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posted by janrinok on Wednesday August 31 2016, @12:07PM   Printer-friendly

The World Health Organization (WHO) is recommending the use of cephalosporins to treat gonorrhea rather than quinolones, due to emergence of quinolone-resistant strains. However, some strains of gonorrhea are already resistant to drugs in the newly recommended class of antibiotics:

The U.S. Centers for Disease Control and Prevention warned back in 2012 that one of two drugs in the class of antibiotics the WHO now recommends, cephalosporins, was in danger of becoming useless to treat gonorrhea, at least in the U.S, and recommended that doctors stop prescribing it. Since then, the CDC's recommended treatment for gonorrhea has been a dual therapy, with the two antibiotics ceftriaxone and azithromycin, but an analysis in July warned that the bacteria could even become resistant to that combination.

As for when antibiotic options will run out altogether, Teodora Wi of the WHO's Department of Reproductive Health and Research tells the journal Science, "We will have to have new drugs in 5 years, I think." The U.S. government is spending millions of dollars through the CDC and National Institutes of Health to develop new antibiotics and combat resistance.

The WHO also revised its guidelines for treating two other sexually transmitted infections, chlamydia and syphilis. Neither is facing severe antibiotic resistance. Syphilis, for example, can be treated with a single dose of penicillin, although there is a worldwide shortage of the drug.


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  • (Score: 2) by VLM on Wednesday August 31 2016, @01:22PM

    by VLM (445) Subscriber Badge on Wednesday August 31 2016, @01:22PM (#395662)

    Maybe much like an AIDS cure would kill the pharma industry, they're better off financially trying to treat the symptoms and slow the rate of death than to cure.

    So I suspect the PR handwringing is just handwringing.

    So what pills are in the pipeline to treat the symptoms while not curing the infection? Thats the real question to be asked about new products.

    Starting Score:    1  point
    Karma-Bonus Modifier   +1  

    Total Score:   2  
  • (Score: 3, Interesting) by Francis on Wednesday August 31 2016, @01:32PM

    by Francis (5544) on Wednesday August 31 2016, @01:32PM (#395666)

    The issue here is that ranchers, doctors and patients have been fucking this up. The pharmaceutical companies have run out of most easily obtained antibiotics and are having to go to greater and greater lengths to get new antibiotics.

    Ultimately the solution is to stop screwing around and switch to phages, but the FDA procedures for approving them would cost literally billions each time they want to provide treatment. So we'll wind up with incurable ecoli outbreaks because we refused to do the right thing before running out of effective antibiotics.

    You can thank doctors for overprescribing them, patients for not finishing the prescribed treatment and ranchers for using antibiotics on healthy cows to improve their value for antibiotic resistance.

    • (Score: 2) by Gravis on Wednesday August 31 2016, @01:50PM

      by Gravis (4596) on Wednesday August 31 2016, @01:50PM (#395673)

      Ultimately the solution is to stop screwing around and switch to phages,

      actually, you had it right the first time: the ultimate solution to STDs is to stop screwing around. using phages may work (for now) but it's not an ultimate solution. it's survival of the fittest and nature doesn't care about people's morals or your objections to them.

      • (Score: 1) by Francis on Wednesday August 31 2016, @02:02PM

        by Francis (5544) on Wednesday August 31 2016, @02:02PM (#395681)

        Phages will work for anything in perpetuity. When the bacteria evolve, the phages evolve. The problems are things like certain strains ecoli that are fatal in tiny concentrations. And that's not something that they need to do to survive.

        Each time they use phages they take a sample and use an appropriate page. They're not using them on large segments of the population.

        • (Score: 0) by Anonymous Coward on Wednesday August 31 2016, @02:10PM

          by Anonymous Coward on Wednesday August 31 2016, @02:10PM (#395688)
          Which is why they don't work so well for the conventional FDA approval process. They are like a different drug each time.
    • (Score: -1, Redundant) by Anonymous Coward on Wednesday August 31 2016, @02:12PM

      by Anonymous Coward on Wednesday August 31 2016, @02:12PM (#395690)

      What ranchers have been doing to cows is disgusting. SMH

    • (Score: 2) by Kromagv0 on Wednesday August 31 2016, @06:46PM

      by Kromagv0 (1825) on Wednesday August 31 2016, @06:46PM (#395794) Homepage

      ranchers for using antibiotics on healthy cows to improve their value

      It isn't just ranchers but most farmers who raise livestock. While they are given to livestock to improve their value, through additional weight gain of 100-200lbs, they are also used preemptively. When you have animals knee deep in their own shit eating nose to nose disease spreads quickly. Add in that the diet that is fed to feed lot cattle is really awful and cramming cheap antibiotics in them pays off in spades especially since they can be brought to market quicker. Then again I don't buy meat raised like that , and by the way bacon that comes from pigs that have mostly been fed ice cream is awesome.

      --
      T-Shirts and bumper stickers [zazzle.com] to offend someone
      • (Score: 2) by VLM on Friday September 02 2016, @12:16PM

        by VLM (445) Subscriber Badge on Friday September 02 2016, @12:16PM (#396634)

        and by the way bacon that comes from pigs that have mostly been fed ice cream is awesome.

        "Long pig" or more to story?

  • (Score: 2) by Gravis on Wednesday August 31 2016, @01:39PM

    by Gravis (4596) on Wednesday August 31 2016, @01:39PM (#395669)

    sir, your tinfoil hat does not mean regulation standards.

  • (Score: 5, Interesting) by Hartree on Wednesday August 31 2016, @01:54PM

    by Hartree (195) on Wednesday August 31 2016, @01:54PM (#395675)

    "an AIDS cure would kill the pharma industry"

    Nonsense. None of the drugs for it are even in the top ten in terms of profits for them. There just aren't enough AIDS patient in wealthy countries for it to be.

    If you want profits go for cholesterol meds (Lipitor for example), or gastro-esophageal reflux treatments like Nexium or psychiatric meds. Large numbers of people use them.

    (I'm hardly defending big pharma. They are many times incredibly cutthroat. It's just AIDS is a poor example in this case.)

    Much of the problem with antibiotic resistance is that Mom Nature is just so much better at this game than we are. Organisms have been adapting to antibiotics produced by other bacteria or the creatures they infect for billions of years. In fact, most of the resistance genes that bacteria use against our antibiotics are old. They just were only in a very small subset of the population because there's a cost to carry them along and make the product they code for. (Example: Making lots of Beta Lactamase uses up cellular resources and isn't worth it unless something is making lots of penicillin-like antibiotics in your environment.)

    Yes, we do get some new adaptations, but mostly it's just Mom Nature resurrecting something from a game she played millions/billions of years ago. Humans with our "wonder drugs" are Johnny come latelies, and most weren't created by us. We borrowed them from existing microorganisms. It's no surprise there would be a countermeasure out there.

    • (Score: 2) by TheRaven on Thursday September 01 2016, @03:39PM

      by TheRaven (270) on Thursday September 01 2016, @03:39PM (#396211) Journal

      Add to that, a cure for AIDS would be a huge PR win, in an industry where most players spend as much on marketing as they do on R&D. It's hard to buy PR like being able to put in every advert: 'Buy drug X, from the people that eradicated AIDS'.

      --
      sudo mod me up
  • (Score: 2, Insightful) by Anonymous Coward on Wednesday August 31 2016, @01:56PM

    by Anonymous Coward on Wednesday August 31 2016, @01:56PM (#395676)

    I think much of the problem with antibiotic resistance is the fact that doctors, at least here in the U.S., way way way under prescribe dosages. In other countries the dosages are much higher. The reason is that the FDA puts a very strict limit on dosages for various situations.

    The problem with this is that the prescribed dosage isn't strong enough to completely eliminate the infection the first time around. So when the infection recovers it is now resistant and even a much higher dosage won't work anymore. Now these resistant organisms start spreading.

    If you are going to prescribe an antibiotic or antihelminth you better make sure the dosage is sufficient from the first time. Otherwise the only think you're going to end up with are antibiotic resistant organisms.

    • (Score: 1, Insightful) by Anonymous Coward on Wednesday August 31 2016, @03:33PM

      by Anonymous Coward on Wednesday August 31 2016, @03:33PM (#395713)

      No. The real problem in the USA is this: http://www.politifact.com/truth-o-meter/statements/2013/oct/15/louise-slaughter/rep-louise-slaughter-says-80-antibiotics-are-fed-l/ [politifact.com]

      Most antibiotics are fed to livestock that aren't sick. This creates a _constant_ environment where only resistant bacteria can live. Hospitals are another such place. Whereas if you take a course of antibiotics only once every few years, after those few years the descendants of the resistant bacteria might be rather different (think of how many bacterial generations is a few years) or they might even get outcompeted/displaced by other bacteria and stuff.

      But you then eat a hamburger patty that has e-coli because due to typical slaughterhouse practices too much shit gets in the meat. And the e-coli is resistant to antibiotics because the cows get antibiotics all the time.

      Or you go to a hospital for some surgery and then while you're there you get the antibiotic resistant strain of MRSA that hangs about in hospitals, because hospitals use antibiotics all the time: http://www.decodedscience.org/hospital-acquired-methicillin-resistant-staphylococcus-aureus-infections-prove-hazardous-to-hospital-inpatients/18273 [decodedscience.org]
      See also: http://www.latimes.com/business/la-fi-superbug-sewers-20160307-story.html [latimes.com]

      • (Score: 0) by Anonymous Coward on Wednesday August 31 2016, @04:37PM

        by Anonymous Coward on Wednesday August 31 2016, @04:37PM (#395732)

        Part of not being PC is dealing with reality.

        Part of my friends job was going out and notifying people that they had potentially been exposed to XYZ and should see a doctor and get tested. He did this for diseases where treatment is mandatory like TB, and where under our state law you can be compelled to say who you slept with for STDs. He told me about homosexual men and women who would routinely rattle off a list of 30+ names of recent partners but most of them unreachable because they only had a first name and prostitutes who had the same issue. Almost every new STD variant first showed up in the gay community, then blacks, hookers, and finally the general population. That pattern likely holds true today. Some were particularly nasty variants that caused cancers that were almost entirely unique to the gay community for almost a decade. This issue was a problem even in the 1990's due not only to non-compliance, but a lack of regular testing, exceedingly high levels of promiscuity and these organisms evolving. Eventually the health department began running PCR samples more routinely as it became cheaper to do so and often found people with 3-4 variants of the same STD. Even the threat of AIDS did not get most people to substantially modify behavior, and notifications there were even less fun. He even told me about "positive" clubs where people would literally come to be infected (if it sounds insane it is, but ...). Nothing that has been tried has really made a dent in human behavior. He worked for the department of health during the 1990' and into the early 2000's before going to work for the veterans administration.

        If you want to target human compliance for STDs those are your target groups. I wish you luck and I hope you have some better ideas than what has been tried. Even criminalizing certain behaviors has not made a dent nor is it likely to as prosecution is rare even in AIDS cases. I don't think any of this changes without a very large budget PR campaign to attempt to modify behaviors, and in the current political environment that is simply not going to happen.

        • (Score: 2) by Azuma Hazuki on Wednesday August 31 2016, @05:22PM

          by Azuma Hazuki (5086) on Wednesday August 31 2016, @05:22PM (#395751) Journal

          Statistically speaking, gay women have LOWER rates of almost every STD out there; I think the only exception was some form of mild chlamydia, and I will bet my shiny gold star THAT one was introduced by some bisexual woman who caught it off a man.

          The risk factor seems to be lack of forethought and self-control, and men seem to have more of a problem with this than women do for whatever reason. That old joke about the U-Haul on the second date has some truth to it.

          --
          I am "that girl" your mother warned you about...
          • (Score: 0) by Anonymous Coward on Wednesday August 31 2016, @10:29PM

            by Anonymous Coward on Wednesday August 31 2016, @10:29PM (#395900)

            The risk factor seems to be lack of forethought and self-control, and men seem to have more of a problem with this than women do for whatever reason.

            Have a reference for that? What are the usage rates of barrier contraceptives for gay women verses gay men?

            Transmission of STDs are highly dependent on the type of sexual activity.

            • (Score: 3, Funny) by Azuma Hazuki on Thursday September 01 2016, @07:15AM

              by Azuma Hazuki (5086) on Thursday September 01 2016, @07:15AM (#396068) Journal

              Number of partners is the major risk factor, from the sound of it.

              In case you're not familiar with it, the U-Haul joke is:
              Q - what does a lesbian do on the second date?
              A - she drives up in a moving van with all her stuff!

              This is tongue in cheek (or something else...sorry, not sorry), but unintentionally very revealing, as is the follow up "Q - Okay, then what does a gay guy do on the second date? A - *What* second date?" Obviously you can't generalize to millions of people, especially not through humor, topical as it may be. But it's not for nothing that these have been stereotypes since before I was born.

              Unpacking it, what this means is gay women tend to bond *hard;* the worst you can (could?) say about most of us is we're serial monogamists. I've only had one sexual partner, of three relationships total (one ongoing), and I don't--can't!--do casual sex. As you may expect, regular STD screenings turn up clean. It's not lesbians you hear about when people mention the Castro district. Whatever the reason, men seem a lot more motivated to have sex with a lot of partners. Maybe something evolutionary?

              It follows, then, that if having a lot of partners is likely to get you infected, all else being equal, the group with the most partners per person will have the most STDs. And all else is NOT equal: fingering is a lot less likely to get you something nasty than anal sex for example.

              --
              I am "that girl" your mother warned you about...
        • (Score: 0) by Anonymous Coward on Wednesday August 31 2016, @06:09PM

          by Anonymous Coward on Wednesday August 31 2016, @06:09PM (#395768)

          Another quite convincing argument to vote for Clinton, right here on Soylent news!

  • (Score: 0) by Anonymous Coward on Wednesday August 31 2016, @08:34PM

    by Anonymous Coward on Wednesday August 31 2016, @08:34PM (#395845)

    an AIDS cure would kill the pharma industry

    Citation needed.

    Whichever pharmaceutical company that came up with it would make a boat-load of money and get a lot of free advertising. The cure for HCV has made Gilead a lot of money.

    they're better off financially trying to treat the symptoms and slow the rate of death than to cure

    If they could predict the future, form a giant conspiracy with their competitors, and hide the positive clinical trial results from their investors/doctors/scientists/FDA/employees. Also, they would need people that value slower long-term profit over a large short-term profit (we all know how common a trait that is in CEOs).

    https://en.wikipedia.org/wiki/Sofosbuvir [wikipedia.org]