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posted by mrpg on Friday November 18, @10:44PM   Printer-friendly

https://www.wired.com/story/the-6-billion-dollar-shot-at-making-new-antibiotics-before-the-old-ones-fail/

[...] A piece of legislation lined up for a vote in Congress, called the Pasteur Act (named both for the 19th-century microbiologist and to stand for Pioneering Antimicrobial Subscriptions to End Upsurging Resistance), could repopulate that empty landscape by guaranteeing government funds to help a small number of new antibiotics make it to market. The proposal has bipartisan support in both the House and Senate, is backed by the Department of Health and Human Services (HHS), was implicitly endorsed in the last White House budget, and resembles programs already implemented in other countries.

[...] "If this doesn't pass, or something like it doesn't get implemented, then I don't know what Plan B is," says Joe Larsen, a vice president at Locus Biosciences Inc. who launched an Obama–era program of antibiotic investment while serving in the US government's Biomedical Advanced Research Development Authority. "We need to re-envision the way we support antimicrobials in the US."

That patients might run out of effective antibiotics is a jarring thought. The Centers for Disease Control and Prevention estimates that antibiotic-resistant infections already kill more than 48,000 Americans each year and sicken 2.8 million. A January study in The Lancet estimated the annual global death toll at 1.27 million. Antibiotic resistance got worse during the pandemic as health care workers tried to protect Covid patients from bacterial infections, not just in individual outbreaks in hospitals but across the US.

[...] Lacking enough income to balance their expenditures, the big companies left the field to small biotechs. These new players believe in the mission, but typically don't have income from other product lines to buoy them while they wait for sales. Since 2010, the makers of five out of 15 new antibiotics approved by the FDA have folded or sold themselves at auction because they could not outlast the lag between approval and earnings. A sixth company backed off an antibiotic in Phase 3 trials in May and laid off three-fourths of its staff. A seventh reorganized itself just last month.


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  • (Score: -1, Flamebait) by Rodxit on Friday November 18, @11:15PM (6 children)

    by Rodxit (16192) on Friday November 18, @11:15PM (#1280413)

    Phage therapy: An alternative to antibiotics in the age of multi-drug resistance https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547374/ [nih.gov]
    * The Russian are the leading authority in this alternative to antibiotics.
      Jesus Christ the Russian. If the Russian use it, it must be wicked.
    * There is no immunity to being eaten. Ever.
      Jesus Christ are you stupid you can't sell a sort of drug without a clear follow-up drug update path.
    * Unlikely to have side effects.
      Which part of clear follow-up drug update AND side path did you not get ?

    • (Score: 4, Touché) by HiThere on Saturday November 19, @04:03AM (4 children)

      by HiThere (866) on Saturday November 19, @04:03AM (#1280438) Journal

      1) phage therapy is a lot more complicated than you are suggesting.
      2) sorry, but immunity happens. The normal answer is to switch phages until you find one that works. Just like with antibiotics.
      3) side effects aren't unusual.

      That said, it is a reasonable approach to investigate more than we have. But it's sure not likely to be a panacea.

      --
      Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
      • (Score: -1, Flamebait) by Rodxit on Saturday November 19, @10:53AM (3 children)

        by Rodxit (16192) on Saturday November 19, @10:53AM (#1280479)

        You have not read the paper. Stupid.
        Or you have read the paper and still claim lies.
        --
        Don't argue with fools they will drag you down to their level and beat you with experience.

        • (Score: 3, Insightful) by khallow on Saturday November 19, @01:56PM (2 children)

          by khallow (3766) Subscriber Badge on Saturday November 19, @01:56PM (#1280492) Journal

          You have not read the paper. Stupid.

          HiThere's point remains no matter what's said in that paper. In particular, 2) and 3) are obvious. Evolved resistance is going to be a thing because it's something that bacteria have done for billions of years with respect to viruses.

          And side effects are inevitable because bacteria don't die nice. Just from my layman point of view, I can think of a few sources for side effects. There will be leftover protein fragments and such. A sudden large population of phages will trigger the immune system and they can get around the human body a lot better than bacteria can (due to their smaller size). For example, we might see inflammation of tissues in areas far from the infection site. While it would presumably be rare, there's the possibility of those phages damaging human cells by latching on to similar protein sites (with a rarer chance of actual infection).

          Antibiotics have their own massive side effects such as collapsing intestinal fauna, similar storms of protein fragments, and a rigid delivery schedule so that's not a deal killer. But it's foolish to only consider one side of the balance sheet.

          There's another problem here, 4) time lag. Even if we assume that phage therapy can kill infections just as fast as antibiotics, we still would have to deliver phages that are compatible with the bacteria in question. That means identifying the infectious agent so that you can deliver the right selection of phage agents. There's a time loop that's not present in the "we have signs of bacterial infection, let's put you on antibiotics" choice. Presently, running tests like that can take hours to days.

          Or you have read the paper and still claim lies.

          Because the only way anyone could ever disagree with you is by ignorance or lies? Not because they understand this problem better than you, right? That plus the earlier, pointless quip about the Russians (ignoring that nation's great weaknesses in other areas of biology and medicine, as well as economic dystopia, that will hamper their development of phage therapy) just indicates that you came into this with a huge chip on your shoulder.

          • (Score: 2) by HiThere on Saturday November 19, @02:32PM

            by HiThere (866) on Saturday November 19, @02:32PM (#1280496) Journal

            Well, the Russians *are* more "advanced" in the area of phage solutions. There are good historic reasons for that, and some that are just quirks, but it's true. And if I had been responding to his points literally, rather than as they were (I assume) intended to be taken, they would appear more effective. E.g. most things don't do well after being eaten. Roundworms are one of many exceptions, though. But the real thing is that evolution keeps happening, so any treatment will have ways evolved around it. Even autoclaves became less effective over time. (They *could* have opted for raising the temperature, but they chose, instead, to switch to single use items.)

            Also there are clearly situations where phage treatment is optimal. But they aren't common.

            All that said, how should invasive fungi be treated? We don't have many good treatments, and it's worrying. Fungi are a lot more similar to chordates than are microbes. Phage therapy should be investigated for this as we don't have much else. If it gets a good toe-hold in one niche, then it can expand from then in appropriate circumstances. But it's not going to be a simple process.

            --
            Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
          • (Score: 1) by shrewdsheep on Sunday November 20, @02:38PM

            by shrewdsheep (5215) on Sunday November 20, @02:38PM (#1280676)

            And side effects are inevitable because bacteria don't die nice. Just from my layman point of view, I can think of a few sources for side effects. There will be leftover protein fragments and such.

            Well, that is not the source of side-effects. All of life shares a common origin and very similar cellular processes. Antibiotics therefore have to disturb processes in bacteria while sparing human/animal ones. The low-hanging fruit has been picked already like cell walls (which are quite bacteria specific) and differences in the replication cycle (like ribosomes). Targeting new biological processes makes them more likely to be more closely shared between bacteria and humans making side effects more likely.

            Antibiotics are toxic substances. Only take them if you need them.

    • (Score: 0) by Anonymous Coward on Saturday November 19, @06:26AM

      by Anonymous Coward on Saturday November 19, @06:26AM (#1280462)
      Problem with phage therapy is standardization. The phages used aren't like an active chemical that's the same for all treatment. They are viruses and they can evolve. Also when they're looking for phages that can kill the bacteria they kinda take samples from often unsanitary places and then look for what seems to kill the target bacteria.

      So one batch might be different from another. So if the FDA certifies one batch does that mean all other batches are also certified?

      It's for a similar reason the "poop transplant" treatment for IBS etc had issues getting certified even if it worked. They had to come up with "standardized poop" bacteria.
  • (Score: 2) by MIRV888 on Saturday November 19, @05:27AM (1 child)

    by MIRV888 (11376) on Saturday November 19, @05:27AM (#1280449)

    ' Lacking enough income to balance their expenditures, the big companies left the field'
    Big Companies drop a medicine because it's not profitable. The 'small biotechs' get the scraps from the giants.
    All of it hinges on very important medications being profitable as apposed to necessary.

    • (Score: 0) by Anonymous Coward on Saturday November 19, @12:45PM

      by Anonymous Coward on Saturday November 19, @12:45PM (#1280486)

      It's a TV game show. You have a choice of two doors, both glass that you can see through.
      One of the doors has a table behind it with a small pile of money, neatly stacked, the other a much larger messy pile and you can see $100 bills sticking out all over.

      Which door do you choose? It's always possible that the big messy pile is nearly all $1 bills with the $100s strategically placed, but not all that likely.

      Pretty clearly these companies have enough of a view of the future to choose the (potentially) more profitable product.

  • (Score: -1, Troll) by Username on Saturday November 19, @02:59PM

    by Username (4557) on Saturday November 19, @02:59PM (#1280500)

    I don't think the government, the people who legislate what laws you must obey, should be in the business of making drugs. Even if it just starts out as aspirin.

    programs already implemented in other countries

    So, why not just buy their drugs if we need them? Let India, Afghanistan, some other place be the drug country. I proudly support afgan antibiotics.

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