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posted by hubie on Monday February 03, @05:25PM   Printer-friendly

A 2015 article in The Atlantic describes the problem of antibiotic resistance and some of its causes (alternative link):

The overuse of antibiotics, both in human patients and, importantly, in livestock, has led to an explosion of antibiotic-resistant bacteria, both in the U.S. and around the world. Deaths from resistant infections are currently at about 700,000 per year, and estimated to rise to 10 million per year by 2050. If nothing changes, the World Health Organization predicts the future will look a lot like the past—where people die from minor injuries that become infected.

Though new drugs are an important piece of the puzzle, Laxminarayan worried that there isn't enough being done to monitor the use of the ones we have. "What I worry about more than the development of new drugs is the lack of money for things like surveillance and stewardship," he said. "You can have a new drug five years from now, but that could go obsolete if we use it inappropriately."

Examples of inappropriate use include starting patients on antibiotics before test results come back, putting them on a broad-spectrum antibiotic when it's unclear what bacteria is causing the infection, or keeping them on the drugs even when tests come back negative.

It can take a few days to get the results from growing a culture to identify the specific bacteria responsible for a serious infection. In those instances, it may be necessary to prescribe a broad spectrum antibiotic while awaiting the results of the culture. Although there are exceptions to these guidelines, antibiotics are overused, and this contributes to the growing problem of antibiotic resistance. Antibiotics also aren't especially profitable for pharmaceutical companies because they're only needed when a person has a bacterial infection. If bacteria quickly develop resistance to new drugs, it might prevent companies from making a return on their investment in new antibiotics. A more recent article in Chemical & Engineering News discusses some of the regulatory and economic barriers to new antibiotics:

Zevtera is one of three antibiotics to gain FDA approval for humans so far [in 2024], and the only systemic one. The other two are for urinary tract infections (UTIs): Utility Therapeutics' Pivya, for uncomplicated UTIs; and Allecra Therapeutics' Exblifep, for complicated, or drug-resistant, UTIs.

But outside of 2024, the US has approved few new antibiotics in recent years. Only 17 new systemic antibiotics and one related biologic netted approval between 2010 and May 2021 (Ann. Pharmacother. 2022, DOI: 10.1177/10600280211031390). Experts worry that even that number could represent a peak. These approvals were decades in the making, and a labyrinth of scientific, financial, and regulatory challenges are sending today's antibiotic developers fleeing.

In biotech, there's a concept called the valley of death. It marks the stretch of time between when a firm discovers promising science and when that science is de-risked enough, usually with human data, that the firm can raise money to advance it. In antibiotics, there's a second valley of death that takes place after regulatory approval and before the company can sell enough of the drug to become financially solvent.

There are novel machine learning algorithms to identify possible new antibiotics including applying the same techniques used in large language models. New antibiotics have been proposed to exploit the mechanisms used by bacteria to develop antibiotic resistance. Although this research is promising, it is only helpful in solving the antibiotic resistance problem if these antibiotics are eventually used widely to treat infections. That may require changes to existing policies about how antibiotics are used and the regulatory requirements to gain approval before they are brought to market.


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  • (Score: 5, Insightful) by Frosty Piss on Monday February 03, @05:38PM (6 children)

    by Frosty Piss (4971) on Monday February 03, @05:38PM (#1391409)

    All of this is true, and well known. And while the Agencies in charge of setting policy about these things certainly has left much to be desired, expect action related to any actual science under the current Junta to be nonexistent.

    • (Score: 4, Insightful) by Thexalon on Monday February 03, @05:45PM (1 child)

      by Thexalon (636) on Monday February 03, @05:45PM (#1391410)

      We have a classic collective action problem: For any individual patient and doctor, "gimme that amoxicillin!" is a rational response that both maximizes the chances nothing bad happens to them and no malpractice suit is filed. But if everybody does that, then we're all collectively screwed as amoxicillin resistance works its way into the bacteria population.

      So what's actually going to happen is nothing, until it's too late, at which point most of the alleged leaders of the affected societies will panic and blame somebody else for the problem.

      --
      "Think of how stupid the average person is. Then realize half of 'em are stupider than that." - George Carlin
      • (Score: 2) by looorg on Monday February 03, @07:52PM

        by looorg (578) on Monday February 03, @07:52PM (#1391431)

        Are they eventually now then not going to sue them for giving them to much antibiotics? Completely messing them up. In the end someone always gets sued.

        Yes it is a problem that they had it out like it was candy for everything. They can't just say take two aspirin, have a rest for a few days and drink some water. Nope. It has to be antibiotics for everything. The maximum legal dosage before it kills you -- none of that normal strength shit. Extra Maximum Mega Strength Quick Acting Long Lasting Dosage! Or whatever it is the commercials are claiming. Clearly it's for you!

        No matter how bad things might be in the US tho there are countries out there that doesn't have any kind of regulation at all. Antibiotics for everything over the counter all the time. It just comes in a plastic baggie. In humans and animals and everywhere. Constantly. You coughed or looked a bit pale, here have some antibiotics of some kind. Have two. Which is probably why we are screwed.

        The policy needed is that actual Medical Doctors should tell people NO. You don't need it. Go home and rest. Drink some water. Not everything needs antibiotics. You'll heal without them. But they don't cause the patient will get angry and they'll just go see another doctor or they'll order some online from some source. Cause they think they need them to heal.

    • (Score: 4, Insightful) by Anonymous Coward on Monday February 03, @07:06PM (3 children)

      by Anonymous Coward on Monday February 03, @07:06PM (#1391424)

      I thought that the major overuse of antibiotics was in animal feed--where it makes it possible to cram the chickens/cows/?? into smaller spaces, and may even assist with shorter time to slaughter (faster maturity)?

       

      • (Score: 5, Insightful) by looorg on Monday February 03, @07:54PM (2 children)

        by looorg (578) on Monday February 03, @07:54PM (#1391432)

        That is indeed a common problem in some countries. Antibiotics in everything. Maximum growth and slaughter weight. It's also for humans in some countries for just everything. All that ails can apparently be helped along with a large over the counter antibiotics. No need to be very specific. It's all good.

        • (Score: 0) by Anonymous Coward on Monday February 03, @08:07PM

          by Anonymous Coward on Monday February 03, @08:07PM (#1391435)

          Maximum growth and slaughter weight... also for humans

          Yep, the meat is for the man, the bone is for the dog.

          DOGE will set policy. We can trust them, right?

        • (Score: 2) by Username on Tuesday February 04, @03:40PM

          by Username (4557) on Tuesday February 04, @03:40PM (#1391541)

          I love the liberty in Mexico. Just go into the store and buy $5 of amoxicillin that would cost $50 here, plus doctor visit, around $125 total. We should have that here.

  • (Score: 5, Insightful) by FuzzyTheBear on Monday February 03, @05:56PM

    by FuzzyTheBear (974) on Monday February 03, @05:56PM (#1391412)

    With the dismantling of the US government well under way , all the people in position to help will be gone , fired or their whole departments closed.
    Good luck USA>

  • (Score: 5, Insightful) by Anonymous Coward on Monday February 03, @06:18PM (1 child)

    by Anonymous Coward on Monday February 03, @06:18PM (#1391415)

    We are all going to die if we don't develop a resistance to Musk.

    Our government now serves the president, not the public. There will be no policy for the benefit of the public. It seems almost silly to discuss "policy" under this regime, self inflicted pain. We are in deep trouble, would appreciate some thoughts and prayers.

    • (Score: 0) by Anonymous Coward on Wednesday February 05, @02:52PM

      by Anonymous Coward on Wednesday February 05, @02:52PM (#1391733)

      Don't ya know, the law of the Universe is you serve the guy with the money. Aka worship Mammon just like it says in the Biiiiible praise tha Laaard!

  • (Score: 3, Interesting) by EJ on Monday February 03, @10:08PM (1 child)

    by EJ (2452) on Monday February 03, @10:08PM (#1391455)

    This is another in a long list of reasons why I think we will never encounter extraterrestrials. Even if they don't annihilate each other in wars, all sentient lifeforms will probably science themselves to death in one way or another trying to control things that can't be controlled.

    I know this may seem a little off-topic, but consider that WE are the "aliens" some other civilization is out there wondering about why we haven't visited them. Maybe we will all die off before we get the chance.

    • (Score: 4, Insightful) by sgleysti on Monday February 03, @10:46PM

      by sgleysti (56) Subscriber Badge on Monday February 03, @10:46PM (#1391461)

      I think it's on topic.

      It's kind of amazing our species survived the cold war. I attribute this to dumb luck.

  • (Score: 5, Insightful) by Azuma Hazuki on Tuesday February 04, @01:23AM (1 child)

    by Azuma Hazuki (5086) on Tuesday February 04, @01:23AM (#1391475) Journal

    ...this scares the everloving mess out of me and has been doing so for years. There are some bugs out there that are immune to essentially everything we can throw at them, including the horrible last-resort ones like colistin. New derived classes of antibiotic are being worked on, but they're similar enough to existing ones -- think "what if we took this tetracycline structure and added a bit to it?" -- that I don't see too much progress.

    --
    I am "that girl" your mother warned you about...
    • (Score: 0) by Anonymous Coward on Wednesday February 05, @02:54PM

      by Anonymous Coward on Wednesday February 05, @02:54PM (#1391734)

      Wait, I have an idea... what if we.... inject..... hold on, it's coming..... inject bleach??! Right in the eyeball!! Boss says let's do it!

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