We're fucked. Resistance to last-resort antibiotic has now spread across globe

[Berkut]

some experts in the field suspect that it may very well be the case that the last several decades of human ability to decisively treat bacterial infections might be just a blip in human history, and long term we will go back to lots of people dying from these...

OTOH, even if they're correct, that puts a bit of perspective on the issue--we managed to survive as a species for thousands of years without antibiotics.

In dramatically smaller numbers and for dramatically shorter periods of time with a dramatically higher mortality rate.  So yes, it does provide a great deal of perspective.

Yeah, I don't think the concern here is that without antibiotics humanity will cease to exist.

[crazy canuck]

some experts in the field suspect that it may very well be the case that the last several decades of human ability to decisively treat bacterial infections might be just a blip in human history, and long term we will go back to lots of people dying from these...

OTOH, even if they're correct, that puts a bit of perspective on the issue--we managed to survive as a species for thousands of years without antibiotics.

In dramatically smaller numbers and for dramatically shorter periods of time with a dramatically higher mortality rate.  So yes, it does provide a great deal of perspective.

Yeah, I don't think the concern here is that without antibiotics humanity will cease to exist.

On the bright side, it would do wonders for our global warming problem. 

But the advantage we do have is that bacteria has a very fast generational cycle time (well, that is an advantage and disadvantage, of course). That means that while they can quickly develop resistance, that resistance would likely go away relatively quickly as well...if we could somehow stop using the particular class of anti-biotic.

Probably doctors will prescribe cocktails of antibiotics that each are potentially effective, diminishing the chance resistance will go away.

Doctors already prescribe wide spectrum antibiotics.   The problem is a growing resistance to even the most powerful of those wide spectrum drugs.  If it was really as simple as putting together a new "cocktail" then there would be no problem.  But it is not that simple.

[Valmy]

I would like to think the medical community has learned a powerful lesson in our battle with bacterial infection that will be useful in future efforts and not so much 'DOOOMED' but we will see.

[crazy canuck]

I would like to think the medical community has learned a powerful lesson in our battle with bacterial infection that will be useful in future efforts and not so much 'DOOOMED' but we will see.

The issue isn't with the medical community.  They already know the problem and who is causing it.  The problem is frankly the livestock industry and everyone who buys medicated meat to eat.

[Berkut]

It is a classic economics problem.

there is a HUGE hidden cost to giving individuals antibiotics that should result in doctors being very careful about doing so. However, there is also huge and immediate pressure to value the current health of a patient over the largely invisible and collective cost of over-prescribing antibiotics. This is well known, well understood, and has been very visible in theory for a very long time within the medical community...and yet largely ignored because at the end of the day doctors answer to their immediate patients needs.

I don't know if there is any possible solution to this that would work in a basically free society. you would need the government to take control of antibiotics or something.

[crazy canuck]

It is a classic economics problem.

there is a HUGE hidden cost to giving individuals antibiotics that should result in doctors being very careful about doing so. However, there is also huge and immediate pressure to value the current health of a patient over the largely invisible and collective cost of over-prescribing antibiotics. This is well known, well understood, and has been very visible in theory for a very long time within the medical community...and yet largely ignored because at the end of the day doctors answer to their immediate patients needs.

I don't know if there is any possible solution to this that would work in a basically free society. you would need the government to take control of antibiotics or something.

You have not identified the correct economic problem.  The rise in drug resistant bacteria is mainly a problem of using the drug to raise meat on an industrial scale.  The benefit is relatively cheap and abundant meat so that everyone can still buy an inexpensive hamburger.  The huge hidden cost is the resulting drug resistant bacteria.

[Berkut]

It is a classic economics problem.

there is a HUGE hidden cost to giving individuals antibiotics that should result in doctors being very careful about doing so. However, there is also huge and immediate pressure to value the current health of a patient over the largely invisible and collective cost of over-prescribing antibiotics. This is well known, well understood, and has been very visible in theory for a very long time within the medical community...and yet largely ignored because at the end of the day doctors answer to their immediate patients needs.

I don't know if there is any possible solution to this that would work in a basically free society. you would need the government to take control of antibiotics or something.

You have not identified the correct economic problem.  The rise in drug resistant bacteria is mainly a problem of using the drug to raise meat on an industrial scale.  The benefit is relatively cheap and abundant meat so that everyone can still buy an inexpensive hamburger.  The huge hidden cost is the resulting drug resistant bacteria.

Is that the primary driver, or is it just prescribing antibiotics in humans itself?

edit: I know this is what THIS particular article focused on, but I've been reading about the overall issue long before anyone brought up antibiotic use in livestock. I don't doubt that this could accelerate the problem, of course. But I am skeptical that absent it, the problem doesn't still exist.

[crazy canuck]

It is a classic economics problem.

there is a HUGE hidden cost to giving individuals antibiotics that should result in doctors being very careful about doing so. However, there is also huge and immediate pressure to value the current health of a patient over the largely invisible and collective cost of over-prescribing antibiotics. This is well known, well understood, and has been very visible in theory for a very long time within the medical community...and yet largely ignored because at the end of the day doctors answer to their immediate patients needs.

I don't know if there is any possible solution to this that would work in a basically free society. you would need the government to take control of antibiotics or something.

You have not identified the correct economic problem.  The rise in drug resistant bacteria is mainly a problem of using the drug to raise meat on an industrial scale.  The benefit is relatively cheap and abundant meat so that everyone can still buy an inexpensive hamburger.  The huge hidden cost is the resulting drug resistant bacteria.

Is that the primary driver, or is it just prescribing antibiotics in humans itself?

It is.  There is some drug resistance which occurs when prescribing to a human patient to deal with an infection but that normally occurs when the patient doesn't take the drug properly - ie to the end of the prescription and they simply stop taking it when they start feeling better.  Under those circumstances some of the infecting bacteria can survive and pass on their resistance so that the next generation of that bacteria is resistant to that dose.  But when the drug is taken properly it is rare for the bacteria being treated to survive.

As an anecdote - in the years I have needed to take antibiotics to clear an infection from my lungs I have been able to take the same one and the same dose each time.  I am very careful of course to take the drug exactly as prescribed so I don't slowly kill myself by building my own drug resistant strains.  But I am still obviously at risk of coming into contact with other resistant strains.

There is also the problem of prescribing to people who don't actually have an infection.  That is probably the biggest problem.

[Berkut]

Interesting - I am sure you know more about this than myself, since it directly affects you of course.

This is actually pretty good news, since it does mean that there could be a solution at least. Get fucking China to quit feeding cows our antibiotics!

[Valmy]

It is.

Well then we have an straightforward solution don't we? Outlaw antibiotics for use in livestock. That is sure much more straightforward than regulating doctor prescriptions.

[Valmy]

This is actually pretty good news, since it does mean that there could be a solution at least. Get fucking China to quit feeding cows our antibiotics!

Yep.

[crazy canuck]

Interesting - I am sure you know more about this than myself, since it directly affects you of course.

This is actually pretty good news, since it does mean that there could be a solution at least. Get fucking China to quit feeding cows our antibiotics!

Good and bad.  There is a possible solution but I am doubtful consumers will stop buying medicated meat in large enough numbers to change the industry in North America or elsewhere.

[Berkut]

Interesting - I am sure you know more about this than myself, since it directly affects you of course.

This is actually pretty good news, since it does mean that there could be a solution at least. Get fucking China to quit feeding cows our antibiotics!

Good and bad.  There is a possible solution but I am doubtful consumers will stop buying medicated meat in large enough numbers to change the industry in North America or elsewhere.

Shrug.

This is a perfect example of why I am a "small-l" libertarian.

A classic case where you need some kind of intervention because the free market (certainly the global free market) does not suffice to protect society as a whole.

Simply make it part of the licensing process for sale of meat. It cannot be treated with these kinds of antibiotics.

Of course, the problem then becomes how do you force a country like China to play ball. Not so hard to do if they want export said meat, but the problem is that even their domestic consumption has impacts outside China.

Isn't this what we have the UN for???

[Valmy]

Good and bad.  There is a possible solution but I am doubtful consumers will stop buying medicated meat in large enough numbers to change the industry in North America or elsewhere.

Um if medicated meat is going to endanger all of our lives I am pretty sure we will. And why wouldn't a major health crisis not be regulated?

[crazy canuck]

Interesting - I am sure you know more about this than myself, since it directly affects you of course.

This is actually pretty good news, since it does mean that there could be a solution at least. Get fucking China to quit feeding cows our antibiotics!

Good and bad.  There is a possible solution but I am doubtful consumers will stop buying medicated meat in large enough numbers to change the industry in North America or elsewhere.

Shrug.

This is a perfect example of why I am a "small-l" libertarian.

A classic case where you need some kind of intervention because the free market (certainly the global free market) does not suffice to protect society as a whole.

Simply make it part of the licensing process for sale of meat. It cannot be treated with these kinds of antibiotics.

Of course, the problem then becomes how do you force a country like China to play ball. Not so hard to do if they want export said meat, but the problem is that even their domestic consumption has impacts outside China.

Isn't this what we have the UN for???

Before you start looking at China, take a closer look at what is happening in the US.  Everyone is using industrial meat production. I think it is going to take a serious outbreak of an untreatable strain of bacteria before that is stopped.