Seen the BBC article about antibiotic resistance? This keeps cropping up every so often – is it a real concern or clever marketing for people who want more money to continue their research? According to BBC without htem we are heading back into medieval medicine.

How long does it take to develop a new antibiotic I wonder? They’ve been saying we need new antibiotics for years..

I’m not. I’ve never had ’em in my life.

It’s inevitable, sadly – we can’t simply keep coming up with new antibiotic classes ad infinitum, especially if these ‘drugs of last resort’ are then used extensively in human and veterinary medicine in the very places where novel resistant bacterial pathogens are most likely to arise.

Doesn’t mean that all antibiotics will suddenly become useless overnight.

is it a real concern or clever marketing for people who want more money to continue their research?

The first one. Part of the problem is a lack of R&D money investment – it’s not a big money-making area for the pharma companies, so there is a lack of new antibiotics making it to market.

BUT misuse of existing antibiotics is a much bigger problem.

How long does it take to develop a new antibiotic I wonder?

7 to 15 years for most drugs. Don’t know about antibiotics specifically.

It has been a concern for a while but we’ve not seen the widespread consequences of resistant bacteria. Evolution means that bacteria will always end up becoming resistant. The long term effect is that a lot of people would die, but some would become resistant to the bacteria

I think it was 30 years or so since the last one and then that’s not been used a lot to keep it in reserve but it seems that’s no longer effective in China.

I’m not. I’ve never had ’em in my life.

Any of us could get knocked off our bikes tomorrow and end up acquiring a nasty strain of MRSA courtesy of the local NHS.

real concern – see MRSA, particularly the MR as the SA isn’t that bad.

It depends on what you mean by new. There are broad classes of antibiotics that use the same chemistry. E.g. A fair few are based on penicillin. However, to combat resistance and make them more effective researches stick on other atoms and you end up with similar sounding drugs. You will see a lot of -“cillins”.

The problem comes from the fact that we haven’t found any fundamentally new antibiotic chemistries in a long time so this approach doesn’t work long term.

It is remarkably hard to develop a drug. Something like 99% of potential candidates don’t make it to market for various reasons. Bacteria aren’t massively different from our own cells. Antibiotics work by selectively disrupting the bacteria (or killing them). The trick is to do this without introducing something that will harm the person significantly.

As an aside this is why treating cancer is so hard as the difference between the cancer cells and normal cells is tiny and so there are very few avenues to pursue. Chemo therapy is horrible since while it attacks the cancer it still attacks the person to some extent.

it’s pretty much a real threat

take a look at this

There’s some scary shit in there, such as a lake somewhere in India near to lots of drug factories, where the concentrations of some antibiotics in the water are as high as we can achieve in a patient. Imagine what’s breeding in there

I’ll have a read of that later scaredypants.

I figured it was a real issue but slightly exagerated by the news.

Doesn’t mean that all antibiotics will suddenly become useless overnight

which was the impression I got from the BBC article. I guess we’re likely to have a period where antibiotics are less sucessful and then in due course are the problem worsens we’ll get newr drugs.

Does our reliance on antibiotics mean our bodies are going to be less well able to fight resistant strains due to our immune systems having less of a ‘work-out’ when we do get infected as we are so regulalry treated saving the immune system the work?

It seems to be that we’ll have to get to a crisis before we start looking at antibiotic research really hard again.

There is a fair bit of research going on (I talk to lots of biotech start ups) but non of them has huge funding which will probably be required for some new antibiotic classes.

We might even go back to bacteriophage treatments of hospitals like they used to use in the Soviet Hospitals.

Have a read of William Gibson’s The Peripheral – he had a good think about this and (bar some of the plot devices) the actual future he describes is pretty convincing.

Doesn’t mean that all antibiotics will suddenly become useless overnight

No but to stretch a metaphor, it’s about 4a.m. currently

The newly reported Chinese resistance to colistin means that “all” antibiotics that might kill something like E.coli now have a resistance gene that can be transferred on a plasmid. That’s way more efficient than “waiting around for a mutation” in order to spread resistance

Once farmed animals are “all” carrying enteric bacteria with ESBL, KPC, this new colistin one (and with them a few other resistances, because gene cassettes are where it’s at) …

I’m really hoping that the drug companies have some secret shit hidden away

Sort of related to subject – http://www.bbc.co.uk/news/health-34790038

be interested to hear what people with appropriate knowledge think about:
– modern culture needing an instant fix, demanding ‘treatment’, or inappropriate use of antibiotics
– people not finishing prescribed course of antibiotics when they seem ok

I’m not. I’ve never had ’em in my life.

I suspect you are misunderstanding the risk here.

The real worry isn’t that you personally take too many antibiotics so they don’t work well for you.

It’s that antibiotic use in the general population represents an evolutionary obstacle that selects for antibiotic-resistant strains of bacteria which we then have no defence against.

Or to put it another way.. ”Life, uh, finds a way”

The bacteria in question that is resistant to the last resort antibiotic colistin is not a threat to humans in any way possible, although saying that, it may mutate in the future to become an issue.

Overblown scare story but it provides a good headline to throw about on news items.

(i am not a biologist, but my wife is, and she explains things slowly to me)

…The bacteria in question that is resistant to the last resort antibiotic colistin is not a threat to humans in any way possible…

i thought bacteria could do clever gene-sharing tricks?

eg, this:

… a resistance gene that can be transferred on a plasmid. That’s way more efficient than “waiting around for a mutation” in order to spread resistance

sounds like the kind of thing my wife might say.

It’s more of an economic problem than a scientific one – where is the incentive for a company to spend 1 bn on developing an antibiotic drug that then gets locked in a box and everyone’s v careful not to use?

New antibiotics are very feasible, scientifically – no drug is ever easy to develop, but antibiotics are orders of magnitude more tractable targets than a target in the CNS, say. Toxicity is tough, though, as some antibiotics are dosed really high – horse medicine style. If you’re ever unfortunate enough to be in hospital on a vancomycin drip you’ll be seeing grams of it per day. That puts a lot of pressure on the therapeutic window – still doable, though.

They need to ban the use of antibiotics in all farm animals, it’s just one massive resistance farm brewing away…

Big fuss over nothin, it’s Greggs and cakes what are the real danger to most on here. 🙂

It’s more of an economic problem than a scientific one – where is the incentive for a company to spend 1 bn on developing an antibiotic drug that then gets locked in a box and everyone’s v careful not to use?

True enough, and they are beginning to look at ways of encouraging firms but then also, several of the “lastish” resort drugs are £300-500+ per patient per week.

The real concern to manufacturers, I suspect, is unregulated manufacture and usage of drugs in developing/less-regulated economies. Not only taking your profits away but also driving early resistance

It’s difficult, but there are companies working on new antibiotics. Even near Manchester.

Here’s a scientist’s take on it.
Antibiotics

I figured it was a real issue but slightly exagerated by the news.

It could maybe be a rare case of the news not being able to state the importance clearly enough. We report trivial risks such a bacon-gate with such a lack of perspective that stories of real concern are difficult to give any weight to.

It amazes me that antibiotics are so taken for granted given than in one lifespan its changed our lives completely.

I’m far from an expert on this, but I am a scientist and hope I largely understand these sorts of things, and my understanding is that this is the real deal. The suggestion is that this is not the first time resistance to colistin has been found, but the difference is that the gene involved this time is easily shared with other bacteria and the opinion of those who know about these things seems to be that sooner or later it will be passed on to things which are truly dangerous to us.

Reading this story makes me really angry though:

Early indications suggest the Chinese government is moving swiftly to address the problem.
Prof Walsh is meeting both the agricultural and health ministries this weekend to discuss whether colistin should be banned for agricultural use.

Well hello stable door shutter – the horse is out there in the field. WTF has colistin use been so widespread in agriculture?

Someone who works for a pharmaceutical company told me that antibiotics have had their day and the clever money is on genetically engineered viruses that will infect bacteria and kill them.

Somebody esle has written in the same discussion on UK Climbing that drug companies are investing most of their money in drugs for type 2 diabetes, an illness of the overweight world.

WTF has colistin use been so widespread in agriculture?

it’s one of those drugs that human medicine largely “abandoned” years ago – right up ’til we started seeing resistance to the preferable drugs

as somebody said up ^ there, phages (antibacterial viruses) are now being researched – I think some are already used in fish farming, as are more vaccines, better & faster diagnostic tests ‘n’shit

we’re still doomed 🙁

companies are investing most of their money in drugs for type 2 diabetes,

We’ll if we’re going to have the diabetes but no effective antibiotics then I think the smart money would be buying shares in artificial limbs.

Im not a biologist so could do with some help here.

The reason Im not totally convinced this will be as big a catastrophe as everyone is saying is that life is very keen to stream line.

There’s always advantages and disadvantages to each mutation in any organism.

Surely if any bacteria has all these antibiotic resistant adaptions it will require more energy that a non resistant strain and therefore is likely to breed slower in an environment without Antibiotics that a more stream lined bacteria and therefore will be out competed.

In highly competitive environments, life very rarely keeps a mutation if it is not needed otherwise we’d all be superhuman athletes. In our case it has proved evolutionary more favorable to have weedy humans who use less resources and therefore require less energy.

There’s no reason we could nt be stronger our ancestors were and almost all remaining apes are also stronger than us. But once the human brain arrived and we could use spears etc we started to lose our strength as it was no longer vital.

Surely if any bacteria has all these antibiotic resistant adaptions it will require more energy that a non resistant strain and therefore is likely to breed slower in an environment without Antibiotics that a more stream lined bacteria and therefore will be out competed.

yeah, but where do human pathogens find an environment like that ?

If you remove a drug from use, observed resistence falls but it’s very gradual and there’s no guarantee at all that it’s not latent in the remainder – some mechanisms are inducible, so the gene expression is switched on/up when it’s needed, i.e. in the presence of the drug.

I think the “costs” are variable anyway, and the persistent and widely dispersed mechanisms are clearly going to be the least costly.

I can imagine a UKIP Nirvana scenario where borders shut super tight as resistant strains begin to export.

There really is a scenario where hospitals are literally unable to treat serious infection. I can only imagine how horrid that scenario would be.

Still, there are simply too many people on the planet – which is effectively the main cause of the issue. Every time I put my grey matter to the test it comes back to doomsday scenario. We need a good culling, unfortunately.

Happy thursday everyone!

We’ll if we’re going to have the diabetes but no effective antibiotics then I think the smart money would be buying shares in artificial limbs.

I wouldn’t as they’ll die is sepsis before needing limbs.

I heard ‘they’ have a cure for all infections but won’t release it as ‘they’ look after the shareholders. 😀

A couple of people have mentioned phages, and the use of them by the Russians; I remember seeing something about this some time ago, on telly, and there seemed to be a lot of positive benefits from the use of phages against bacteriological infections, the Russians appeared to have the process quite well developed, so have phages not proved to be as effective as first thought, or has ‘big pharma’ kicked the idea in the head because it’s not profitable enough?