factors (like varying levels of antibiotics), and that's eventually a very bad thing. Viruses evolve as well, and the nasty viruses that we could eradicate entirely if we had good global vaccination coverage instead -- for a host of often-silly reasons -- get to explode in numbers in various outbreaks. Even if a measles outbreak kills no one, it is still a huge increase in the amount of virus in the wild, and that means faster evolution. I hate to imagine a parent who has been against vaccines (due to being duped by the anti-vaxxers) finding that their own local outbreak was the source for the super-measles virus, which isn't reliably stopped by vaccines and spreads like wildfire, or is more deadly than current strains.

route66 13y ago
Careful though, antibiotics are not directed against viruses but bacteria. These in turn are not being "preempted" by vaccination, to use a threading term for a threat. http://health.howstuffworks.com/medicine/medication/question88.htm http://health.howstuffworks.com/medicine/medication/question...
- throwaway812 13y ago
  GP made no claims about antibiotics and viruses. (S)he was simply going on a tangent about the problems with the anti-vaxx folks.
astrodust 13y ago
What we need is more research into bacteriophages, viruses that prey exclusively on bacteria, to combat the bacteria we don't want. The enemy of our enemy is our friend.

cvshepherd 13y ago

all the articles i've come across regarding this topic, fail to mention that there are well studied plant extracts / phytochemicals capable of dealing with antibiotic-resistant bacteria[1]. are these really not considered a viable option for treatment in the near future, or are there other reasons for neglecting to mention them in such articles? [1] http://www.scielo.br/scielo.php?pid=S1517-83822000000400003&script=sci_arttext http://www.scielo.br/scielo.php?pid=S1517-83822000000400003&...

cantankerous 13y ago

Since new anti-biotic development is so critical, I don't get why the feds don't in-source it to the CDC or provide massive incentives already. This is an infuriating problem that should've been dealt with decades ago on the R&D-funding front.

snowwrestler 13y ago
As I understand it, the problem is more fundamental than that. Antibiotics were originally discovered accidentally, and a lot of subsequent antibiotics were discovered/created by investigating and extending the mechanisms of the original discoveries. We're now running out of those implications to chase down. To get the "next breakthrough" in antibiotics will require another surprise discovery, or some other fundamental breakthrough in basic biological understanding.
- bbatchelder 13y ago
  Last I heard, the next breakthrough is expected to be the exploitation of quorum sensing. Tricking the bacteria into thinking there are already more than enough of them so they at least stop reproducing.
  - DerpObvious 13y ago
    Another use of interfering with quorum sensing is keeping bacteria docile, even when they've multiplied to levels where they could be threatening to the host.
protomyth 13y ago
At one point[1], I heard that there were 3 new anti-biotics in development at various drug companies. It was my understanding that, like the lyme disease vaccine, they would probably not bring them to production given the current regulatory environment. I would imagine if it all goes to heck, then they would probably move forward. 1) its been a number of years so this might not be accurate anymore if it once was

NovemberWest 13y ago

Yay. This is what our current healthcare system is giving us. And it is impossible to talk about alternatives. You morons are going to die of hubris. Basically.