The antibiotics crisis

JirikiJiriki retired ns1 playerMembers, NS1 Playtester, Squad Five Silver Join Date: 2003-01-04 Member: 11780Posts: 614 Advanced user
edited December 2013 in Discussions
As people are really busy taking about climate change, there's another real issue and that is antibiotics, namely the global overuse of them. I don't see climate changing killing much anyone in western societies but a future without antibiotics would be lethal. Here's a polemic article about them. Long story short, surgery (anyone had a surgery? I have) could become lethal, minor cuts could kill, heart transplant would be impossible and so on.

As ex-libertarian I can say that antibiotics is probably one of the best examples of tragedy of commons we know. Basically anyone who uses them does not pay the externality costs completely, and can extract huge rents. Any kind of Coasean solution has not happened and is not going to happen. There's already plenty of evidence that this can be fixed, and indeed has been fixed (here for example) with proper regulation.
3 out of 10 people who contracted pneumonia before antibiotics were used, died.
23 0000 people die each year as a direct result of antobiotic-resistant infection
80% of all antobiotics are used on farm animals

Here are some articles in scientific medial journals:
The continuing crisis in antibiotic resistance

The emergence of antibiotic resistance in bacterial pathogens is an inevitable consequence of antibiotic use. Despite repeated warnings, negligent antibiotic use and poor infection-control practice have led to the continuing development of extensive resistance problems worldwide. Multidrug-resistant pathogens are now characterized by their heterogeneity, increasing virulence, resistance even to reserve agents and spread within and between hospitals and the community. Examples are glycopeptide-resistant meticillin-resistant Staphylococcus aureus (MRSA) and enterococci, extended-spectrum β-lactamase- and carbapenemase-producing coliforms, and toxin-hyperproducing Clostridium difficile. Effective national and international programmes of control to combat these problems are urgently needed. The potential for success of such coordinated efforts has been demonstrated by the recent dramatic reductions in MRSA and C. difficile infections in England.
The Crisis in Antibiotic Resistance

The synthesis of large numbers of antibiotics over the past three decades has caused complacency about the threat of bacterial resistance. Bacteria have become resistant to antimicrobial agents as a result of chromosomal changes or the exchange of genetic material via plasmids and transposons. Streptococcus pneumoniae, Streptococcus pyogenes, and staphylococci, organisms that cause respiratory and cutaneous infections, and members of the Enterobacteriaceae and Pseudomonas families, organisms that cause diarrhea, urinary infection, and sepsis, are now resistant to virtually all of the older antibiotics. The extensive use of antibiotics in the community and hospitals has fueled this crisis. Mechanisms such as antibiotic control programs, better hygiene, and synthesis of agents with improved antimicrobial activity need to be adopted in order to limit bacterial resistance.

A Call to Arms: The Imperative for Antimicrobial Stewardship

Antimicrobial resistance is a major public health crisis. The prevalence of drug-resistant organisms, such as the emerging NAP1 strain of Clostridium difficile, now highly resistant to fluoroquinolones, Acinetobacter species, Klebsiella pneumoniae carbapenemase-producing organisms, and methicillin-resistant Staphylococcus aureus, is increasing nationwide. The sources of antimicrobial resistance are manifold, but there is a well-documented causal relationship between antimicrobial use and misuse and the emergence of antimicrobial-resistant pathogens. As the development of new antimicrobial agents is on the decline, the medical community, across all specialties and in conjunction with public health services, must develop and implement programs and strategies designed to preserve the integrity and effectiveness of the existing antimicrobial armamentarium. Such strategies are collectively known as antimicrobial stewardship programs and have the potential to minimize the emergence of resistant pathogens.
ENSL Head Admin 2006-2012

Comments

  • VetinariVetinari Members, Squad Five Blue, Reinforced - Shadow, WC 2013 - Silver Join Date: 2013-07-23 Member: 186325Posts: 3,468 Advanced user
    I did not read the longer quotes, but what worries me is especially the overuse on farm animals.

    The magazine GEO (they are printed in english, too, aren't they?), which features very high quality articles, had an interesting article about bacteriophages this year.

    Basically, there is a hospital somewhere in eastern europe, where they do research on bacteriophages (bacteriophages = viruses that kill bacteria). They have certain "standard mixtures" with about 40 different viruses, and are able to treat almost every bacterial infection with it - without side effects.

    Unfortunately, contrary to antibiotica, you can't make much money with those. Additionally, this research was, as some of it dates back to the early twentieth century, labeld "communist" in the west and therefore never properly researched here.

    I can look up the exact magazine and more facts once I'm home, but I am confident that we can solve the antibiotics problem this way.
    formerly known as F0rdPrefect

    I am good Onos
  • JirikiJiriki retired ns1 player Members, NS1 Playtester, Squad Five Silver Join Date: 2003-01-04 Member: 11780Posts: 614 Advanced user
    Overuse in farm but also prescription-free use on humans. This is rampant especially in Asia (China leading the growth).

    Phage therapy sounds interesting. Is that in vitro or tissue sample? (this is the question I got asked by an antibiotics researcher I talked to some weeks ago). The problem is I guess you are dealing with evolutionary life-form. Maybe this needs more public funding. I hope the regulation would be made by people with understanding of economics and medicine with research-based views and not absurd fears of next SARS.

    Phages seem powerful in the long run but I think we have to fix antibiotics in the short-run.
    ENSL Head Admin 2006-2012
  • BestProfileNameBestProfileName Members Join Date: 2013-01-03 Member: 177320Posts: 448 Advanced user
    Jiriki wrote: »
    Overuse in farm but also prescription-free use on humans. This is rampant especially in Asia (China leading the growth).

    Phage therapy sounds interesting. Is that in vitro or tissue sample? (this is the question I got asked by an antibiotics researcher I talked to some weeks ago). The problem is I guess you are dealing with evolutionary life-form. Maybe this needs more public funding. I hope the regulation would be made by people with understanding of economics and medicine with research-based views and not absurd fears of next SARS.

    Phages seem powerful in the long run but I think we have to fix antibiotics in the short-run.

    Whether or not it is in vitro a tissue sample is often not representative of in vivo anyway. And what did you mean by "evolutionary life-form"?
  • 1dominator11dominator1 Members Join Date: 2010-11-19 Member: 75011Posts: 1,171 Advanced user
    edited January 2014
    As far as society goes I would welcome a good plague, even if it would cost me dearly. Also I have never taken antibiotics for a cut, minor or otherwise, so I doubt that it is true. We still have immune systems, for the moment...
    As for phage therapy, that has been the go to equivalent of antibiotics in the 2nd world for much of the 20th century (not that anyone here knows, their scientific literature has only recently been translated), and as you can see they have yet to succumb to disease epidemics so I for one would not be too worried.
  • AlignAlign Remain Calm Forum Moderators, Constellation Join Date: 2002-11-02 Member: 5216Posts: 8,207 mod
    As far as society goes I would welcome a good plague, even if it would cost me dearly.
    What. Why?
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