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103 points pseudolus | 1 comments | | HN request time: 0.197s | source
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itsme0000 ◴[] No.45601359[source]
I’m really glad this article acknowledges that better access to antibiotics is probably the best solution to the problem. I’ve actually heard people argue the opposite.

Many people, even doctors will blame patients for creating antibiotics resistant strains. While it’s true that a resistant strain can develop and spread due to an individual’s actions, those strains will gradually lose their resistance once no longer exposed to antibiotics, so it’s probably better have antibiotics be accessible drugs everywhere to prevent any initial spread and just trust people won’t use them chronically for no reason. Though I’d argue lack of access to antibiotics contributes more to the spread of disease then careless patients stuffing down their mouths, it really depends on what type of bacteria it is. Patients with viruses often misdiagnose themselves as needing antibiotics and that’s another reason it’s not over the counter, that builds resistant bacteria, not inside the patient but in the external environment due to excretion in urine etc.

Doctors will often chide patients for not taking the whole bottle of antibiotics once they stop feeling symptoms as if this gives more opportunity for the resistant strain to spread. It’s true it’s probably safer to totally ensure you are free of disease before stopping a medication, but increasing the overall level of antibiotics in the environment boosts resistance in every case. As people on this thread have pointed out the mass use of antibiotics in cattle farming is going to contribute significantly to resistance because it permanently increases the amount of antibiotics in the environment. Other than stopping that not much can be done to prevent this

It’s kind of a non-issue on an individual level as resistant strains lose resistance over relatively short periods time, once no longer exposed to the antibiotic, people just assume if the bacteria evolved an advantageous trait it will never lose that trait even though it’s no longer advantageous once it’s environment returns to normal.

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Supermancho ◴[] No.45601505[source]
> those strains will gradually lose their resistance once no longer exposed to antibiotics,

I've never heard this. Can you cite an example or source for this? How could we be losing if medicine can afford to "wait out" a strain? MRSA's been around 80 years. Call me skeptical.

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JumpCrisscross ◴[] No.45601520[source]
> Can you cite an example or source for this?

“We previously reconstructed a 1,000-year-old remedy containing onion, garlic, wine, and bile salts, known as ‘Bald’s eyesalve’, and showed it had promising antibacterial activity. In this current paper, we have found this bactericidal activity extends to a range of Gram-negative and Gram-positive wound pathogens in planktonic culture and, crucially, that this activity is maintained against Acinetobacter baumannii, Stenotrophomonas maltophilia, Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus pyogenes in a soft-tissue wound biofilm model” [1].

> How could we be losing if medicine can afford to "wait out" a strain?

In general, “mutations that confer larger” resistance “are more costly” in terms of fitness [2].

Absent the selection pressure of a particular antibiotic, the bugs without that resistance generally outcompete the ones weaving chainmail against Tomahawks.

[1] https://www.nature.com/articles/s41598-020-69273-8

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC4380921/

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Dylan16807 ◴[] No.45601580[source]
To prove the claim we need to see that the salve is useful and that it used to be less useful because of resistance. Is that proven somewhere? This just looks like a "new" antibiotic.

And the more important part is losing resistance in a meaningful timeframe, much smaller than 1000 years. Also the relevant genes can't be easy to reactivate.

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1. JumpCrisscross ◴[] No.45601647[source]
> we need to see that the salve is useful and that it used to be less useful because of resistance. Is that proven somewhere?

No proof, but when I came across this it was suspected the treatment fell out of use due to resistance.