We have 5 known antibiotics. There are "MRSA" bacteria (which is a property of bacterial species, not a name for a particular species (anymore)) which don't care or react to about 4 of them and the 5th one is showing slightly reduced effectiveness already.
Why? Presumably because, of course, the new government rules imposed on doctors for antibiotics are about saving money and NOT about fighting resistance. The 5th antibiotic is ... not expensive in an absolute sense, but compared to the other 4 it's pretty expensive. The guideline from scientists is that if you decide to use it you need to nearly overdose the patient on it, despite that that is not necessary to cure them. Doing that is much more expensive (not that much more expensive really, it just looks impressive in % and presumably in excel sheets), but fights resistance. We're not doing that, and so we have ... probably not even a decade ... and then we have no treatment anymore against bacterial infection.
And in a decade, we will still be surrounded by lethal bacteria. Look at your hand. It's overwhelmingly likely you can't see them but you're looking at lethal pneumococci, several species. This is a clean hand we're taking about. Even a freshly scrubbed hand of a surgeon will still have quite a few bacteria. Grab a handful of soil. You know, the kind plants grow in. Your hand now has botulinum-producing bacteria, as well as many other toxins, tuberculosis (definitely if you're anywhere near a farm), tetanus, and the list goes on and on), some of which we have no vaccine against at all, and many we don't vaccinate for because it's not practical.
So the choice is between developing DNA sequences for viruses, or having a pandemic 100x worse than COVID every 30 years or so.
The guideline from scientists is that if you decide to use it you need to nearly overdose the patient on it, despite that that is not necessary to cure them. Doing that is much more expensive (not that much more expensive really, it just looks impressive in % and presumably in excel sheets), but fights resistance.
I'm skeptical of this often cited claim. The more you use it the greater the evolutionary pressure you place and the more you force evolved resistance. If you overuse an antibiotic, you kill off all of the bacteria that could compete with the resistant strains, thus strongly promoting resistance.
I posit that like with all other evolutionary pressures, reducing the pressure is the right approach.
What you say would make sense if phages designed from scratch with generative AI were the only solution to antibiotic resistance. That's obviously not the case.
I went to chatGPT to get what the fuck you mean (just in case saving money meant the government isn't giving me or my colleagues access at all to some antibiotics). But sadly it's not that. It's a correct answer, just totally disregarding resistance. In order to arrive at 10 classes, ChatGPT is naming classes that are defeated, like Penicillin. I didn't consider or count antibiotics that became completely useless before 1980 or so (because other than historical and research interest, what's the point? Nobody's going to make penicillin effective again) and then 5 is very much the correct count.
So yes, counting useless antibiotics (useless in curing humans, not necessarily useless in research or other procedures like making custom antibodies), there are 10 classes (although if you're going there, why not go further than 10? But whatever)
So let's classify ChatGPT's suggestions:
1) Fully defeated by Bacteria: penicillins, macrolides, fluoroquinolones (yes, very occasionally there will be something these do still work against, however no sane physician will "trust" these, and nobody outside of research bothers testing anything against them)
2) Mostly defeated: carbapenems, cephalosporins, and vancomycin. If you know what you're dealing with these can be used, but if even slightly in doubt what bacterium it is, we do not go here. Without a lab test confirming that what's ailing the patient responds to these (positive confirmation needed), do not use. This also means they're not useful in emergencies.
3) Useful ... except: tetracyclines, aminoglycosides, "combinations", Daptomycin (and lipopeptides in general), oxazolidinones. These can be used "by default". These are "the 5" that we're talking about.
And yes, I got updated, until 2024 there was no known resistance to Daptomycin (which is an "updated" version of Vancomycin in some ways). There now are known resistant strains against all of them, which means we've actually climbed one more rung on the ladder.
Current state: for every antibiotic we know there is a disease that just totally ignores that antibiotic. However we are not yet in the state that one disease is immune against everything (although there are MRSA strains that are highly resistant to 4 out of 5, in India, and frankly, probably in China, except they're lying about it. These strains are also active in Pakistan and probably Afghanistan and Iran except nobody really knows for sure)
You should hear about the war that occurs in the ocean non stop. Quadrillions of bacteria, bacteriaphages, and viruses are in a constant battle and evolving to one up each other.
Really I don't get how multicellular life survived it.
Comments
We have 5 known antibiotics. There are "MRSA" bacteria (which is a property of bacterial species, not a name for a particular species (anymore)) which don't care or react to about 4 of them and the 5th one is showing slightly reduced effectiveness already.
Why? Presumably because, of course, the new government rules imposed on doctors for antibiotics are about saving money and NOT about fighting resistance. The 5th antibiotic is ... not expensive in an absolute sense, but compared to the other 4 it's pretty expensive. The guideline from scientists is that if you decide to use it you need to nearly overdose the patient on it, despite that that is not necessary to cure them. Doing that is much more expensive (not that much more expensive really, it just looks impressive in % and presumably in excel sheets), but fights resistance. We're not doing that, and so we have ... probably not even a decade ... and then we have no treatment anymore against bacterial infection.
And in a decade, we will still be surrounded by lethal bacteria. Look at your hand. It's overwhelmingly likely you can't see them but you're looking at lethal pneumococci, several species. This is a clean hand we're taking about. Even a freshly scrubbed hand of a surgeon will still have quite a few bacteria. Grab a handful of soil. You know, the kind plants grow in. Your hand now has botulinum-producing bacteria, as well as many other toxins, tuberculosis (definitely if you're anywhere near a farm), tetanus, and the list goes on and on), some of which we have no vaccine against at all, and many we don't vaccinate for because it's not practical.
So the choice is between developing DNA sequences for viruses, or having a pandemic 100x worse than COVID every 30 years or so.
There is no choice here.
I'm skeptical of this often cited claim. The more you use it the greater the evolutionary pressure you place and the more you force evolved resistance. If you overuse an antibiotic, you kill off all of the bacteria that could compete with the resistant strains, thus strongly promoting resistance.
I posit that like with all other evolutionary pressures, reducing the pressure is the right approach.
What you say would make sense if phages designed from scratch with generative AI were the only solution to antibiotic resistance. That's obviously not the case.
Googling the 5 known antibiotics comes back
I went to chatGPT to get what the fuck you mean (just in case saving money meant the government isn't giving me or my colleagues access at all to some antibiotics). But sadly it's not that. It's a correct answer, just totally disregarding resistance. In order to arrive at 10 classes, ChatGPT is naming classes that are defeated, like Penicillin. I didn't consider or count antibiotics that became completely useless before 1980 or so (because other than historical and research interest, what's the point? Nobody's going to make penicillin effective again) and then 5 is very much the correct count.
So yes, counting useless antibiotics (useless in curing humans, not necessarily useless in research or other procedures like making custom antibodies), there are 10 classes (although if you're going there, why not go further than 10? But whatever)
So let's classify ChatGPT's suggestions:
1) Fully defeated by Bacteria: penicillins, macrolides, fluoroquinolones (yes, very occasionally there will be something these do still work against, however no sane physician will "trust" these, and nobody outside of research bothers testing anything against them)
2) Mostly defeated: carbapenems, cephalosporins, and vancomycin. If you know what you're dealing with these can be used, but if even slightly in doubt what bacterium it is, we do not go here. Without a lab test confirming that what's ailing the patient responds to these (positive confirmation needed), do not use. This also means they're not useful in emergencies.
3) Useful ... except: tetracyclines, aminoglycosides, "combinations", Daptomycin (and lipopeptides in general), oxazolidinones. These can be used "by default". These are "the 5" that we're talking about.
And yes, I got updated, until 2024 there was no known resistance to Daptomycin (which is an "updated" version of Vancomycin in some ways). There now are known resistant strains against all of them, which means we've actually climbed one more rung on the ladder.
Current state: for every antibiotic we know there is a disease that just totally ignores that antibiotic. However we are not yet in the state that one disease is immune against everything (although there are MRSA strains that are highly resistant to 4 out of 5, in India, and frankly, probably in China, except they're lying about it. These strains are also active in Pakistan and probably Afghanistan and Iran except nobody really knows for sure)
Jesus, how are the other living things existing at all?
You should hear about the war that occurs in the ocean non stop. Quadrillions of bacteria, bacteriaphages, and viruses are in a constant battle and evolving to one up each other.
Really I don't get how multicellular life survived it.
Why go to the ocean, because that happens everywhere, non-stop. If your immune system stops working, then you are a dead man.