We're losing the war against drug-resistant infections faster than we thought

130 pointsposted 4 months ago
by pseudolus

12 Comments

burnt-resistor

4 months ago

The war is being lost for 3 main reasons:

- Overuse in meat agriculture evolving new DRB as a side-effect of profiteering from animal cruelty by force-feeding animals soy and corn.

- Overuse for emotional customer satisfaction reasons rather than evidence-based scientific treatment of viruses with totally-inappropriate antibiotics. This isn't a problem limited to the Global South that this article wags its finger at with imperial arrogance. This happens all the time with American primary care doctors dispensing antibiotics without proof of bacterial infection.

- Lack of R&D into new drug classes.

WalterBright

4 months ago

I once went to the doc with symptoms of strep. He prescribed antibiotics. I asked, why didn't you do a strep test first, as I didn't want to take the antibiotics if it wasn't strep? He looked annoyed and did the strep test. The results came back in a few minutes that I had strep.

itsme0000

4 months ago

I’m really glad this article acknowledges that better access to antibiotics is probably the best solution to the problem. I’ve actually heard people argue the opposite.

Many people, even doctors will blame patients for creating antibiotics resistant strains. While it’s true that a resistant strain can develop and spread due to an individual’s actions, those strains will gradually lose their resistance once no longer exposed to antibiotics, so it’s probably better have antibiotics be accessible drugs everywhere to prevent any initial spread and just trust people won’t use them chronically for no reason. Though I’d argue lack of access to antibiotics contributes more to the spread of disease then careless patients stuffing down their mouths, it really depends on what type of bacteria it is. Patients with viruses often misdiagnose themselves as needing antibiotics and that’s another reason it’s not over the counter, that builds resistant bacteria, not inside the patient but in the external environment due to excretion in urine etc.

Doctors will often chide patients for not taking the whole bottle of antibiotics once they stop feeling symptoms as if this gives more opportunity for the resistant strain to spread. It’s true it’s probably safer to totally ensure you are free of disease before stopping a medication, but increasing the overall level of antibiotics in the environment boosts resistance in every case. As people on this thread have pointed out the mass use of antibiotics in cattle farming is going to contribute significantly to resistance because it permanently increases the amount of antibiotics in the environment. Other than stopping that not much can be done to prevent this

It’s kind of a non-issue on an individual level as resistant strains lose resistance over relatively short periods time, once no longer exposed to the antibiotic, people just assume if the bacteria evolved an advantageous trait it will never lose that trait even though it’s no longer advantageous once it’s environment returns to normal.

Supermancho

4 months ago

> those strains will gradually lose their resistance once no longer exposed to antibiotics,

I've never heard this. Can you cite an example or source for this? How could we be losing if medicine can afford to "wait out" a strain? MRSA's been around 80 years. Call me skeptical.

cyberax

4 months ago

> those strains will gradually lose their resistance once no longer exposed to antibiotics

No, they do not. Bacteria eventually optimize and streamline genes that confer resistance, and they stay around basically forever in a small reservoir of bacteria. So once you start using the antibiotics again, these streamlined genes almost immediately reappear.

aziaziazi

4 months ago

The majority of antibiotics are not consumed by humans though, but by the animals raised to be eaten.

looofooo0

4 months ago

https://en.wikipedia.org/wiki/Phage_therapy

Basically use dirty water, finely filter it, such that only things as big as phages remain. Put that liquid in a solution of bacteria you want to treat. Filter it again, repeat... In the end you should end up with some phage solution which specifically attacks the bacteria. If these phages don't work anymore, find new ones.

like_any_other

4 months ago

Another source of antibiotic resistance (which the article forgets to mention) is their routine use in livestock, preventatively and to accelerate growth. I would wager that is the far more significant contributor, since there's simply much more of it - compare the total number of cattle in places where such use is allowed (meaning cattle are exposed to antibiotics for most of their lives), versus the number of people being treated with antibiotics (i.e. a very limited population, for a very limited period):

https://pmc.ncbi.nlm.nih.gov/articles/PMC12029767/

https://pmc.ncbi.nlm.nih.gov/articles/PMC6017557/

spwa4

4 months ago

Don't worry governments worldwide (except perhaps China, who knows) are defunding medical research. And they're defunding nothing faster than research into new antibiotics.

This last bit is partially indirect, since it has the problem that while new antibiotics might very well exist, governments will not approve them unless they have no other choice. Yes, nationalized health insurance providers are the majority of the worldwide market. Second a number of markets (notably India, but certainly not just them) will rip off the medication and not pay a dime for it. This all combines to make it really hard to get people to invest in widely applicable antibiotics. Unfortunately that does include direct subsidies as well (governments do ask big pharma what to subsidize).

So the money is in medicines that fix one particular fatal illness, medications for which no alternatives exist, that are very difficult to produce. This makes getting approval very easy, and allows for high prices.

At least that was the situation ~2016. Since then governments have been "tightening the belt" or whatever they call it and the situation has gotten worse to the point that a number of (especially European) labs now don't exist anymore. Which means even if the defunding is undone they will take a decade to get back up to speed. This is affecting a lot of other things as well. Like the ever-worsening doctor shortage predicted to worsen to the point that even just actual life-saving operations (now ~40% of the total, which is already way too much) won't be able to happen anymore ... by 2035, in the UK. This is not when you get ill, and need a treatment in 6 months, this is about someone closing up internal bleeding when you get hit by a car. Needless to say, the government is defunding education of new surgeons further, worsening the situation. I mean, everything is getting worse, on purpose, in the UK. From roads, public transport, and indeed the NHS. "Doing less with less" seems to be the government motto.

gmerc

4 months ago

You just executed a kill mission on the HQ and general staff in this war, the CDC. Totally gonna change the trajectory

irjustin

4 months ago

The whole article talks about tracking and tracking better is helpful I get that but that won't stop it reverse the trend? Even in areas where we have clean data we see the trends.

So what's next?

metalman

4 months ago

here are simple facts

humans are now, and have been for some time, the largest biological niche to exist.

biological law: all niches will be filled.

all life shares the same chemistry

humans are activly digging up and playing with every tiny little other nitche on the planet and moving stuff around, AND useing various genetic edditing technolgys to modify numerous life forms, which are "washed" down the drain after the experiment is over.

it goes on.(edit), and on

we are so fucked.