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93 points mooreds | 10 comments | | HN request time: 0.949s | source | bottom
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ChrisMarshallNY ◴[] No.45409599[source]
This isn’t news. The alarm bells have been clanging away for decades. One of the scariest, is drug-resistant TB. I understand there’s also drug-resistant leprosy, but that doesn’t transmit easily.

I’m old enough to remember that penicillin cured almost everything. You started a 10-day course, and felt better in a day and a half.

The problem was that many folks stopped taking it, when they felt better.

These days, American meat is absolutely overflowing with antibiotics. I don’t know if there’s any kind of serious effort to address that.

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1. MountDoom ◴[] No.45409663[source]
> The problem was that many folks stopped taking it, when they felt better.

This really wasn't the problem. There was never any strong science behind it, other than just an abundance of caution. But you can also argue that taking antibiotics for an extra week is bad because it prolongs the evolutionary pressure on microbes to develop resistance.

Either way, stuff like that is inconsequential. Most drug-resistant strains crop up in hospice and hospital settings where immunocompromised or gravely ill patients are kept on a cocktail of antibiotics for months or years, and resistant bacteria have a significant advantage and can spread easily.

And it's not like we have a good alternative to that - "let more people die earlier" is not an easy sell.

This is possibly followed by overuse of antibiotics in animal husbandry, although that part is more complicated than usually implied.

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2. Panzer04 ◴[] No.45409743[source]
I've heard it's actually just completely wrong. The earlier you stop taking antibiotics the faster the selective pressure for resistance goes away.

stopping when you feel better might actually just be better, though I'd have to go find that reference again.

Eg: https://www.bmj.com/content/358/bmj.j3418

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3. technion ◴[] No.45409861[source]
Where the logic made no sense was optional repeats. I would get told "here is one course, if you dont feel better, you can take this script for the second". So after five days you finish the first and if you feel better its fine to stop. But if you take one pill from course 2, well you better finish it or you'll be breeding resistance.
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4. robbiep ◴[] No.45410011[source]
The difficulty is stopping when control of the organism is actually achieved, not just when you ‘feel better’. Most people are totally unable to make this judgement
5. GeekyBear ◴[] No.45410131[source]
Humans, as a rule, do not take antibiotics every day of every year.

Factory Farms do feed animals low doses of antibiotics constantly because doing so makes farm animals more efficient at converting animal feed into tasty, tasty meat.

We aren't talking about giving injured or sick animals or people antibiotics until they are well, we are talking about creating conditions on huge factory farms where bacteria can only survive and thrive if they evolve the ability to shrug off the constant presence of antibiotics.

Unfortunately, bacteria also are able to trade those antibiotic resistance genes from one strain to another, so new antibiotic resistance genes can get transferred to bacteria like tuberculosis that are already a problem without learning new genetic tricks.

Look up the percentage of antibiotics by weight that are used on farms vs. those given to people.

> Of all antibiotics sold in the United States, approximately 80% are sold for use in animal agriculture; about 70% of these are “medically important” (i.e., from classes important to human medicine). Antibiotics are administered to animals in feed to marginally improve growth rates

https://pmc.ncbi.nlm.nih.gov/articles/PMC4638249/

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6. alexashka ◴[] No.45410674[source]
> And it's not like we have a good alternative to that - "let more people die earlier" is not an easy sell

Decreasing big pharma's quarterly profits is not an easy sell, you mean?

Or are we supposed to pretend any of this has to do with concern over people's well being?

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7. carlmr ◴[] No.45410834[source]
>> Of all antibiotics sold in the United States, approximately 80% are sold for use in animal agriculture; about 70% of these are “medically important”

I expected more, since biomass distribution is 62:34 for livestock to humans, the remaining 4% are wild animals[1]. So rather a 2:1 ratio.

The antibiotics are 4:1.

Livestock is fed a constant stream of antibiotics, but apparently Americans are fed a half as constant stream of antibiotics as well?

Last time I took antibiotics was decades ago. What are you all doing?

[1] https://ourworldindata.org/wild-mammals-birds-biomass

8. MountDoom ◴[] No.45410975[source]
First, selling generic antibiotics isn't the money-maker you might be imagining. A lot of them are made overseas.

Second, try to convince a random family that they should withhold antibiotics and let grandma die of pneumonia and report how that conversation went.

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9. kaikai ◴[] No.45411950[source]
Was the second script a different antibiotic? I could see trying a different class if the first didn’t work, in which case you’d want to take the whole course.
10. alexashka ◴[] No.45418859{3}[source]
Keeping old sick people alive as long as possible is absolutely the money maker for big pharma.

Part of keeping old sick people alive is generic antibiotics.

Therefore, we will continue to have them.

It has nothing to do with what people who have no power think, feel or do.