Slashdot Mirror
Existing Drugs Fight Antibiotic-Resistant Bugs
sciencehabit writes "Medical experts have been powerless to stop the rise of antibiotic-resistant bacteria and are increasingly desperate to develop novel drugs. But a new study finds that smarter use of current antibiotics could offer a solution. Researchers were able to keep resistant bacteria from thriving by alternating antibiotics to specifically exploit the vulnerabilities that come along with resistance—a strategy that could extend the lifespan of existing drugs to continue fighting even the most persistent pathogens."
I was thinking somewhat along the idea, written in summary. We could battle resistance with somekind of phasing of antibiotics in and out of use.. For example we could phase out one type of antibiotic for say decade, then bring it back and phase out another. Could this work?
It's Bactrim, no it's Zifromax, now Amoxycillin, back to Bactrim... SCORE!!!
Science advances one funeral at a time- Max Planck
Don't use them unless they are necessary.
In TNG, Starfleet made it a regulation to alternate phaser frequences in order to fight the Borg. The Borg soon adapted to that strategy.
It would be strange for the bacteria not to adapt to the strategy of alternating antibiotics as well. It seems the bacteria have a very good pattern recognition mechanism.
"*Big Pharma Companies* have been powerless to stop the rise of antibiotic-resistant bacteria and are increasingly desperate to develop novel drugs."
Here's a hint: Stop indiscriminately throwing antibiotics at everything that moves. It's precisely the over-use of these drugs that has created the problem in the first place.
Our nurses would use several IV vitamin C infusions to "reset" the biofilm resistence in chronic UTI for amoxicillin reuse, as repeatedly shown for antibiotic resistance in culture tests. Cipro was a patient killer, much less the nastier expensive stuff.
Probably the biggest mistake we made the last century was to change away from using copper and brass in hospitals, to stainless steel and chrome - turns out that copper cladded work surfaces is a very effective way to control bugs in hospitals and they don't get resistant to it.
Excuse me, but please get off my Pennisetum Clandestinum, eh!
Over prescription of antibiotics is a huge problem here in Asia mostly due to cultural face saving practices. In the West when you go see a doctor you are sometimes, probably not often enough, told to just go home, stay hydrated, rest and that you don't need any medication because there's no medication that can really help.
In Asia however, when someone sees a doctor they expect to go home with something. Even though the doctor's advice is 'respected' it would be a loss of face for a patient seeking treatment to be told to just to go home and rest, no medication is needed. It's hard for Westerners to understand, and IMHO serves very little purpose in today's society, but Asians would view coming home from a doctor without medication as the doctor not doing their job. Also, by not providing some kind of medication the doctor is basically, in the Asian mind, telling the patient "you are wrong, there's nothing wrong with you" which would be a big loss of face for the patient.
There's also a cultural service and purchasing custom that applies but it's much more esoteric and difficult to describe. Briefly, there's an expression "buy 10 buns, get 11 bags" because everyone is conditioned that a transaction is not complete until the goods or services are delivered well and completely packaged. It's a nice polite custom and all but you should see the dumbfounded look on many vendors' faces when I tell them I do not want a plastic bag for my purchase(s). It may sound irrelevant but it comes into play at the doctor's office in terms of, the service transaction is not complete until medicine is delivered.
So, doctors here are not able to go against the cultural grain, even though they know medically and scientifically that antibiotics will do more harm (in the long run) than good, the cultural conditioning is too strong so they always prescribe and 9 times out of 10 it's antibiotics. I was a paramedic in the US for years and I know treatments are highly relative to cultures. I've got no problem with cupping or coining or other 'treatments' that appear to be absurd when viewed through the filter of my culture but, none of those practices have an international impact.
Over prescription of antibiotics is a very significant international problem and Asia is doing the world a huge disservice by allowing it's cultural customs to influence medicine to such a degree in this matter.
Less *is* more.
But when you have hours or minutes (or even a day, just long enough to get a culture and preliminary resistance check) to start treating a bacterial infection before septic shock sets in, DNA typing and creating a phage takes too long. The opposite problem is that if your first guess isn't 100% effective, than you also just upped the chance of training the bacteria to be more resistant.
It's not the standard e.coli UTI that causes resistances (chances are macrodantin or 'cillin or 'sporin will kill it good). It's the strange Kleb or Psudomonas A UTI that gets treated with standard UTI drugs for 24 hours and then switched to a proper cure. That action leads to e.coli and enterococcus and any other gut bacteria and even skin bacteria getting a head start on resistance. Replace UTI with respiratory or blood infections, and the same thing happens. TB carriers are probably the reason that TB has gotten into the extreme resistance bandwagon; going through the same UTI/sinus/respiratory/gastric infections.
And then there is the whole deal of treating every sinus and upper respiratory infection with antibiotics without proof that they aren't viral. I'd blame parents and doctors, and adore that my doctors have a 'no sinus infection antibiotics' sign in every room that stays in force until they get a positive culture result.
"It's Bactrim, no it's Zifromax, now Amoxycillin, back to Bactrim... SCORE!!!"
No, the pharma industry will package them in a special containers that deliver one identical looking pill (with different content) each day for only 4 times the price as if we'd rely on the user remembering when to take what.
Seem quite simple, doesnt it? The fact that cattle, fish and shrimp feed in asia have huge amounts of antibiotics as a "preventive" measure to keep the animal from going sick, and the resistance the bacteria gain dealing in that sick field, and whatever trickles up the food chain doesnt seem to bother anyone, has long money is made. And nobody will care until it is too late. Big pharma also doesnt care, quite by the contrary the patents have long expired, and antibiotics are bought by the shovel, as soon as they stop working they will have then gov "fund" to further develop very expensive nanomeds. This seems like a stupid plot from a bad scifi movie.
This isn't just an Asia thing. You have described at exactly how food production in the USA works. I'm sure that there are other countries where it's the same. Food production in the USA is Big Business and Big Business always gets what it wants. What they want is zero loss and the way to achieve this is to use high amounts of pesticides that kill any bug that dares to get near produce and feed antibiotics to animals to keep them alive long enough to slaughter them.
Using viruses as weapons against bacteria seems like an awesome idea, however, wouldn't a person's own immune system start attacking its ally the phage?
I mean, parts of the immune system, all they do is react to antigens, and phages would be seen as just another invader that doesn't belong, regardless of the fact that it is attacking a common enemy.
For this reason I'm not sure phage therapy would necessarily work.
--PM
Perhaps drug researchers can find a way to allow the original organism in some antibiotic sources, say penicillin mold, to react to the evolved bacterium, thus changing its antibacterial toxin naturally as it must have done for millions of years to keep ahead of whatever was trying to consume it. Could we let nature battle the evolving immunity issue naturally? Large tanks of naturally acquired, say penicillin mold again, with its natural genetic variations placed in close proximity to the antibiotic-resistant bacteria.
And, another thought: could drug companies herd the evolving drug resistant bacteria into a cul-de-sac where we are waiting for them by adding a "hook" of some kind to the antibiotic that they (the bacterium) would also change for - to their future disadvantage. We (humans) would be waiting with another antibiotic specifically formed to take advantage of that "hook."
E Proelio Veritas.