

Rising Threat of Infections Unfazed by Antibiotics - cromulent
http://www.nytimes.com/2010/02/27/business/27germ.html?em

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cwan
Despite the on-again off-again media hysteria, it would seem that there is
some promising research on the horizon. Check out the TED talk by Kary Mullis:
[http://www.ted.com/talks/lang/eng/kary_mullis_next_gen_cure_...](http://www.ted.com/talks/lang/eng/kary_mullis_next_gen_cure_for_killer_infections.html)
"Drug-resistant bacteria kills, even in top hospitals. But now tough
infections like staph and anthrax may be in for a surprise. Nobel-winning
chemist Kary Mullis, who watched a friend die when powerful antibiotics
failed, unveils a radical new cure that shows extraordinary promise."

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ledger123
This article is scary.

To me it seems that we are just creating more powerful strains of various
bacteria with our use of anti-biotics.

May be it is time we need to look at alternate ways to enhance our immunity so
that we are not that much susceptible to bacterial (or virus) infection.

May be alternative medicine or Michael Pollan way of eating.

Any ideas?

~~~
tokenadult
_we need to look at alternate ways to enhance our immunity_

Vaccines suit this description. But natural selection will favor bacteria that
beat your immunity, however your immunity is enhanced. The bacteria for which
we have effective defenses, of whatever kind, we forget about, but the few
kinds of bacteria that can harm human beings continue to be surprising. That's
the arms race of natural selection.

~~~
camccann
I've heard it proposed that we could try and work _with_ this instead of
against it, by "domesticating" diseases. Take some harmful bacteria, breed a
strain that's mostly benign and moderately contagious, then let it loose to
displace the more harmful strains while carefully avoiding doing too much to
kill it. In other words, create selection pressures that favor mild strains.

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btilly
This is a disaster in slow motion. It is a few years old, but _Betrayal of
Trust_ is still an excellent overview of the problem:
[http://www.amazon.com/gp/product/0786884401?ie=UTF8&tag=...](http://www.amazon.com/gp/product/0786884401?ie=UTF8&tag=randomobser0b-20)

~~~
billswift
I haven't read that one, but I read Garrett's earlier one, "The Coming Plague"
- it was an hysterical, anti-Western, fear-mongering eco-nut screed. In the
decade and a half since she wrote it, not a single one of the "plagues" she
claimed were about to break out across the world has shown any signs of
getting worse, much less becoming the sort of widespread "disaster" she
claimed was imminent.

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jrockway
At least the pharmaceutical companies are hard at work finding new drugs to
make your eyelashes grow longer.

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anamax
While the eyebrow example is wrong, let's assume that the gist was correct.

In general, folks tend to produce things that other people are willing to pay
for. Why should pharma be any different? And why is this wrong?

You want more drugs that save peoples lives? Great! So do I. Here's how we do
it.

Make it possible for folks to get rich on drugs that save people's lives. Note
- cost controls won't do it (unless we're talking about controlling regulatory
costs).

~~~
JunkDNA
You've hit the nail on the head. I spent several years in one of the biggest
antibiotics research centers in big pharma. I watched as they systematically
disbanded it. The business folks had decided that there was no money in
antibiotics. The reason? The FDA (and similar agencies in other countries) are
pretty much guaranteed to make any new, very successful antibiotic a "drug of
last resort". This means you can only give it to an individual who has failed
all the standard line therapy.

From a business perspective, why develop something if you are never going to
be able to sell it in decent enough quantities to make a profit? Now, you
could argue that at some point in the future, that drug will become standard
line therapy when all the current front line drugs are completely useless.
Unfortunately, by that time the drug is off patent and generic competition
will ensure there won't be much profit.

This is a complex situation, and I'm not pretending that there is an easy
solution. It seems there are a confluence of regulations and politics that
conspire to prevent serious attempts at new antibiotics development. The
situation is changing somewhat, and my hope is that once the problem becomes
more acute, the necessary incentives will be aligned.

~~~
jrockway
"Hi, we're the government. Instead of bombing Iraq, we would like to buy the
IP for this critical drug you developed."

It's already developed, and they don't want to commercialize it, so why not
sell the IP to the government or a charity. (The government could even
theoretically compel the agreement via eminent domain. Or, the pharmaceutical
company could donate the drug to the public domain and take a massive tax
write off.)

~~~
JunkDNA
Drug companies do sell or give away IP from time to time. But even in the
scenario you suggest, with finite resources, why put money into antibiotics
development? Why not just fund cancer research at a higher level? I think most
pharmas wouldn't want to take the risk that the governmnt would leave them
holding the bag. Contrary to the popular meme, drug companies don't generally
want to sit on a drug that is ready to go.

But all that aside, there is nothing stopping the NIH from starting a research
program and developing their own antibiotics (or any academic institution).
This happens a bit already, but then it comes time to run the clinical trials
and develop the research compound into an actual medicine. This requires
expertise and infrastructure that does not exist in the public sector at a
sufficient level to get the job done.

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tumult
I know someone who contracted MRSA after randomly scraping his knee. Almost
killed him, and it came out of nowhere. Some hospitals have MRSA fatality
rates over 20%. Scary as shit! Antibiotics abuse has screwed us, I guess,
along with the sloppiness of many healthcare providers.

~~~
electromagnetic
MRSA lives in the community just as much, if not more, than it lives in the
hospitals. From what I know of the area, some hospitals had up to 80%
community-acquired infections as opposed to hospital-acquired infections, this
meant that the majority of these patients were being killed _by their
families_. I know many ICU's in the UK have full out bans on any family
members entering, because if anyone in an ICU catches MRSA they're gone.

It's easy to blame the healthcare providers, and I'm sure in many cases it is
the healthcare providers' fault. However, if they simply flat-out banned
people from visiting in the hospital MRSA infection rates (in good hospitals)
would drop like a rock.

I wouldn't be surprised if hospitals with MRSA fatality rates over 20% allow
visitors in the ICU and don't have well established visitor protocols in the
regular hospital. I know some wards in the UK (I have friends and family who
work in hospitals) will escort you out if they see you go between patients'
beds; essentially they allow you to visit 1 person per day, and they
frequently have visiting hours only a couple hours long so they can actively
enforce this.

My advice to anyone visiting a friend in hospital, don't touch them. No
handshakes, especially no hugs. This seems extreme, but patients have died
from MRSA infection in key-hole surgery incisions.

~~~
tumult
Right, I think it is sloppy of a hospital to allow people to walk in and cause
that kind of damage. I think not allowing outsiders into the ICU could be a
good move for many.

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Mz
This is the part of the article I most like:

 _“You don’t really have much choice,” said Dr. Azza Elemam, an infectious-
disease specialist in Louisville, Ky. “If a person has a life-threatening
infection, you have to take a risk of causing damage to the kidney.”

Such a tradeoff confronted Kimberly Dozier, a CBS News correspondent who
developed an Acinetobacter infection after being injured by a car bomb in 2006
while on assignment in Iraq. After two weeks on colistin, Ms. Dozier’s kidneys
began to fail, she recounted in her book, “Breathing the Fire.”

Rejecting one doctor’s advice to go on dialysis and seek a kidney transplant,
Ms. Dozier stopped taking the antibiotic to save her kidneys. She eventually
recovered from the infection._

Of course, I'm highly biased in that regard. :-)

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ledger123
"Of course, I'm highly biased in that regard."

This prompted me to look at your info and now reading your website
(<http://www.healthgazelle.com/>) and I am pleased, to say the least.

I added my comment above (or below where ever it appears) without reading your
website.

~~~
Mz
I suppose that answers your closing question of "Any ideas?". ;-)

