My hope is that phage therapy can solve the issue of drug-resistant bacteria. Also we really need to get our things together and work against misuse of antibiotics.
Antibiotic resistance was already a pressing problem. Penicillin-V was little more use than a placebo as of 1984; Amoxicillin was in danger, MRSA was already out there. The big short-term hope was Augmentin (Amoxicillin/clavulanic acid) -- clavulanic acid was a beta-lactamase inhibitor, beta-lactamase being the primary pathway for penicillin resistance in bacteria, so it was somewhat effective against penicillin-resistant infections. But resistance was already showing up for almost every antibiotic on the market except vancomycin (which is pretty nasty stuff, toxicity-wise). Today, resistance to vancomycin and other antibiotics of last resort is a thing. So there are infections out there that will kill you gruesomely, just as there were in the 19th century and earlier, because we collectively dropped the ball.
As with anthropogenic climate change, the writing has been on the wall for decades -- and has been systematically ignored by policy-makers. Adding antibiotics to animal feed improves weight gain in farm animals so farmers still shovel the stuff by the bucketload. But it also applies a selection pressure for antibiotic resistance to the bacteria infesting those animals, and when they go to the slaughterhouse the resistant strains migrate into the human reservoir.
And this says nothing about the structural incentives to discount antibiotic R&D in the commercial pharmaceutical industry. (Bluntly: they're not profitable enough to bother with, because bacterial infections are acute disease -- you cure it in a few days or weeks, your customer goes away satisfied. Unlike antidepressants or anti-hypertensives or diabetes meds, which the patient is typically on for years to life.)
We should have restricted access to antibiotics the way we (try) to restrict opiates. Failing that we should have government funded R&D via non-profits. Only now it's too late and corrective action won't take effect for years.
> Also we really need to get our things together and work against misuse of antibiotics.
Too late for that, we already have the superbugs. Not to say that reducing antibiotic usage in farms is not worth the effort (because it is), but we need to ramp up investment in basic R&D for antibiotics again - there is almost none of that any more since it is extremely cost-intensive and the medications are low-revenue [1].
ETA: Additionally, we could curb human antibiotic usage by making rapid tests for common viral infections more available. Routinely checking for strep throat and the various flu viruses both at-home and in clinical situations could save people a lot of completely unnecessary antibiotics courses - as well as teaching basic life education like "if it's not a bacterial infection behind your sore throat, an antibiotics course won't help at all, it will go away on itself after three to four days".
Lateral flow rapid tests are incredibly cheap to manufacture and (as the last two years have shown) capable of being self-administered - making them account for multiple sorts of antibodies is already done for COVID tests.
All the health agencies in the world know this is a problem, but are there any actual changes being made to prevent the worst-case scenario?
I worry this is the same situation as Covid, where health agencies knew for years hospital capacity was stretched thin, and lo-and-behold, thousands of people die unnecessarily when a new virus arrives because hospital capacity was overwhelmed.
Afaik, one problem is that the health agencies can only do so much. Most antibiotics and antibiotics misuse happens in agriculture where a totally different agency is responsible. Yes, they should foster more research into new drugs, but the main challenge remains prophylactic animal treatment.
It's like insurance, they think they won't need it and they don't have any incentive to do the right thing (spend more, much more, for a catastrophic but low chance scenario).
Well. There are two old St.Aureus vaccines which, in combination, allowed me to eradicate MRSA which I got during a hospital stay. One these vaccines was created long time ago in USSR for veterinary workers, another one - to treat skin infections in babies. Both are still produced and available though most of the doctors are not aware of them. Both, of course, were never tested in proper trials.
> Our approach can be divided into five broad components: number of deaths where infection played a role, proportion of infectious deaths attributable to a given infectious syndrome, proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antibiotic of interest, and the excess risk of death or duration of an infection associated with this resistance
The headline that you wrote phrases this as "died of superbacteria", does this relate to the number where an infection played a role or the number attributable to a given pathogen?
dang|4 years ago
legulere|4 years ago
cstross|4 years ago
Antibiotic resistance was already a pressing problem. Penicillin-V was little more use than a placebo as of 1984; Amoxicillin was in danger, MRSA was already out there. The big short-term hope was Augmentin (Amoxicillin/clavulanic acid) -- clavulanic acid was a beta-lactamase inhibitor, beta-lactamase being the primary pathway for penicillin resistance in bacteria, so it was somewhat effective against penicillin-resistant infections. But resistance was already showing up for almost every antibiotic on the market except vancomycin (which is pretty nasty stuff, toxicity-wise). Today, resistance to vancomycin and other antibiotics of last resort is a thing. So there are infections out there that will kill you gruesomely, just as there were in the 19th century and earlier, because we collectively dropped the ball.
As with anthropogenic climate change, the writing has been on the wall for decades -- and has been systematically ignored by policy-makers. Adding antibiotics to animal feed improves weight gain in farm animals so farmers still shovel the stuff by the bucketload. But it also applies a selection pressure for antibiotic resistance to the bacteria infesting those animals, and when they go to the slaughterhouse the resistant strains migrate into the human reservoir.
And this says nothing about the structural incentives to discount antibiotic R&D in the commercial pharmaceutical industry. (Bluntly: they're not profitable enough to bother with, because bacterial infections are acute disease -- you cure it in a few days or weeks, your customer goes away satisfied. Unlike antidepressants or anti-hypertensives or diabetes meds, which the patient is typically on for years to life.)
We should have restricted access to antibiotics the way we (try) to restrict opiates. Failing that we should have government funded R&D via non-profits. Only now it's too late and corrective action won't take effect for years.
mschuster91|4 years ago
Too late for that, we already have the superbugs. Not to say that reducing antibiotic usage in farms is not worth the effort (because it is), but we need to ramp up investment in basic R&D for antibiotics again - there is almost none of that any more since it is extremely cost-intensive and the medications are low-revenue [1].
ETA: Additionally, we could curb human antibiotic usage by making rapid tests for common viral infections more available. Routinely checking for strep throat and the various flu viruses both at-home and in clinical situations could save people a lot of completely unnecessary antibiotics courses - as well as teaching basic life education like "if it's not a bacterial infection behind your sore throat, an antibiotics course won't help at all, it will go away on itself after three to four days".
Lateral flow rapid tests are incredibly cheap to manufacture and (as the last two years have shown) capable of being self-administered - making them account for multiple sorts of antibodies is already done for COVID tests.
[1]: https://www.nature.com/articles/d41586-020-02884-3
zerr|4 years ago
Guessnotgauss|4 years ago
PabloRobles|4 years ago
I linked the original study, but I saw it Spanish national media, and then here: https://edition.cnn.com/2022/01/19/health/bacterial-antimicr...
MaxBarraclough|4 years ago
Also, here's a BBC article on the topic: https://www.bbc.co.uk/news/health-60058120
ErikVandeWater|4 years ago
I worry this is the same situation as Covid, where health agencies knew for years hospital capacity was stretched thin, and lo-and-behold, thousands of people die unnecessarily when a new virus arrives because hospital capacity was overwhelmed.
patall|4 years ago
hogrider|4 years ago
pshirshov|4 years ago
Not like anyone cares.
https://www.rlsnet.ru/tn_index_id_5850.htm
https://www.vidal.ru/drugs/therapeutic_staphylococcal_vaccin...
b112|4 years ago
TB vaccine is troublesome and not that effective, to the point that some debate it should not be used, tetanus seems wildly successful.
(These are the only other bacteria vaccines I know of)
ppod|4 years ago
The headline that you wrote phrases this as "died of superbacteria", does this relate to the number where an infection played a role or the number attributable to a given pathogen?
unknown|4 years ago
[deleted]
tim333|4 years ago
>Microorganisms found in dirt have yielded antibiotics that can kill pathogens resistant to multiple drugs. https://www.nature.com/articles/d41586-018-01931-4
and similar stuff? We could do with some government action to develop some and ban using them in farming.
mrtri|4 years ago
[deleted]