[HN Gopher] The antimicrobial resistance crisis needs action now
___________________________________________________________________
The antimicrobial resistance crisis needs action now
Author : ikbdsk
Score : 37 points
Date : 2022-12-25 21:41 UTC (1 hours ago)
(HTM) web link (journals.plos.org)
(TXT) w3m dump (journals.plos.org)
| mustafabisic1 wrote:
| I bet all those antibiotics prescribed for covid didn't help as
| well. That was happening on a massive scale in my country
| eschaton wrote:
| Why were doctors prescribing antibiotics for COVID?!
| pram wrote:
| I think some of those 'kits' countries were distributing to
| people early-on (before the vaccine) contained stuff like
| doxycycline.
| AustinDev wrote:
| Secondary infections of bacterial pneumonia were common with
| COVID iirc.
| dopylitty wrote:
| A study just came out showing that co-infections weren't
| common [0]
|
| 0: https://academic.oup.com/ofid/article/9/Supplement_2/ofa
| c492...
| anbende wrote:
| When I was in Peru, they kind of prescribed antibiotics for
| everything. Persistent cold? Antibiotics. Like that.
|
| Source: lived there with Peruvian partner for 18 months.
| getoj wrote:
| Same deal in Japan, every time my kid has a cold her mum
| takes her to the doctor and comes home with antibiotics.
| When I get a cold the first thing anyone asks is whether I
| went to the doctor yet. For what? "Medicine."
| silisili wrote:
| Even in the US, pre COVID, every time I went to to doctor with
| a bad cold/flu, they'd just give you a Z Pak(antibiotics) and
| say...if it's bacterial this will kill it, if it's viral it'll
| work itself out. So I can definitely see how they're
| overprescribed.
| seunosewa wrote:
| They are cheaper than the tests to determine whether they're
| needed.
| zw7 wrote:
| Z-pak (azithromycin) is not the recommended antibiotic for
| bacterial sinus infections nor pneumonia (common bacterial
| infections associated with upper respiratory infections) per
| most guidelines. Interestingly though, it does have anti-
| inflammatory properties in addition to its main antibacterial
| effect. When I see a clinician prescribe a Z-pak (urgent
| cares are notorious for having a low threshold for
| prescribing Z-paks), part of me wonders if it's to avoid
| overuse and potential resistance to appropriate antibiotics
| and placate patients who want a quick fix.
|
| The downside is that since they feel better from the anti-
| inflammatory effect, its supports their initial thought they
| needed antibiotics and in the future will always think they
| need them, even though they very likely only have a viral
| infection.
| xahrepap wrote:
| I'm still amazed at how many people are able to get their dr to
| prescribe them antibiotics just by asking.
|
| I knew someone who had a cold and said "but I asked my Dr for
| some antibiotics and I'm taking DayQuil so I'll be better in a
| day or two"
|
| Im always left open mouthed gaping at them like... even if YOU
| don't know. But at least the Dr should ...
| YLYvYkHeB2NRNT wrote:
| US doctors have to do everything to keep patients happy. CMS
| rules their careers with satisfaction metrics. Hospital
| ADMINS really push it on them. Complaints lead to job loss.
| therusskiy wrote:
| My wife has just got better from a case of pneumonia that
| developed rapidly within several hours. If not for antibiotics...
|
| We are back to medieval times if antibiotics stop working.
| throwaway0x7E6 wrote:
| >if
|
| when
| DrJohanson wrote:
| [dead]
| zosima wrote:
| I am quite sure, that if a sufficient bounty was given out for
| developing new kinds of antimicrobials, they'd be developed in no
| time.
|
| The problem is that cost and risk of development and trials is
| too large for the current rewards, and hence there is very little
| new antimicrobials being developed. There are very many promising
| leads though, and either making development cheaper (by requiring
| smaller or fewer clinical trials) or ensuring good prices or
| bounties for successful development would likely create a
| plethora of antimicrobials in a quite short time frame.
| lofatdairy wrote:
| This is actually completely right. I believe there's some
| policy in the works in the US after talking to a friend who's
| doing some consulting work to help align the Cost-Benefit side
| of antimicrobial development.
|
| I can't say if there's a plethora of drugs just waiting to be
| released after CT requirements are lowered, but definitely
| there is less of an R&D incentive currently because pts who
| take antimicrobials only take them temporarily and cases where
| you need an advanced antimicrobial to deal with an AMR case are
| thankfully uncommon.
|
| Edit: I think this is the specific bill:
| https://www.congress.gov/bill/117th-congress/house-bill/3932...
| pazimzadeh wrote:
| There are alternatives to antimicrobials being developed. Instead
| of directly killing bacteria and therefore putting selective
| pressure on them, you can prevent their ability to bind to host
| surfaces and wash them away. The best example is probably
| mannosides, which are high affinity mannose analogues currently
| in clinical trial in humans for UTI treatment.
|
| https://pubmed.ncbi.nlm.nih.gov/22089451/
| SonOfLilit wrote:
| How is this putting less selection pressure on them?
| nextos wrote:
| We need more research in bacteriophages. They can be engineered
| to avoid any resistance, and they can replace antibiotics in all
| use cases.
|
| Besides, they are much more selective. Getting antibiotics when
| needed is OK, but they can lead to other health complications
| down the road.
___________________________________________________________________
(page generated 2022-12-25 23:00 UTC)