MultiDrug Cocktails – A Solution or Tragedy?

The big problem with antibiotic resistance is that we don’t know what is next in terms of solutions. In a few years someone could make a miraculous discovery. Or we could wait decades and all that changes is the number of people dying.

One option is combining multiple antibiotics together, something that has been shown to work. Although the scientists don’t fully understand why it works, it gets results just like multidrugs for HIV.

So there’s a conundrum. It could just work for a hundred years. Or it could work for 5 years and create super-super-drug resistant bacteria that will never be defeated.

I guess the solution is to concentrate on using these products as sparingly as possible.

Story at OZY


Superbug Defeats 26 Antibiotics, Kills Woman

Public health officials from Nevada are reporting on a case of a woman who died in Reno in September from an incurable infection. Testing showed the superbug that had spread throughout her system could fend off 26 different antibiotics.

The near future will have lots more stories like this, and totals, and trends. And slowly and surely many people will choose to lead more hermit-like existences.

Bacteria Containing MCR-1 Gene Found in Denmark

Untreatable Superbug.

Totally resistant to all antibiotics, and recently found in China as well. While there are promising new antibiotics in the pipeline, only time will tell if they are developed quick enough.

Just weeks after the discovery in China of bacteria resistant to all known forms of treatment, the same strain has been found in Denmark. Worse: It’s been there since 2012. Late last week researchers at the Technical University of Denmark announced they had found the feared ‘invulnerability’ gene among E. coli bacteria samples taken from humans and food. The scientists had been conducting a review of a genetic database of some 3000 different E. coli samples taken since 2009. Specifically they were seeking the mcr-1 gene, a mutation which gives bacteria a frightening resistance to the last effective family of antibiotics — colistin.
Herald Sun

The British Government is Trying

Given the ramifications of a world without antibiotics, and the dearth of viable products in the pipeline, you’d think the world’s governments would make some cash incentives available, or attempt to create new products themselves.

Unfortunately the appropriate large and generous reaction is unlikely because it doesn’t win votes. This is the same reason why the city of New Orleans failed to prepare for the inevitable hurricane – it was easier to save dollars and try to be re-elected than “waste” money protecting the public from something that didn’t happen in the short term.

The good news is that the UK government is potentially making an effort, thanks to the recommendations of a Review on Antimicrobial Resistance (AMR), led by former Goldman Sachs chief economist Jim O’Neill:

The first is to establish a five-year $2 billion (£1.3 billion) AMR Innovation Fund to support research and development. Pharmaceutical companies would provide the money – equivalent to less than 0.6% of the top 10 companies’ current R&D expenditure – and universities and small bio-tech companies would receive funding to kick-start early-stage research.

…The second recommendation is to create one global purchaser funded by governments and healthcare providers. This would reward drug companies for valuable new antibiotics – not through sales volume, but based on their social value. [The Conversation]

Hopefully it amounts to something, or even leads to inter-government dialogue.

1000-year-old Remedy Kills MRSA

MRSA, as you probably know, is an antibiotic-resistant superbug. On a whim, UK researchers have tested the abilities of a recipe found in Bald’s Leechbook, a thousand-year-old compendium of medical advice and potions.

Take cropleek and garlic, of both equal quantities, pound them well together… take wine and bullocks gall, mix with the leek… let it stand nine days in the brass vessel…

Intended to cure eye infections, it looks like it might help in the fight against MRSA.
I say might, because Wikipedia already lists a number of other natural MRSA killers – like honey, akin, cannabis – but none are doing the job for us yet.

Read more:

Antibiotic Resistance in Wild Animals

In a study published this September in PLOS ONE, Cristóbal-Azkarate and a team of researchers from Cambridge, the University of Washington, and Fundación Lusara in Mexico City reported that they had detected an abundance of bacteria resistant to clinical antibiotics in the feces of seven wild species in the Veracruz region of southeast Mexico. In addition to howler monkeys, the superbugs were present in spider monkeys, tapirs, jaguars, a puma, a dwarf leopard, and jaguarundis—small wildcats native to the area. Moreover, monkeys that lived far from humans were just as likely to harbor drug-resistant bacteria as those that were closer to people.

While the discovery surprised Cristóbal-Azkarate, who primarily studies hormonal influences on primates, other researchers have documented antibiotic resistance in animals all over the world—from wild rodents in Britain to iguanas in the Galapagos Islands. “Resistance is everywhere.  It is found in places that are ‘pristine’ and in places that are ‘polluted,’” said Randall Singer, an epidemiologist at University of Minnesota.

Source: The Scientist

HOPE: Teixobactin Kills Super-Bugs in Mammals

Developed by a privately-held company, NovoBiotic. I hope that Teixobactin is affordable, and the owners become very rich.

A paper in the journal Nature details how the new antibiotic, dubbed teixobactin, proved completely effective at healing mice infected with the most common drug-resistant forms of super-bug MRSA and tuberculosis.

What’s more, it could take a long while for bacteria to become resistant – which is particularly useful as pathogens around the world build up resistance to treatments.

…The microbes that create teixobactin, along with another 24 potential new antibiotics, were found in a soil sample taken from a field in Maine. To grow the samples, the researchers put one bacterium in a board called an iCube and enclosed it in a semipermeable membrane.

The iCube is then put into a box of the wonder soil, taken from the field, and its payload allowed to grow. In this way, the bacteria reproduces efficiently outside of a petri dish and harvested for drug production.

…The drug itself isn’t going to be available for some years yet, however. While it has been proven non-toxic to other mammals, testing on human subjects now has to be carried out, but teixobactin looks like our best bet yet against mankind’s oldest enemy.

Source: The Register

11 Million Useless Antibiotic Prescriptions Each Year.

A new study says that doctors have been prescribing antibiotics more than twice as often as needed to children suffering from acute respiratory infection [Source: NPR].

Even though only 27% of these infections are caused by bacteria, doctors have still been prescribing antibiotics 57% of the time.

“Last year the American Academy of Pediatrics recommended that doctors use caution when prescribing antibiotics for ear infections. That included giving parents a “contingency” prescription to use if the child doesn’t get better in a few days.”

What price new antibiotics?

While it is remotely possible that there are no more useful antibiotic products to be discovered / created, it seems that the only reason no new ones have been produced is that there is (currently) little chance of profit.

According to New Scientist, the estimated cost of coming up with a new and useful antibiotic is about $2.5 billion. Despite the massive customer base, getting a return from such an outlay is impossible while the market already has off-patent products still selling at low prices.

Here’s the most likely order of events:

  • Big Pharma will avoid antibiotics while cheap, current products are still being sold
  • Public awareness will develop regarding the impotence of current products
  • Big Pharma will work on new antibiotics, and for 5-10 years we will become shockingly more mortal
  • At the same time governments will fund research, and add to the news that we are in trouble
  • Eventually we will either have numerous new & effective antibiotics, or we will go through phases of having useful products and many people dying, or no new antibiotics will be discovered and we are screwed

Time To Start Wearing Gloves?

It seems the main ways of acquiring a transmissible illness is by either someone coughing into the air you are about the breathe, or by touching a contaminated surface with your hand and then your hand touches your mouth.

Because people generally wouldn’t touch their mouth with a glove, wearing one out in public might be a good precautionary measure, especially now that antibiotics are looking like they are no longer the miracle cure.

However it is not that easy. It is awkward to handle phones, keys, coins etc with gloves. The thinnest gloves are latex and not suited to being out and about in public. In fact, they could scare folk away. And most fashionable gloves are too cumbersome.

I have found these and will give them a go:

Ansell HyFlex 11-618

Not fashionable, but not creepy either. This isn’t my first choice, but at $80 AUD for a pack of 12, perhaps worth a go.

The multipurpose glove has a palm of coated nylon/polyurethane and an elasticised knitwrist. It is 20% lighter in weight than the manufacturer’s other equivalent products, but provides light mechanical protection.

My first choice is the Tough Gloves Ultra™ Thin Patrol Cabretta – the same product that police use, the same that TV character Dexter uses. $48 in the USA. They suggest you get the fit right, and tight.