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Imagining the Post-Antibiotic Future

samzenpus posted about 10 months ago | from the no-more-pills dept.

Medicine 453

Hugh Pickens DOT Com writes "Health authorities have been struggling to convince the public that the threat of totally drug-resistant bacteria is a crisis. Earlier this year, British chief medical officer Sally Davies described resistance to antibiotics as a 'catastrophic global threat' that should be ranked alongside terrorism. In September, Dr. Thomas Frieden, the director of the U.S. Centers for Disease Control and Prevention, issued a blunt warning: 'If we're not careful, we will soon be in a post-antibiotic era. For some patients and some microbes, we are already there.' Now Maryn McKenna writes that we are on the verge of entering a new era in history and asks us to imagine what our lives would be like if we really lost antibiotics to advancing drug resistance. We'll not just lose the ability to treat infectious disease; that's obvious. But also: The ability to treat cancer, and to transplant organs, because doing those successfully relies on suppressing the immune system and willingly making ourselves vulnerable to infection. We'll lose any treatment that relies on a permanent port into the bloodstream — for instance, kidney dialysis. We'd lose any major open-cavity surgery, on the heart, the lungs, the abdomen. We'd lose implantable devices: new hips, new knees, new heart valves. We'd lose the ability to treat people after traumatic accidents, as major as crashing your car and as minor as your kid falling out of a tree. We'd lose the safety of modern childbirth. We'd lose a good portion of our cheap modern food supply because most of the meat we eat in the industrialized world is raised with the routine use of antibiotics, to fatten livestock and protect them from the conditions in which the animals are raised. 'And it wouldn't be just meat. Antibiotics are used in plant agriculture as well, especially on fruit. Right now, a drug-resistant version of the bacterial disease fire blight is attacking American apple crops,' writes McKenna. 'There's currently one drug left to fight it.'"

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terrorism! ha! (5, Interesting)

Anonymous Coward | about 10 months ago | (#45489923)

If this is a threat that "should be ranked alongside terrorism" then I'm not even going to waste my time reading about it.

Re:terrorism! ha! (2)

somersault (912633) | about 10 months ago | (#45489979)

I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.

Plus how the hell is falling out of a tree any less dangerous than being in a car crash? I'd rather be surrounded by steel and air-bags if something hard is going to be slammed into my body.. uh, well, that sounded a bit wrong, but whatever.

Maybe the author's point was that they don't love their kids, because having your kid get hurt isn't as bad as risking yourself..?

Re:terrorism! ha! (5, Insightful)

Dcnjoe60 (682885) | about 10 months ago | (#45490079)

I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.

Plus how the hell is falling out of a tree any less dangerous than being in a car crash? I'd rather be surrounded by steel and air-bags if something hard is going to be slammed into my body.. uh, well, that sounded a bit wrong, but whatever.

Maybe the author's point was that they don't love their kids, because having your kid get hurt isn't as bad as risking yourself..?

The author's point was that falling out of a tree usually causes a minimum of a cut or abrasion in the skin. Likewise a car accident. No antibiotics means even a minor break in the skin could become life threatening.

Re:terrorism! ha! (5, Insightful)

Anonymous Coward | about 10 months ago | (#45490197)

I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.

Plus how the hell is falling out of a tree any less dangerous than being in a car crash? I'd rather be surrounded by steel and air-bags if something hard is going to be slammed into my body.. uh, well, that sounded a bit wrong, but whatever.

Maybe the author's point was that they don't love their kids, because having your kid get hurt isn't as bad as risking yourself..?

The author's point was that falling out of a tree usually causes a minimum of a cut or abrasion in the skin. Likewise a car accident. No antibiotics means even a minor break in the skin could become life threatening.

This is where they lost me. How often are scrapes and cuts (or even car accidents) treated with antibiotics? Sure, major lesions will warrant a general antibiotic, but in my first three decades of life i can count on one hand the number of times I took antibiotics, and almost all of them were preventative (meaning even without them, the risk to life was statistically indistinguishable from 0). Trying to rally the public with "if you get a scrape you will die" is pretty much fear mongering. And fear mongers can fuck right off.

Re:terrorism! ha! (5, Insightful)

bunratty (545641) | about 10 months ago | (#45490327)

They didn't say "if you get a scrape you will die." They said "if you get a scrape you could potentially die," which is a factual statement if we have no effective antibiotics.

This is a common strawman argument. Restate a scientists' position so that it is extreme, then chide the scientists for taking such an extreme position. It seems to be remarkably effective with a significant percentage of the population, but it seems transparent enough to me.

Re:terrorism! ha! (0)

Anonymous Coward | about 10 months ago | (#45490351)

> They said "if you get a scrape you could potentially die," which is a factual statement if we have no effective antibiotics.

This is factual even with antibiotics.

In fact we tend to forget the only actual fact of life: you will eventually die.

Re:terrorism! ha! (2)

dargaud (518470) | about 10 months ago | (#45490445)

Yeah, per the article one in 9 people who get a skin infection after something as minor as a scrape... dies. That's food for thoughts.
Barely a few years ago there was a violent discussion on /. about adding antibiotics to cattle fodder. There were plenty of shills who defended it as safe. And I remember that I wrote that it would be our downfall. I tried to find that discussion again without success. I wish /. would implement a better search algo so that we can for instance search our own past posts.

Re:terrorism! ha! (1)

Cro Magnon (467622) | about 10 months ago | (#45490363)

Absolutely! I'm in my 50s, and I've taken antibiotics twice, both preventative after dental work. Cuts and scrapes get soap and bandages.

Re:terrorism! ha! (0)

martyros (588782) | about 10 months ago | (#45490465)

Cuts and scrapes get soap and bandages.

Of course, and that's the right thing to do -- until such time as you discover that your leg has actually been infected, and that you need antibiotics. It doesn't happen very often, but when it does, it can be incredibly dangerous. I don't know what the rate of bacterial infection is for falling out of a tree, but let's say it was 1 in 1,000. No antibiotics means that goes from "1 in 1000 children who scrape their knee hospitalized" to "1 in 1000 children who scrape their knee die", which is pretty bad.

Re:terrorism! ha! (3, Insightful)

Anonymous Coward | about 10 months ago | (#45490107)

I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.

Not in the US. Here in the land of the "free to lobby and oppose just because" any politician that comes out in favor of dealing with this situation will be attacked by the opposition for doing so (anti-business, anti-health, anti-patriotic, anti-think_about_the_children, anti-etc). They will face the war chests of some anti-politician's_name_here group and their pro-anti-anything_the_opposition_wants lobbyists. Gaining public understanding and support is essential to defend themselves against this type of attack.

Re:terrorism! ha! (3, Insightful)

SuricouRaven (1897204) | about 10 months ago | (#45490317)

Plus the meat industry would donate heavily to their opponent.

Re:terrorism! ha! (1)

Anonymous Coward | about 10 months ago | (#45490255)

Yeah, why blame the public? Blame the doctors, hospitals and the farmers for the antibiotic abuse. Guess where are the good places for antibiotic resistant bacteria to out-compete other bacteria? Places like hospitals and farms that are full of antibiotics.

It's not us who set the policy or prescriptions. A doctor gave me a long rant when I asked him about why the antibiotic prescription he gave me was for just 3 days. If he had said - that's based on new research that'll be fine. But no, he rants on about some health minister and him being a doctor and me not being a doctor etc. I rarely bother with doctors anyway.

Lastly, if people get that desperate they can resort to phage therapy: https://en.wikipedia.org/wiki/Phage_therapy
FDA approval may be difficult or impossible based on current rules. But in a world where antibiotics no longer work you'll use what works.

Re:terrorism! ha! (1)

ultranova (717540) | about 10 months ago | (#45490285)

I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.

Re:terrorism! ha! (1)

minogully (1855264) | about 10 months ago | (#45490501)

I'm not sure why they should be trying to "convince the public" either - they should be convincing those that are handing out the anti-biotics.

In Mexico, many (if not all) antibiotics are over-the-counter. If this remains true, it is definitely the Mexican public that need to be convinced.

I wonder how many other countries sell antibiotics without prescriptions?

Re:terrorism! ha! (4, Insightful)

fuzzyfuzzyfungus (1223518) | about 10 months ago | (#45490007)

If this is a threat that "should be ranked alongside terrorism" then I'm not even going to waste my time reading about it.

It's an idiotic comparison; but only because it's a threat that should be ranked far ahead of terrorism. 'Terrorists' are barely a rounding error compared to the existing morbidity and mortality caused by drug resistant pathogens (I include in this category ones that aren't resistant to literally everything; but are now much harder, more expensive, and potentially more dangerous to treat because they resist most or all of the cheap, common, non-ghastly-side-effects drugs, leaving you with only the options you didn't want to be stuck with).

Re:terrorism! ha! (3, Funny)

ifiwereasculptor (1870574) | about 10 months ago | (#45490117)

Well, it's your fault for not being effective anymore, fuzzyfuzzyfungus.

Re:terrorism! ha! (5, Funny)

fuzzyfuzzyfungus (1223518) | about 10 months ago | (#45490355)

Hey, let's try to keep some sense of perspective about all this.

Some of us have been running a largely successful antibiotic R&D program for much of our ~1.5 billion year history, while occasionally taking time out of our busy schedules to help keep those lazy 'plants' alive [nih.gov] and produce the bread that gives you the energy to sustain life and the ethanol that allows you to endure it.

Others, who I am too tactful to name, spent almost a decade trying to copy our homework, between 1928 and 1938, and after a whole 75 years are on the verge of totally fucking up at antibiotic R&D and regressing to 19th century bacterial morbidity and mortality levels.

But no, I get it, I'm the ineffective one. Sorry about that, all my fault.

Re:terrorism! ha! (2, Informative)

Anonymous Coward | about 10 months ago | (#45490165)

There is more money to be made on terrorism, and government is in the business of making money. In prioritizing funding, government will always direct the cash flow towards the opportunity which (1) cost the most, and (2) is the most easily exploited for personal gain.

Re:terrorism! ha! (0)

Anonymous Coward | about 10 months ago | (#45490041)

I guess they want funding

The boy who cried pandemic! (-1)

TWiTfan (2887093) | about 10 months ago | (#45490111)

But, but, this is a REAL THREAT THAT IS GOING TO KILL US ALL!!!! The CDC swears that this time it's real--not like the hundreds of other pandemics, super-viruses, etc. that they've warned us were going to devastate the world, but then turned out to be nothing.

And it's funny how the threat from any particular area (diseases, terrorism, the environment, etc.) always seems to drastically escalate every time the funding of said agency or officer is threatened in any way.

Re:The boy who cried pandemic! (1)

bunratty (545641) | about 10 months ago | (#45490155)

I think you've been watching too many Hollywood movies and reading sensationalist newspaper and magazine articles. Pandemics, just like hurricanes and earthquakes, happen all the time and kill millions, but they don't "devastate the world" and "kill us all." You're being alarmist.

Re:The boy who cried pandemic! (1)

jythie (914043) | about 10 months ago | (#45490215)

That is another part of the problem. Sensationalism and fiction have warped our world view so much that big problems do not seem all that major since they do not live up to their fictionalized versions. If it is not fast and movie-style dramatically devastating it does not really register for a lot of people.

Which is a bit ironic since on the other end all sorts of relatively minor things with small effects get hyped up into 'OMG' deals, like terrorism.

Re: terrorism! ha! (0)

Anonymous Coward | about 10 months ago | (#45490177)

I for one, welcome our post antibiotic, drug resistant bacterial overlords!

  At least something was listening to Nancy Reagan's "Just say no" speeches.

Re:terrorism! ha! (1)

Jakosa (667951) | about 10 months ago | (#45490185)

None the less - this bad analogy shows how irrational we conceive the world. There is a reason that it is used to make people aware of the threat, because people fear fictitious brown persons overacting in Hollywood-movies more than an abstract scientific risk-calculi. It says more about our ridiculous way of thinking that we need an evil, human face to take a warning serious.

Re:terrorism! ha! (0)

Anonymous Coward | about 10 months ago | (#45490245)

If this is a threat that "should be ranked alongside terrorism" then I'm not even going to waste my time reading about it.

Perhaps she means to say it deserves the response we are giving to terrorism. "We need hundreds of millions of man hours and trillions of dollars". That may sound more appropriately alarming and relevant.

Re:terrorism! ha! (0)

Anonymous Coward | about 10 months ago | (#45490289)

Yeah well, that's a completely stupid comparison. Terrorism is nothing in comparison to growing antibiotics resistant breed of bacteria. The summary is right. It's happening all the time, especially in countries that freely use antibiotics for every minor thing, and then take like half the pills, feel well, and let some part of the bacteria alive. Rince and reapeat, like breeding dogs by killing the weaker portion and then waiting them to multiply again.

Oh nos, terrorists! (0, Insightful)

Anonymous Coward | about 10 months ago | (#45489927)

Saying something is as scary as terrorism is like saying it's as dangerous as marijuana.

Re:Oh nos, terrorists! (4, Funny)

fuzzyfuzzyfungus (1223518) | about 10 months ago | (#45490027)

Saying something is as scary as terrorism is like saying it's as dangerous as marijuana.

Marihuana? The Mexican devil-loco-weed? Assassin of youth? A cause of homicidal mania in our formerly upstanding young men of good character, and most widely used by the Negro, to stoke its lust for depraved violation of White Womanhood?

Truly a terrifying threat, sir!

(This post brought to you by the 1930s)

Re:Oh nos, terrorists! (1)

rmdingler (1955220) | about 10 months ago | (#45490389)

Reefer Madness was sensationalist proganda? Shirley, you jest.

Re:Oh nos, terrorists! (1)

Dcnjoe60 (682885) | about 10 months ago | (#45490101)

Saying something is as scary as terrorism is like saying it's as dangerous as marijuana.

Marijuana is dangerous. Maybe not to smoke it, but ask the drug agents about the drug cartels sometime.

Re:Oh nos, terrorists! (5, Insightful)

Anonymous Coward | about 10 months ago | (#45490175)

If marijuana were legal, drug cartels would not be interested in it because anyone could grow his own with little effort. How many criminal alcohol cartels exist currently? And how many existed during prohibition?

Re:Oh nos, terrorists! (3, Insightful)

ifiwereasculptor (1870574) | about 10 months ago | (#45490199)

Wasn't alcohol about as dangerous during the prohibition? I distinctively remember some mobsters and some shooting.

Re:Oh nos, terrorists! (1)

Anonymous Coward | about 10 months ago | (#45490447)

Let's see, prohibition [wikipedia.org] ended in 1933, and since you distinctly remember it I'd guess you had to be at least 10 years old... You're over 90 years old. Kudos on learning how to use these new fangled com-pooters.

Re:Oh nos, terrorists! (1)

jythie (914043) | about 10 months ago | (#45490225)

Not only that, but if you drop a crate of it on someone's head it will seriously injure them.

What will researchers do next (3, Insightful)

bunratty (545641) | about 10 months ago | (#45489933)

They just want money, so they say there will be some sort of catastrophe so they can get funding for their so-called studies. They even managed to throw in think of the children on top of their other hyperbole. I, for one, want absolute iron-clad proof that something disastrous will happen before we lift a finger to prevent it.

The above post may contain toxic doses of sarcasm.

Re:What will researchers do next (1)

fuzzyfuzzyfungus (1223518) | about 10 months ago | (#45490029)

Any chance we could use a derivative of the sarcasm as the basis for a novel class of antibiotics, or does the toxicity preclude human trials?

Re:What will researchers do next (1)

magamiako1 (1026318) | about 10 months ago | (#45490031)

The sad part is there are people out there that think this very thing. That you're "playing with god's will" if you use antibiotics in such manners. Don't even get me started on the food supply.

Re:What will researchers do next (4, Insightful)

causality (777677) | about 10 months ago | (#45490313)

The sad part is there are people out there that think this very thing. That you're "playing with god's will" if you use antibiotics in such manners.

It's amazing the way someone can believe in an absolutely omniscient, allmighty God Who completely knows the past, present, and future, Who endowed mankind with intellect and reason ... and then think this God had no idea mankind might use and apply that intellect and reason. How do people rationalize such beliefs?

Re:What will researchers do next (1)

c (8461) | about 10 months ago | (#45490065)

The above post may contain toxic doses of sarcasm.

... and yet, it bears an uncanny resemblance to the kinds of things that come out of an average politicians orifices.

Re:What will researchers do next (0)

Anonymous Coward | about 10 months ago | (#45490153)

and yet, it bears an uncanny resemblance to the kinds of things that come out of an average politicians orifices.

Surely you're referring to their mouths. If something similar is coming out of their other orifices then they have serious health issues - perhaps related to overexposure to antibiotics.

Re:What will researchers do next (0)

Anonymous Coward | about 10 months ago | (#45490067)

No, the private industry will hire a bunch of people to pour old soviet research regarding bacteriophage. That's How Capitalism at works people.

Re:What will researchers do next (1)

Dcnjoe60 (682885) | about 10 months ago | (#45490127)

They just want money, so they say there will be some sort of catastrophe so they can get funding for their so-called studies. They even managed to throw in think of the children on top of their other hyperbole. I, for one, want absolute iron-clad proof that something disastrous will happen before we lift a finger to prevent it.

The above post may contain toxic doses of sarcasm.

Proof? Look at mortality rates from simple wounds prior to antibiotics. Read the reports about drug resistant bacteria that already is prevalent in the hospitals and the dangers involved. To clean the hospitals, they use strong chemicals and UV light, both known to be detrimental to human beings. You want proof? All you need to do is look at mortality rates about 100 years ago.

Re:What will researchers do next (2)

Eskarel (565631) | about 10 months ago | (#45490273)

Not to say that anti-biotic resistant bacteria aren't a significant problem, but 100 years ago we had poor nutrition and poor sanitation and poor hygiene. Most of the reason those scrapes and bruises and for that matter surgeries resulted in such appallingly high mortality is that people didn't clean wounds or their hands, including surgeons.

To compare those days to today is really rather ridiculous. Even if a significant number of bacteria strains became totally anti-biotic immune we'd still not have anything close to the death tolls experienced 100 years ago. It's a serious issue, but we don't have a black death coming any more than H1N1 resulted in the kind of death tolls we saw in the early 20th century.

Re:What will researchers do next (1)

stealth_finger (1809752) | about 10 months ago | (#45490401)

They just want money, so they say there will be some sort of catastrophe so they can get funding for their so-called studies. They even managed to throw in think of the children on top of their other hyperbole. I, for one, want absolute iron-clad proof that something disastrous will happen before we lift a finger to prevent it.

The above post may contain toxic doses of sarcasm.

Proof? Look at mortality rates from simple wounds prior to antibiotics. Read the reports about drug resistant bacteria that already is prevalent in the hospitals and the dangers involved. To clean the hospitals, they use strong chemicals and UV light, both known to be detrimental to human beings. You want proof? All you need to do is look at mortality rates about 100 years ago.

You should've finished reading before hitting reply, unless there's delicate, subtle sarcasm in your post I'm not getting.

Re:What will researchers do next (0)

Anonymous Coward | about 10 months ago | (#45490413)

To clean the hospitals, they use strong chemicals and UV light, both known to be detrimental to human beings.

What the what? My sarcasm meter just exploded. What's next, a study on the ravaging effects of DHMO and how closely it's use tracks with death in developed countries?

Re:What will researchers do next (4, Informative)

fermion (181285) | about 10 months ago | (#45490419)

The antibiotic resistant threat of some organisms is real. Princeton is currently having a situation with drug resistant meningitis, and is asking to use an unapproved, in the US, drug to treat it.

A likely cause of this drug resistance is use of antibiotics to increase growth rate in livestock. It has been recently shown that for certain livestock simple sanitation methods can be superior to the use of antibiotics. It is also likely that there are superior methods to antibiotics for all livestock,

To follow your profit motive, most of the antibiotics in the US, 80%, are sold for agriculture. While we can assume that antibiotics for agriculture are sold for less than human use, and so the pharmaceuticals firms will not go immediately bankrupt if agricultural uses are outlawed, we can assume the shock to the sector will be significant.

Given that antibiotics in humans has become a minor part of the business, it is not unreasonable to assume that researchers must find an alternative.

Re:What will researchers do next (2, Insightful)

sl4shd0rk (755837) | about 10 months ago | (#45490429)

They just want money, so they say there will be some sort of catastrophe ... I, for one, want absolute iron-clad proof

Dude, I can't believe that actually got modded insightful. Science is all about extrapolating a "best guess" prediction based on the data you have at hand. There are no "ironclad" guarantees about anything. If I have a room full of scientists telling me sh#t is going to hit the fan unless something is done, always give them the benefit of the doubt. They are much more educated in the topic.

Hypocritical (5, Insightful)

Anonymous Coward | about 10 months ago | (#45489935)

Too many antibiotics in the food supply is a major part of what's causing this problem in the first place!

Re:Hypocritical (1)

jythie (914043) | about 10 months ago | (#45490243)

I would not call it hypocritical. Regardless of how it got started, our food supply is now dependent on its continued application, so if the antibiotics stop working then that will have significant impact on price and availability.

Re:Hypocritical (1)

SuricouRaven (1897204) | about 10 months ago | (#45490347)

You mean McDonald's would have to raise the price of a burger by $0.20?

All is lost.

Re:Hypocritical (4, Funny)

Nite_Hawk (1304) | about 10 months ago | (#45490431)

No, McDonald's has no meat or plant matter in their food, so it doesn't apply.

Re:Hypocritical (1)

theM_xl (760570) | about 10 months ago | (#45490443)

No it's bloody well NOT dependent on continued application. The yield loss is small enough that it's perfectly manageable if implemented sanely. Sweden decided to curtail antibiotic use over a decade ago.

Terror (3, Insightful)

Anonymous Coward | about 10 months ago | (#45489939)

"British chief medical officer Sally Davies described resistance to antibiotics as a 'catastrophic global threat' that should be ranked alongside terrorism."
So it's just a minor concern? Good to hear, I was starting to get worried here.

False flags (0)

Anonymous Coward | about 10 months ago | (#45490073)

Terrorism, a non-issue indeed. But false flag operations? That's another story.

Be Afraid, be very very afraid. (2, Interesting)

auric_dude (610172) | about 10 months ago | (#45489941)

Will the market save us by producing something be it at a price, or, is this too big and needs to be done by government money and research?

Re:Be Afraid, be very very afraid. (5, Insightful)

Anonymous Coward | about 10 months ago | (#45490051)

The market is partially causing this; in India there are antibiotics plants that spew waste into gutters and that waste has plenty of punch to make the local bacteria resistant. Also in India (and other places where drugs are available without prescription) it's not uncommon that people treat infections with a single pill because they don't know any better.

What we need to do is educate people on how antibiotics work and stop unnecessary usage of antibiotics right now. It's counterproductive to feed lifestock antibiotics by the bulk when the problems are treatable otherwise (I'm looking at you corn subsidies and packed to brim handling facilities among other things). Also would be really interesting to see what happened if we phased out some of our antibiotics for a decade; would the resistance still be there in enough scale?

Re:Be Afraid, be very very afraid. (1)

RabidReindeer (2625839) | about 10 months ago | (#45490239)

The market is partially causing this; in India there are antibiotics plants that spew waste into gutters and that waste has plenty of punch to make the local bacteria resistant. Also in India (and other places where drugs are available without prescription) it's not uncommon that people treat infections with a single pill because they don't know any better.

What we need to do is educate people on how antibiotics work and stop unnecessary usage of antibiotics right now. It's counterproductive to feed lifestock antibiotics by the bulk when the problems are treatable otherwise (I'm looking at you corn subsidies and packed to brim handling facilities among other things). Also would be really interesting to see what happened if we phased out some of our antibiotics for a decade; would the resistance still be there in enough scale?

Well, in China and India, lots of stuff gets spewed into the gutters. And rivers. Not that the USA has a sterling record in that department.

Speaking of which. The USA hardly has a pristine environment even now. Even when direct effluents are missing, the lakes, waters, and streams of the USA - including groundwater - contain numerous antibiotics in various degrees of metabolism just because kidneys don't screen them all.

Re:Be Afraid, be very very afraid. (4, Interesting)

fuzzyfuzzyfungus (1223518) | about 10 months ago | (#45490137)

Will the market save us by producing something be it at a price, or, is this too big and needs to be done by government money and research?

Antibiotics are arguably an example of a situation that (while not meeting the classic definition of 'market failure') is not a market victory.

If the price of an antibiotic is relatively low, it becomes economically viable as a growth enhancer/mortality reducer in high-density agricultural applications, likely burning through its effectiveness relatively quickly (with some help from being handed out to treat patients whining about the sniffles and being reflexively used on basically anybody admitted to a hospital; but veterinary uses are the big one). If the price is relatively high, you see a strong incentive for poorer users (especially in the 'developing' world) to try to make do by 'stretching' inadequate supplies across longer times or more patients than the supplies can provide adequate doses for. You also have more incentive for diluted and fraudulently labelled, or outright faked, versions to make it into the supply chain.

On the supply side, I don't know why it isn't working; whether biology is just being a stubborn bastard and we'd need to throw ten times as many scientists at the problem, or whether the ROI on penis pills and hair loss and pimping minor rebadges of old drugs is better than doing research; but the steady advances in increasingly resistant bacteria have not caused the invisible hand to keep pace with new drugs (particularly new drugs with novel mechanisms, which would get us further ahead in the arms race than incremental tweaks on resistance-threatened mechanisms.)

Re:Be Afraid, be very very afraid. (4, Interesting)

jythie (914043) | about 10 months ago | (#45490307)

Not a market victory, but a classic game theory problem.

With antibiotics in industry, it is in any individual company's best interest to have everyone else move away from it. If a company uses lots of antibiotics while others do not, not only does it make their own product cheaper and fattier, but they will get more time out of the antibiotics. So no company (outside luxury brands) has an interest in being the one or group of ones to stop the practice since all it will do is help some competitor who does not play along. Same goes in health care unfortunately.

Re:Be Afraid, be very very afraid. (0)

Anonymous Coward | about 10 months ago | (#45490191)

Will the market save us by producing something be it at a price, or, is this too big and needs to be done by government money and research?

Heretic! Everyone Knows that Government never solved anything. Only the Market can provide solutions.

And if you cannot afford the solution, it's because you're too lazy and therefore deserve to die. All it takes to become a Billionaire is hard work!

[auto-generated by Quack-o-Tron 1800]

Why did we become so dependant? (4, Insightful)

Evtim (1022085) | about 10 months ago | (#45489947)

It's not that Origin of Species is exactly a new book. By the time we developed the antibiotics evolutionary biology was well understood.

I guess as usual , no-one was thinking about long-term consequences.....also I wonder how did my grandparents managed to be successful farmers - earning the most money in the whole family while supporting themselves and the families of their sons with agricultural products (I don't remember my family buying much flour, cheese, meat , fruits and vegetables for decades) without antibiotics. I mean they hardly used machines let alone chemistry...

Sorry for the provocation, but is there anyone who still thinks that free market capitalism is any good in anticipating (let alone solving) global long-term issues?

Re:Why did we become so dependant? (1)

Anonymous Coward | about 10 months ago | (#45489983)

I wonder how did my grandparents managed to be successful farmers - earning the most money in the whole family while supporting themselves and the families of their sons with agricultural products (I don't remember my family buying much flour, cheese, meat , fruits and vegetables for decades) without antibiotics.

Farmers can support themselves and even their local small-town community with low-yield techniques. However, farming and livestock raising in the US has shifted in the last century. It is now dominated by a fairly small group of companies who have to feed a country of over 300 million. As long as Americans eat so much meat and want to have the same availability of produce, Antiobiotics are essential for high-yield food production.

Re:Why did we become so dependant? (5, Insightful)

gallondr00nk (868673) | about 10 months ago | (#45490337)

The trouble is that antibiotics and livestock seems to have allowed the industry to be completely negligent of conditions and the health of their animals. I have no doubt that your grandparents will have treated theirs such better than hormone pumped, antibiotic loaded factory farm livestock we have today. Then again, antibiotics can also save herds from infectious diseases.

In the same way you can't compete with Walmart on price using a hand loom, it seems you can't compete with agri-business without using some of these techniques.

The only solution seems to be to regulate it, and I believe some countries are already doing so in part. That and advances in synthetic or vat grown meat would go towards solving a lot of problems and help remove anti-biotics from the food chain.

Re:Why did we become so dependant? (0)

jythie (914043) | about 10 months ago | (#45490341)

It is worth then 'no good', it is pretty much guaranteed to have this type of result. Any time you have a situation where, within an industry, it is in any one particular company's interest to have all the OTHER companies behave in a more responsible way, they will all race to the bottom. Pure free markets actively punish players that behave in a way that benefits the entire system. It is one of the reasons that successful economies moved away from free markets nearly a century ago since everyone looses in them.

Re:Why did we become so dependant? (1)

MozeeToby (1163751) | about 10 months ago | (#45490421)

also I wonder how did my grandparents managed to be successful farmers

Because everyone else that was farming was doing it the same way they were, so they were cost competitive. Because at the time your grandparents were farming they were part of the 20-25% of Americans directly involved in agriculture (as opposed to the 1-2% now). Also, and I'm just guessing, because they had the resources to buy sufficient land and equipment to get started.

Alongside Terrorism? (5, Insightful)

N1AK (864906) | about 10 months ago | (#45489949)

The loss of effective antibiotics is a genuinely 'catastrophic global threat'; terrorism is a largely imaginary risk for most people with considerably less chance of negatively affecting their life than going near a road. If terrorism was a single fire ant on your leg then widespread drug resistant bacterias would be a pissed off Hippo stomping you into the ground.

Do we blame politicians for not treating this as important and instead pissing billions away on 'the war on terror' or do we blame ourselves for being so ignorant that we (on average) don't care about this major issue but throw our support behind whoever promises to spend most on protecting us from often imaginary bogeymen.

Re:Alongside Terrorism? (4, Insightful)

RabidReindeer (2625839) | about 10 months ago | (#45490265)

The loss of effective antibiotics is a genuinely 'catastrophic global threat'; terrorism is a largely imaginary risk for most people with considerably less chance of negatively affecting their life than going near a road. If terrorism was a single fire ant on your leg then widespread drug resistant bacterias would be a pissed off Hippo stomping you into the ground.

Do we blame politicians for not treating this as important and instead pissing billions away on 'the war on terror' or do we blame ourselves for being so ignorant that we (on average) don't care about this major issue but throw our support behind whoever promises to spend most on protecting us from often imaginary bogeymen.

Never underestimate the capacity of the human race to obsess on trivialities at the expense of their overall welfare.

Re:Alongside Terrorism? (1)

clickclickdrone (964164) | about 10 months ago | (#45490287)

I don't disagree but I'm guessing they figured the threat of terrorism managed to get most people to accept the surveilence state so it was worth a go using it again as a stick to beat people with.

Terrorism? (1)

Anonymous Coward | about 10 months ago | (#45489955)

Of all the things they could have compared it to, they chose terrorism?

A post-antibiotic future is a lot more serious than freakin' terrorism!

Easy fix would be... (5, Insightful)

spacefight (577141) | about 10 months ago | (#45489967)

... to divert the billions of dollars of the "fight" against terrorism directly into medical research.

Re:Easy fix would be... (1)

Therefore I am (1284262) | about 10 months ago | (#45490217)

An easy solution would be to simply accept it as inevitable. As this impending Pharma disaster is going to equally affect people at every level of society we might as well look on it as the world-wide population control that we had to have. Karma on steroids if you like. It really is about time we had a clean sweep...

Easy solution (5, Insightful)

Qbertino (265505) | about 10 months ago | (#45489987)

Easy solution: Ban the use of antibiotics in the meat industry.

Of course then people wouldn't get their insanely cheap meat anymore.

Boohoo - what a disaster.

Re:Easy solution (0)

Anonymous Coward | about 10 months ago | (#45490001)

Easy solution: Ban the use of antibiotics in the meat industry. Of course then people wouldn't get their insanely cheap meat anymore.

As ranching employs a significant number of people in some states, and agrobusiness has great clout with Congress, this just isn't going to happen. Plus, the average American is not going to accept such a sudden stop to his high meat intake. Only a gradual societal shift towards eating less meat is going to work, but this is a produce that will likely take decades. As the antibiotic crisis is happening now, we have to hope that new biomedical advances will arise that will allow farmers to continue innoculating their animals as long as there is a consumer base.

The problem (4, Interesting)

Geoffrey.landis (926948) | about 10 months ago | (#45490281)

The summary says:

We'd lose a good portion of our cheap modern food supply because most of the meat we eat in the industrialized world is raised with the routine use of antibiotics, to fatten livestock

This the source of the problem, not the effect.

Yes, it does turn out that dosing meat animals with antibiotics even when they are not sick will increase their weight (and hence production) by about 10%, This is a small increase-- but the margin on meat production is low enough that it makes a difference in profitability, and hence if some of the farms do it, pretty much all of them follow.

So, we're losing the ability to use antibiotics because we're spraying them across the landscape, not to cure sickness, but as a fattening agent for cattle.

and protect them from the conditions in which the animals are raised.

This is actually a much smaller use of antibiotics. But, yes, the idea is that we can save money by not bothering with sanitation and health in cattle, but instead just dose them with antibiotics.

Anonymous wrote:

As ranching employs a significant number of people in some states, and agrobusiness has great clout with Congress, this just isn't going to happen. Plus, the average American is not going to accept such a sudden stop to his high meat intake.

Actually, it's a very small effect-- eliminating antibiotic use on cattle would have only a trivial effect on price. The problem is that the low margin on meat production means that if one cattle-production factory does it, everybody has to do so to keep up.

Re:Easy solution (0)

Anonymous Coward | about 10 months ago | (#45490095)

What is it with the livestock, that would do nothing to solve the problem, doctors give out antibiotics like there f'in candy to anyone and everyone. This article is the same argument we had not that long ago on /. The Medical Industry is the reason this is going on, because they refuse to find natural ways of fighting infections, and microbes.It may just be too cheap and readily available over the counter, and we dont want that.

Just because you are a vegan doesn't mean you should peddle some false information.

Solving 80 percent of the problem (3, Informative)

Geoffrey.landis (926948) | about 10 months ago | (#45490339)

What is it with the livestock, that would do nothing to solve the problem, doctors give out antibiotics like there f'in candy to anyone and everyone.

It would do something to solve the largest part of the problem

Amount of antibiotics sold by manufacturers for use by food-producing animals: 13.1 million kilograms
Sold for use by people: 3.3 million kilograms

80 percent of antibiotics sold in the US go to increasing meat production from farm animals.

http://www.nytimes.com/2013/03/28/opinion/antibiotics-and-the-meat-we-eat.html [nytimes.com]
http://www.politifact.com/truth-o-meter/statements/2013/oct/15/louise-slaughter/rep-louise-slaughter-says-80-antibiotics-are-fed-l/ [politifact.com]
http://www.rodalenews.com/antibiotics [rodalenews.com]

Just because you are a vegan doesn't mean you should peddle some false information.

Just because you are an Anonymous Coward doesn't mean you should peddle some false information. There, fixed it for you.

Re:Easy solution (0)

Anonymous Coward | about 10 months ago | (#45490143)

Also ensure to make it only available via prescription. Teach people to finish the prescribed dosis (unless allergic reaction). Don't prescribe it for simple colds.

Re:Easy solution (1)

will_die (586523) | about 10 months ago | (#45490407)

Antibiotics in meat is not the major problem you are making it into.
Yes there ahve been some examples in the past. but currently the types of antibiotics that can be used are limited to ones not used by humans and then there is a period of time that has to go by for them the leave the body of the animal, all of this scientificlly based. For anti-biotics that are also used by human they have to be used for very specific reasons and then that period of time of waiting is even longer, again based on science.

Where you do get an easy solution and in fact a solution that would work to solve the problem is this: Doctors don't perscribe anti-biotics except in cases where it would work. The over use of antibiotics and giving them out when they are will not make any difference is the problem. Also need to do somethign about people throwing them in the garbage or toilet but that is not as major.

Re:Easy solution (0)

Anonymous Coward | about 10 months ago | (#45490497)

Since you appear to be an expert on biology and unable to spell well or formulate what exactly you want to say: how is babby formed?

self made tragedy (5, Insightful)

tie_guy_matt (176397) | about 10 months ago | (#45489997)

This is going to be a self made tragedy.

How many times have people gone to the doctor for a cold but the doctor gave them antibiotics almost as a placebo. How many times have people not used the entire bottle of antibiotics? Some ranchers give antibiotics to their live stock as a matter of course so that they can get fatter faster.

Then of course after the Ronald Reagan/Margret Thatcher revolution everything has to be about profits. Well there isn't much profit in antibiotics. If you have a really good antibiotic then the medical comunity will be likely not to perscribe it. They would want to save it for the really nasty bugs. Even if it is perscribed a lot people will only get one bottle and then stop taking it after their infection goes away. The drug industry would rather come up with something like statins; that is something they can put rich people on for the rest of their lives (I am sure there are some in the industry that would rather keep giving out statins than to cure heart disease.) Don't even get me started on creationsits' heads exploding because their bacterial infections are actually evolving.

We already have kids basically getting killed off because they picked their scabs on a minor cut and then got the wrong type of bug. Before antibiotics any little cut was a possible death sentence. Looks like if something isn't done (and I am not holding my breath) we are going to get back there sooner rather than later.

Re:self made tragedy (1, Troll)

SuricouRaven (1897204) | about 10 months ago | (#45490365)

It doesn't bother the creationists, really. They just call it 'microevolution' and say it isn't really evolution at all because the bacteria are still bacteria.

Really shouldn't have compared it to Terrorism... (0)

Anonymous Coward | about 10 months ago | (#45490093)

Saying it ranks up there with terrorism to the rational mind doesn't really make it sound like much as terrorism is actually relatively rare and peanuts are actually more dangerous than that. It would be more dangerous than terrorism if it ranked up there with tap water....

THIS ranks up there closer to alcoholism or AIDs if not worse.

Replicators (1)

egcagrac0 (1410377) | about 10 months ago | (#45490109)

If the natural food supply is in danger, it's time to build food replicators.

It's because we don't try to cure much at all (0, Insightful)

Anonymous Coward | about 10 months ago | (#45490139)

Companies make more money by creating drugs that make you feel better only while continuing to purchase their drugs. Cure a disease and you lose a customer; lesson their symptoms and you have a customer for life.

natural path? (0)

Anonymous Coward | about 10 months ago | (#45490145)

how did we ever make it through the 15th century ?

Re:natural path? (2)

SuricouRaven (1897204) | about 10 months ago | (#45490433)

By breeding faster than we could die.

No one wanted to listen or change (4, Insightful)

erroneus (253617) | about 10 months ago | (#45490147)

The prophylactic use of antibiotics has long been identified as a problem and yet people couldn't manage to stop their ridiculous fear of "getting sick." You know, getting sick once in a while isn't so bad. Keep your immune system strong and healthy and getting sick is a minor inconvenience. Instead we've got a system of marketing driven by ridiculous fears. Sure, wash your hands. But with anti-bacterial soaps all the time? What could possibly go wrong? Certainly not a weakened immune system resulting from a decreased demand load right?

And the crap they allow in the livestock industry? Holy crap. How is that NOT supposed to get into our water and our food?

"Before antibiotics any little cut was a possible death sentence." Really? I wouldn't go quite that far. Conventional remedies took care of the vast majority of such things when I was a child. Iodine, mercurochrome, hydrogen-peroxide and all manner of antiseptics seem to do the job nicely. Of course things needed near-immediate attention and all that but so what? Why do we have to believe "give me a shot and I'll be just fine!" and continue on as if there would be no other effects?

One of the real kickers for me is the scares we've had over the past what? 20 years now? Talking about superbugs and MRSA and all that? Name one thing that has been done to really combat the trend? I know what *I* have done -- I have ensured my practices are nearly opposite of what ever soccer mom does. You won't find "anti-bacterial soap" in my home. There is only the standards like Irish Spring and Ivory. I will not feed into the unrealistic fear pushed onto the public to sell more product. And when I do take medications, I will be sure that (1) I actually need it and (2) it will be far more effective on me because I don't have any acquired resistance.

Nanites (0)

Anonymous Coward | about 10 months ago | (#45490163)

Well, better get to work on Nanites with laserbeams attached to their heads, bacteria can't evolve to be resistant to that =]

Re:Nanites (1)

Eunuchswear (210685) | about 10 months ago | (#45490439)

Well, better get to work on Nanites with laserbeams attached to their heads, bacteria can't evolve to be resistant to that =]

Never bet against evolution, it's almost as dumb as betting against thermodynamics.

Phages will have to be a part of the answer (4, Interesting)

Dr. Manhattan (29720) | about 10 months ago | (#45490221)

Viruses that attack bacteria could be very effective, and harder for bacteria to evolve around. But they're not without downsides; while it's unlikely such a virus could evolve to attack human cells, weird recombinations could happen in a cell that happened to be infected with two viruses at once, one human, one bacteriophage. And more likely, they could wind up attacking 'good' bacteria that our bodies need to have around.

Hopefully our biotech is starting to get to the point where we can tailor viruses to specific targets, at least some of the time. Things like this [codagenix.com] give me some hope. If we can do that, we can do at least some of that kind of tailoring.

Cheap food is not actually cheap (1)

dskoll (99328) | about 10 months ago | (#45490283)

Beef is cheap in the US because they feed cattle corn instead of grass. Cattle are not designed to eat corn, so they get bloated and sick. They're also kept confined in small areas in conditions that promote the spread of disease, so they need antibiotics.

The environmental and humanitarian catastrophe of large-scale factory-farming is a major culprit in the abuse of antibiotics and the rise of antibiotic-resistant organisms. Sometime down the line, we're going to pay the true cost of the "cheap" food.

Re:Cheap food is not actually cheap (1)

SuricouRaven (1897204) | about 10 months ago | (#45490411)

Cattle are fed corn because the US government spends billions of dollars each year subsidizing corn to keep the price down - both direct subsidies for production, and subsidized crop insurance.

The cattle generally escape the worst consequences of a corn diet by simply not living long enough - they reach slaughter-age before reaching that point.

Interesting that this could be synced (0)

Grand Facade (35180) | about 10 months ago | (#45490299)

with the restructuring of our health care coverage here in the US.

Coincidence?

Re:Interesting that this could be synced (0)

SuricouRaven (1897204) | about 10 months ago | (#45490423)

And any day now, I'm expecting to see an 'Obama plans to take away antibiotics and let your children die' column.

Clever but foolish (1)

CyclistOne (896544) | about 10 months ago | (#45490325)

We humans are so acutely clever ... if only we could keep ourselves from doing such stupid things! Oh dear! What's to become of us?

free the innocent stem cells (0)

Anonymous Coward | about 10 months ago | (#45490387)

they have harmed no one.

Solutions are simple, executing them is hard (5, Insightful)

CyberLeader (106732) | about 10 months ago | (#45490435)

Those of us who have been in and around the industry have seen this developing for a long time. The solutions are straightforward but face enormous resistance from those currently benefiting from how antibiotics are currently misused.

1) Ban the use of antibiotics in livestock except to actually treat disease. As the article notes, >60% of all antibiotics by volume are used to fatten livestock in the absence of disease. Because the USDA regulates livestock production rather than the FDA it becomes a jurisdictional quagmire to try to limit use in livestock. While there isn't much antibiotic left in meat when it goes to market, the runoff from stockyards provides the perfect mixture of bacteria and diluted antibiotic (and metabolites) to create resistant strains.
2) Stop prescribing antibiotics in novel classes for routine things like ear infections and sinus infections. Studies show that most of those will clear up on their own without antibiotic treatment, but nobody wants to be the guy who feels miserable but doesn't get a Z-Pak or some fluroquinolones as treatment.
3) Ban these ridiculous anti-bacterial soaps and things that contain triclosan. It's creating cross-antibiotic resistance and isn't even that effective at killing bacteria during primary use because people don't leave it on long enough.
4) An earlier poster asked if the lack of corporate investment to find new antibiotics is a market failure, and the answer is yes. Besides the enormous dysfunction that permeates big pharma in general, the reality is that antibiotics are generally not nearly as profitable as once-a-day drugs that last a lifetime. Either provide regulatory incentives for antibiotic development or do more of the research at the government level or both.
5) In the long run, we need a completely different approach to managing bacterial infection. An earlier poster mentioned phages, and there are multiple different research avenues that show some promise if we can get them going.

Let the market decide (0)

Anonymous Coward | about 10 months ago | (#45490479)

and its decided that there's no money in it. Sorry poors!

It's a crisis of medical malpractice (0)

Anonymous Coward | about 10 months ago | (#45490493)

The DR, XDR, and TDR bacteria crisis is a making of medical malpractice by shoddy doctors who don't know how or when to use antibiotics.

In 2011, doctors wrote 225,000 scripts for antibiotics for symptoms of viral infection. They wrote 981,000 prescriptions with a dose lower than dosing guidelines called for, and 291,000 prescriptions that were not long enough in duration to meet antibiotic usage guidelines.

When Doctors don't even know how to use modern medicine correctly, what else do you expect?

This is not even to mention the issue of interfering with natural selection and devolving our species. Antibiotics make the bugs evolve faster, and the humans evolve slower. It's only a matter of time before a mass extinction event.

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