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The UN just declared antibiotic resistance the greatest and most urgent global risk

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The Lamp

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I had c diff. That shit is scary because it's caused by antibiotic overuse and now I'm scared to death of using antibiotics again for fear that my gut bacteria are permanently altered.
 

The Omega Man

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So basically this is a prequel to how we currently "fight" climage change. Everyone was aware about it, change had to be made before its too late, point of no return yadayada...but it wasnt enough because people didn't want to lose comfort and corporations didn't want to lose profits.

Are we that daft to doom ourselves so easily?



Never underestimate greed and human stupidity.
 

Nivash

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So basically this is a prequel to how we currently "fight" climage change. Everyone was aware about it, change had to be made before its too late, point of no return yadayada...but it wasnt enough because people didn't want to lose comfort and corporations didn't want to lose profits.

Are we that daft to doom ourselves so easily?

Well, yes and no. We always knew the resistance would develop and that we'd lose them eventually, but in the meantime we likely saved billions of lives. Once it's gone we'll be left where we started off provided we don't find a replacement. Climate change is going to make things much worse than how we started off if we do absolutely nothing about it, and it will leave the rest of the ecosystem irreparably damaged. That's not the case with antibiotics, it's more like a non-renewable resource running out. We'll miss it dearly, but it's not like it will end civilisation or anything.

The same mental and institutional blocks are definitely in play though. If it's any consolation, fossil fuels are easier to replace and we're further along in doing it. The post-antibiotic era is likely inevitable, runaway climate change isn't yet.
 

Pamplemousse

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Didn't somewhere say that 10M people would end up dying a year because of it by 2050?

Between this and climate change, the future's looking rough.
 

Alcoremortis

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They should put antibiotics on a rotation, ala crop rotation, where the world is divided up into regions and each can only use a certain variety of antibiotics for some set time (AFAIK there's no data as to how long this needs to be). Exceptions in place for extreme emergencies, of course. Then bacteria wouldn't have enough time to develop resistances to any antibiotics.

There's seriously no reason why every country should use every antibiotic all the time. It's not like antibiotics make a huge amount of money anyways. The pharma companies would probably make more money by rotating their product in a way that would keep it effective for longer instead of just making new antibiotics every few years.
 
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Never underestimate greed and human stupidity.
I try to be optimistic about it, but news like these make it tough to do so. Can't even blame just greedy corporations or politicians. We are way too used to a comfy lifestyle without thinking about the consequences.

Well, yes and no. We always knew the resistance would develop and that we'd lose them eventually, but in the meantime we likely saved billions of lives. Once it's gone we'll be left where we started off provided we don't find a replacement. Climate change is going to make things much worse than how we started off if we do absolutely nothing about it, and it will leave the rest of the ecosystem irreparably damaged. That's not the case with antibiotics, it's more like a non-renewable resource running out. We'll miss it dearly, but it's not like it will end civilisation or anything.

The same mental and institutional blocks are definitely in play though. If it's any consolation, fossil fuels are easier to replace and we're further along in doing it. The post-antibiotic era is likely inevitable, runaway climate change isn't yet.
Thanks for explanation. Always was aware that antibiotics build resistance so I rarely used them but wasn't aware just how they get stronger and more resistant until recently.
 

The Omega Man

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Orniletter

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Is this really a thing when meats are cooked at very high temps? What survives in there?
That's not the problem, this is about the proliferation of multi-resistances against Antibiotics.

Some Bacteria love to share small DNA-rings with each other (Plasmids), they can contain...for them...pretty nifty genes allowing them to dispose of antibiotics or make them more resistant to heavy metals.

The problem is, these plasmids don't stay where they are and don't stay the same. MRSA (multi resistant Staphylococcus aureus) for example has amassed, as the name said, multiple resistances against several antibiotics.

Fake edit : And what marrec said is incorrect. We're not talking about host specific viruses here, your random resistant bacteria doesn't care if it's feasting off a cow or a human being.
 

A-V-B

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Not sure what "super antibiotics" you're referring to, but a Colistin-resistant gene was discovered in China last november and started spreading rapidly soon after.

http://phenomena.nationalgeographic.com/2016/06/23/colistin-resistance-the-pig-is-out-of-the-barn/

Colistin was the true drug of last resort. Nasty stuff we kept locked away only for when we really needed it, because the side effects (including killing your kidneys at a disturbingly quick pace) often made that it worse than the actual infection. Now that's gone too. There are absolutely no antibiotics left that will carry us 50 years.



You probably read about Colistin, actually.



The soil stuff is interesting and novel but it's not something the research community is prepared to hinge their hopes on yet. It's generally accepted that there are no new reliable candidates in the pipeline for the foreseeable future.

http://www.who.int/bulletin/volumes/89/2/11-030211/en/

There's always the possibility that we could have a breakthrough, but it's - again - not something people are hinging their hopes on. There's also the problem that the pace of how quickly bacteria develop resistance has picked up over time. Even if the get a new wonder drug, we could easily lose it even as it's barely out of the factory.



We got to keep the old school drugs for decades. Resistance to newer drugs developed within a year in recent cases.

So we basically have no answer to any of this? We've doomed future generations to suffering on a medieval scale and we've just got to cross our fingers we don't get huge swaths of our population wiped out by some nasty ass bacteria? What a shitstorm.
 

BolognaOni

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New antibiotics are very rare to find, though not impossible. A quick pubmed search showed that one was discovered not too long ago in 2015, http://www.nature.com/nature/journal/v517/n7535/full/nature14098.html (Needs a nature subscription to read, and my VPN is letting me down again, so I've not actually read it yet either), based on something to do with copying bacteria in soil.

Haven't read the actual paper, but there was an interesting New Yorker article on one of the authors and the research a while back. Essentially there appear to a be a huge number of microbes out there that we know very little about as they are difficult to grow in laboratory conditions. Basically these guys have been looking for new microbes, and in doing so found a proteobacteria that secretes a compound that breaks down cell walls of various other microbes.

Potential new antibiotic is pretty neat, but honestly the stuff that is going on to possibly allow us to more completely explore the whole scope of microbial life is probably a bigger deal overall.

It's easy to resort to hyperbole regarding drug companies and something as fundamental as antibiotics, but... They are fantastically expensive to produce at this point, with extremely uncertain returns. Even if they are successful, this is really one class of drugs we want to be accessible. High risk low return ventures are really more appropriate places for public financing rather than private...
 

iamblades

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So we basically have no answer to any of this? We've doomed future generations to suffering on a medieval scale and we've just got to cross our fingers we don't get huge swaths of our population wiped out by some nasty ass bacteria? What a shitstorm.

No, even if we had no antibiotics, things wouldn't quite get to the level of medieval times, because today we have an understanding of how to prevent the spread of these pathogens through hygiene, sanitation etc.

That said it would be bad for the people who did get those infections.

The solution almost certainly will have to be a new technique for targeting bacteria instead of the chemical carpet bombing we are currently doing which is crude and can only ever be temporary, as eventually resistances will evolve.

So we are talking either nanotechnology or genetically engineered bacteriophages, both of which are in the early stages of research as we speak. This is where the research needs to be focused. Phage therapy in particular is already being used therapeutically.


Sure we could find new chemical antibiotics, but that can only ever be a stop-gap effort, we need a fundamental technological shift if we are going to hope to truly overcome disease.
 
May 14, 2008
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It's going to get worse before it gets better, especially since education about antibiotic overuse is painfully low in places where antibiotics are overused.

How possible is it for bacteria to lose antibiotic resistance over time? If we stop using an antibiotic, theoretically there won't be any selection pressure to pass those genes down to future generations, right?

Edit: nvm we doomed
https://www.sciencedaily.com/releases/2016/08/160801142038.htm
 

Walpurgis

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It's going to get worse before it gets better, especially since education about antibiotic overuse is painfully low in places where antibiotics are overused.

How possible is it for bacteria to lose antibiotic resistance over time? If we stop using an antibiotic, theoretically there won't be any selection pressure to pass those genes down to future generations, right?

Edit: nvm we doomed
https://www.sciencedaily.com/releases/2016/08/160801142038.htm
True but there is also no selection pressure to decrease the mutant bacteria population.
 

Codeblue

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This wouldn't be as big of an issue if patients didn't expect a pill and doctors didn't feel pressure to give it to them. See, people with colds.

Yeah, people get mad at me all the time for not writing antibiotics. I tell them to kick rocks if they aren't willing to listen to reason, and they usually go down the street and get them, but at least I can say I'm not contributing to the problem.
 

low-G

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I hope we can all die in nuclear fire before a superbug makes us feel really shitty for months and have a horrible suffering death.
 

~Devil Trigger~

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Isn't this another reason to avoid meat?

- Avoid non-alcohol Hand sanitizers. They're trash, they barely work, but they give bacterias enough info

- And stop taking anti-biotics for viral infections, unless you're immuno-compromised

- Decrease/stop anti-biotic use in farms
 
Apr 10, 2007
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The problem isnt really overperscrition but I'm sure that doesn't help. The real problem is agricultural antibiotic use as a preventative.
 

Sch1sm

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They make a good point. Antibiotics are way too over prescribed and lack of effect from diseases that adapt to them is inevitable.

There are also countries where they are sold very cheaply over the counter. The combined effect has been devastating.

I'm curious if this was always an inevitability.

Truth. On both points.

I work in a pharmacy, and it's unbelievable how many prescriptions for antibiotics come through. I'm not talking specific antibiotics, used for UTIs, or STI courses, or yeast infections, but a general course of antibiotics. Your standard penicillins/cephalosporins, that sort. It's hit the point with some patients where they'll often have to return to the doctor for an extended course, or a different antibiotic all together because the first didn't work. Have a look at their files and, with the exception of those on regular medications, it's the most heavily prescribed.

In terms of other countries, as someone who went to Kenya for 8 weeks this summer, good God. They'll throw an antibiotic at you without even checking to be sure you have a bacterial vs a viral infection. They judge by what you claim your symptoms are, put it through their computer, and spurn out with uncertainty whatever is thrown at them. I got sick toward the end of my trip, and they were fast to give me a 7-day course of them. I didn't take them. Concerns for whether they were genuinely necessary,
and skepticism over expiry dates tbh. ¯_(ツ)_/¯

-------

It's good to see that this is being looked at more closely.
 

NOLA_Gaffer

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Hooray, as if the human race needed more doom and gloom.

How much longer do you guys think we got? 50 years? 75? Surely not 100?
 

dragonzdogma

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So wash my hands with regular soap ( non-antibacterial)
don't shake hands
become a vegetarian (Fish is okay eat)

And I should be good, okay got it.
 
Apr 10, 2007
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What? How?
Just general touching of the genitals/anus/throat. Close physical contact, basically. The bacteria just need to touch the mucus membranes, so dicks and vajayjays don't need to meet. Hell, my doc said you can get it by just using fingers if fluids are involved.
 

CHC

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It's a hard problem. Antibiotics are basically nukes that just get the job done, and in the moment it's very hard to resist that. If you're sick and hacking up mucus all day, it's very hard to say "no thanks" to a pill that can clear it up in 24 hours, compared to weeks of "natural" suffering. If a doctor has a patient with a rash, it's not going to be easy for them to wait and see how it goes, compared to giving something that they know will very likely clear it up.

But that's just the nature of why humanity is destroying the planet. It's like AC on a hot day - can't say no but every little bit is just another drop in the growing ocean.
 

shira

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Didn't somewhere say that 10M people would end up dying a year because of it by 2050?

Between this and climate change, the future's looking rough.

Some really hard choices are going to have to be made if people get infected or if a building or hospital has become exposed.
 

Meffer

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Jun 16, 2014
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I had c diff. That shit is scary because it's caused by antibiotic overuse and now I'm scared to death of using antibiotics again for fear that my gut bacteria are permanently altered.

That's nasty shit, man. Sorry you had it.
 

Breakage

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I wonder how this will change attitudes in places where people are used to being sexually promiscuous. I guess this will alter casual hook-up/Tinder/FWB cultures that are popular at the moment.
 

Trojan

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My brother in law is a microbiologist, and he's been talking about this for years. It's truly scary stuff when conventional medicine can be rendered useless.
 

Alebrije

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Is this really a thing when meats are cooked at very high temps? What survives in there?

That's not how it works now, it helped decades ago but today bacterias are spreaded more than ever on different ways.

We abused not just the use of antibiotics but cleaning soaps also. Traditionally antibacterial hand soaps have Triclosan but over decades bacterias have developed resistance to it and now companies are using other chemicals on soaps.

http://ec.europa.eu/health/scientific_committees/opinions_layman/triclosan/en/


So if you regularly use antibacterial hand soap look for one that does not uses triclosan. Other problem is that most of people do not know how to wash their hands , look at this video and bet most of your friends do not wash their hand this way :

https://youtu.be/vYwypSLiaTU







Well cooked food helps to reduce the bacteria contamination but soon of later heat resistant bacterias will emerge. Some researches in Canada found E Coli that resist 140 F and even 160 F that is tje FDA recommended heat level to cook food.

Is more about cultural care these days

Look at this video about it :

https://m.youtube.com/watch?v=ZquWcf7DInQ

E Coli grow rate is high ,they basically divide every 20 minutes , so if a guy do not wash his hans properly after poop, this happens :



Just imagine this guy walks to a grocery store , touch some handles , some fresh fruits ,. Etc. He spreads e Coli . Yep our body can hadle E Coli otherwise we would be extinct but the problem is super EColi or other bacterias that we actually do not have developed defenses.
 
D

Deleted member 80556

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I hope we can all die in nuclear fire before a superbug makes us feel really shitty for months and have a horrible suffering death.

Don't worry, if a superbug infects you and puts you into sepsis, you won't last that long.
 

Breakage

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It's remarkable how many people don't wash their hands properly. It's not something limited to poor people either. I've come across "middle-class" people with shitty hygiene habits.
Always grosses me out when I see people touching handle bars on public transport or handling money then proceeding to push food into their mouths with unwashed hands.
 

Osiris

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This is just what I needed to read after getting home from the hospital, where my son is recovering from an infection. :(

I dread reading stuff like this, my son is completely and utterly reliant on antibiotics, both in prophylactic form (daily), and reactive when he suffers an infection. (He's a very high sepsis risk patient due to medical conditions he's had since birth).
 

Sulik2

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Absolutely terrifying. I swear human civilization started on the downward slope of the bell curve in the last couple of years.
 

gwarm01

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They should put antibiotics on a rotation, ala crop rotation, where the world is divided up into regions and each can only use a certain variety of antibiotics for some set time (AFAIK there's no data as to how long this needs to be). Exceptions in place for extreme emergencies, of course. Then bacteria wouldn't have enough time to develop resistances to any antibiotics.

There's seriously no reason why every country should use every antibiotic all the time. It's not like antibiotics make a huge amount of money anyways. The pharma companies would probably make more money by rotating their product in a way that would keep it effective for longer instead of just making new antibiotics every few years.

I can see your reasoning, but it wouldn't work in reality.

There are numerous antibiotics, but they are all part of a relatively few amount of classes which have similar mechanisms of action. Any given infection may be susceptible to a particular class of antibiotics, or to specific agents in a singular class. Cephalosporins are an example of this, where multiple agents are separated into different generations roughly based on the type of bacteria they tend to cover.

A health system needs access to the full arsenal to be able to combat any sort of infection that may come their way. On any given day you may see a patient with an infection that could be treated with anything from standard penicillin to one of our last agent drugs like Colistin.

The real key is stewardship. I should state that I am a clinical pharmacist working in an institutional setting, so that is where my experience comes from. Antimicrobial stewardship is a large part of modern institutional healthcare. When someone is in the hospital with an infection we get cultures and determine susceptibilities, then deescalate treatment to the narrowest spectrum antibiotic that is effective. This allows adequate treatment without contributing significantly towards resistance.

In the past we tended to give patients these all inclusive broad-spectrum antibiotics. They had great marketing, excellent studies. Give someone a drug like ampicillin or doxycycline and they will get better regardless of what bug they had. Call it naivety, but we were ignorant of bacteria's ability to form resistance and transfer it between relatives and even other species.

These days the most common culprit in the misuse of antibiotics in the US are the rank and file doctors in our community. When a patient arrives with a cold and demands something for their copay, it's just easier to give them an antibiotic to make them happy.

That said, I think we should be optimistic. I know most doctors are aware and many are active participants in stewardship. It's especially prevalent among the younger generation, but I know many experienced docs who are changing their practice.

Honestly, the best thing we could do is educate the general population so they will stop expecting antibiotics for every little cough. Maybe after that we can remind them that vaccines are safe an effective, but I'll take one step at a time.
 
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