# The Post-Antibiotic Age? **URL:** \ **Category:** Factual Questions\ **Created:** [November 22, 2013, 6:24am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499 "2013-11-22T06:24:22Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [November 23, 2013, 12:52am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/21 "2013-11-23T00:52:57Z")
> [@kaltkalt](#): > > If we treated antibiotics as “controlled substances” with extreme hatred and extreme punishment for doctors who prescribe them “unnecessarily” the way we treat C-II opioids i’m certain we wouldn’t be facing this problem. > > Imagine hearing about a doctor who went to federal prison for 20 years for prescribing antibiotics to someone with a viral infection. A few instances of that and problem solved. Although that sounds draconian, I basically agree. But you are ignoring the elephant in the room: the wholesale use of antibiotics in animal husbandry. It is insane, insane, insane (and I wish there were a stronger word) to permit it. It led directly to the rise of virulent strains of E. coli. E. coli is generally a tame organism. When I was working in a lab in the mid 50s, I would pipette without bothering to use a bulb to avoid any possibility of imbibing it. It is all over the gut, in all of us. But these virulent strains are brand new. Moreover, the animals are incubators for all sorts of diseases. Why do we allow it? Because it makes the animals grow faster. Perhaps more important, it allows the animals to be crowded together in more and more unsanitary surroundings. It is criminal. And yes, drug companies are less interested in working on drugs that you take for 10 days to treat an acute disease than on a drug you might take for the rest of your life for something chronic. And things that prevent diseases are the worst of all from their point of view. That’s why the anti-vaxxer claim that big pharma is pushing vaccines is so risible (or would be if it weren’t so tragic). ---
**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\ **Post date:** [November 23, 2013, 1:00am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/22 "2013-11-23T01:00:27Z")
> [@ralph124c](#): > > Dr. Paul Ehrlich found a chemical which killed syphilis (salvarsan)-why not revive the chemical route? Salvarsan has a rather drastic side effect list. That being said, antibiotics are chemicals, and the various classes have differing modes of action. ---
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [November 23, 2013, 2:28am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/23 "2013-11-23T02:28:03Z")
> [@kaltkalt](#): > > As I always say, there should NEVER be a law. My only point is IF we’re going to have “controlled substances” and severely restrict their prescription, opioids and drugs with recreational potential shouldn’t be the ones controlled. Antibiotics should. I’d feel a lot better if the DEA were going after unnecessary antibiotic prescribers as opposed to pain mgmt doctors. But that’s a different topic. Well, if colchicine were OTC there are quite a few people I wouldn’t have a quiet drink with … I do understand what you are getting at though - but there are a lot of drugs that shouldn’t be self-prescribed. Hell, there have been what 2 or 3 murders/attempts with insulin? And blood pressure meds can be twitchy to get correct. You see that little list of small print listing the possible side effects, interactions and contraindications? How many people are qualified to self prescribe? I am pretty clued in on diabetic and blood pressure meds from some 30 years of living as a diabetic and almost 5 years now with BO issues, and it took me and a cardiologist almost 3 full months to dial in 5 different BP and cardiac meds to get the cocktail that drops me down from 210/190 to 130/85. Then we have to take into account my other pre-existing conditions, some of which have requirements that are contraindicated in combination with my other meds… ---
**Author:** ![kaltkalt](https://avatars.discourse-cdn.com/v4/letter/k/bb73d2/32.png) [@kaltkalt](https://boards.straightdope.com/u/kaltkalt)\ **Post date:** [November 23, 2013, 2:42am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/24 "2013-11-23T02:42:40Z")
> [@aruvqan](#): > > Well, if colchicine were OTC there are quite a few people I wouldn’t have a quiet drink with … > > I do understand what you are getting at though - but there are a lot of drugs that shouldn’t be self-prescribed. Hell, there have been what 2 or 3 murders/attempts with insulin? And blood pressure meds can be twitchy to get correct. You see that little list of small print listing the possible side effects, interactions and contraindications? How many people are qualified to self prescribe? I am pretty clued in on diabetic and blood pressure meds from some 30 years of living as a diabetic and almost 5 years now with BO issues, and it took me and a cardiologist almost 3 full months to dial in 5 different BP and cardiac meds to get the cocktail that drops me down from 210/190 to 130/85. Then we have to take into account my other pre-existing conditions, some of which have requirements that are contraindicated in combination with my other meds… Freedom is dangerous. Freedom can always be measured by the number of dead people that result. The more people who die, especially children, the more free we are. Plus as long as acetaminophen, one of the most hepatotoxic substances known to man which causes over 50,000 deaths annually is OTC then so should heroin-cocaine combo speedball prefilled injections (with a touch of methamphetamine). Acetaminophen kills more people each yr than oxycontin and vicodin and all that stuff combined. Meanwhile the most dangerous, intoxicating, also hepatotoxic drug out there - alcohol - is perfectly legal and on the shelf - there’s not even a counter to reach over. Alcohol is the only drug that actually does what drug war propagandists claim other drugs do. But my right to do something arguably risky/stupid is worth millions of dead people. Meanwhile, stupid stuff like skydiving, bungee jumping and free-diving are perfectly legal and nobody talks about banning them. I contend it’s worth millions of dead children just to be able to have really soft toilet paper. And if millions of children were dying in africa and we could save them all by using cardboard to wipe our asses, those kids would continue to die without much debate at all. Think how many lives we could save by lowering all speed limits on all roads to 5mph? But it’s worth hundreds of thousands of dead lives (including many of The Precious Children) for the convenience of going faster than a horse. I have yet to find a single person who disagrees with that and would support lowering all speed limits to 5mph with felony penalties for speeding (20 years in prison for going 10mph). ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [November 23, 2013, 4:10am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/25 "2013-11-23T04:10:31Z")
> [@Ferret\_Herder](#): > > Salvarsan has a rather drastic side effect list. That being said, antibiotics are chemicals, and the various classes have differing modes of action. Yeah, because it contains arsenic, and people had to take it for as long as 18 months of weekly (or thereabouts) injections to be considered “cured”. My own experience with people who had infections resistant to everything is that they were in very poor health beforehand. I also believe that the obsession with antibacterial this and that has contributed to the rise in allergies and auto-immune diseases. I don’t use hand sanitizer unless I have to. ---
**Author:** ![eschereal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eschereal/32/18939_2.png) [@eschereal](https://boards.straightdope.com/u/eschereal)\ **Post date:** [November 23, 2013, 4:32am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/26 "2013-11-23T04:32:23Z")
> [@kaltkalt](#): > > Anything I read that sounds like it’s meant to be scary I take with a huge grain of salt. But I have been hearing about more and more antibacterial resistant strains for a while now … We do have a trump card in hand. [This might ease your fears](http://en.wikipedia.org/wiki/Bacteriophage) just a little. They have been using these in other parts of the world for quite some time. > [@kaltkalt](#): > > But yes, putting so much antibiotics into milk, meat, cows, fish, chickens, etc is ridiculous. This is entirely profit-motivated. Every sick pig that you cannot safely butcher and sell is a money loser. The same economy that discourages new antibiotic development also encourages this kind of abuse. > [@kaltkalt](#): > > The only “controlled substances” should be antibiotics. They’re the only drug someone else can use and have it actually affect me. I suspect you are being naïve here. I recall reading about Prozac having a serious effect on the viability (breeding) of some shellfish like oysters: Prozac that exits urethras unaltered, travels through sewers, and is not captured by treatment plants. There seems to be a medicine cabinet full of various drugs in our water systems, much of it not good for the things that live in water. ---
**Author:** ![kaltkalt](https://avatars.discourse-cdn.com/v4/letter/k/bb73d2/32.png) [@kaltkalt](https://boards.straightdope.com/u/kaltkalt)\ **Post date:** [November 23, 2013, 7:32am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/27 "2013-11-23T07:32:32Z")
> [@For You](#): > > I suspect you are being naïve here. I recall reading about Prozac having a serious effect on the viability (breeding) of some shellfish like oysters: Prozac that exits urethras unaltered, travels through sewers, and is not captured by treatment plants. There seems to be a medicine cabinet full of various drugs in our water systems, much of it not good for the things that live in water. And nitroglycerin can be used as an explosive. I’m only talking about controlled substances from a stupid, pointless, moronic “drug war” stance, trying to keep certain medicines out of the hands of people because their use will somehow “harm society” as a whole. There’s only one pill you can take that can, however remotely and indirectly, negatively affect me. That’s an antibiotic (by creating resistant strains). You can shoot up all the heroin and snarf all the meth and cocaine you want, it won’t affect me in any way. Driving while intoxicated on any substance, whether it be alcohol or sudafed, is a different issue. I don’t see anything about prozac exiting the body unaltered. A lot of it is metabolized into norfluoxetine. I’m sure many chemicals have a negative affect on shellfish and other marine life. I doubt excreted prozac is a serious issue. ---
**Author:** ![dtilque](https://avatars.discourse-cdn.com/v4/letter/d/d6d6ee/32.png) [@dtilque](https://boards.straightdope.com/u/dtilque)\ **Post date:** [November 23, 2013, 9:50am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/28 "2013-11-23T09:50:50Z")
> [@kaltkalt](#): > > I said most strains are not resistant, pointing out that most are still susceptible to penicillin, something that’s been in use for 70 years. Why are most bacteria (at least the infectious ones we treat with antibiotics) not immune to penicillin? Because it costs bacteria energy, time, and materials to maintain that resistance. The actual mechanism of resistance is irrelevant. It may be that they generate a chemical which interferes with the antibiotic or maybe they just pump the antibiotic out of their cells. Whatever, it costs more. So in environments that have little to no antibiotic, bacteria that don’t have the resistance will multiply faster and thus be the dominant bacteria. And such environments are still very common, much more common than those with high levels of antibiotic. Note the above applies to any antibiotic resistance, not just for penicillin. ---
**Author:** ![j\_sum1](https://avatars.discourse-cdn.com/v4/letter/j/8baadc/32.png) [@j\_sum1](https://boards.straightdope.com/u/j_sum1)\ **Post date:** [November 23, 2013, 11:31am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/29 "2013-11-23T11:31:09Z")
[Relevant article – Call to ban antibacterial household cleaners](https://www.google.com/url?q=http://www.stuff.co.nz/manawatu-standard/news/9434797/Call-to-ban-anti-bacterial-home-products&sa=U&ei=PJGQUoPNFMr2iwL7kYCQCA&ved=0CBgQFjAJ&client=internal-uds-cse&usg=AFQjCNHdRWxeaKqVo-wAOVyQEIN8uvY8SA) ---
**Author:** ![Alley\_Dweller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alley_dweller/32/430_2.png) [@Alley\_Dweller](https://boards.straightdope.com/u/Alley_Dweller)\ **Post date:** [November 23, 2013, 11:38am UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/30 "2013-11-23T11:38:31Z")
> [@j\_sum1](#): > > [Relevant article – Call to ban antibacterial household cleaners](https://www.google.com/url?q=http://www.stuff.co.nz/manawatu-standard/news/9434797/Call-to-ban-anti-bacterial-home-products&sa=U&ei=PJGQUoPNFMr2iwL7kYCQCA&ved=0CBgQFjAJ&client=internal-uds-cse&usg=AFQjCNHdRWxeaKqVo-wAOVyQEIN8uvY8SA) I don’t understand this article. Why would overuse of triclosan, for example, in household cleaners cause a bacterium to become resistant to methicillin? ---
**Author:** ![Canadjun](https://avatars.discourse-cdn.com/v4/letter/c/76d3ee/32.png) [@Canadjun](https://boards.straightdope.com/u/Canadjun)\ **Post date:** [November 23, 2013, 3:37pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/31 "2013-11-23T15:37:23Z")
> [@Alley\_Dweller](#): > > I don’t understand this article. Why would overuse of triclosan, for example, in household cleaners cause a bacterium to become resistant to methicillin? I think the article is correct but poorly written. My interpretation is that they are arguing (quite reasonably IMHO) against inappropriate use of all antibacterials and antibiotics and they are mixing the arguments against both together. ---
**Author:** ![Spoke](https://avatars.discourse-cdn.com/v4/letter/s/a88e57/32.png) [@Spoke](https://boards.straightdope.com/u/Spoke)\ **Post date:** [November 23, 2013, 4:26pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/32 "2013-11-23T16:26:06Z")
Another recent and relevant (and scary) article: [Imagining the Post-Antibiotics Future](https://medium.com/p/892b57499e77) ---
**Author:** ![Mr.Kobayashi](https://avatars.discourse-cdn.com/v4/letter/m/4af34b/32.png) [@Mr.Kobayashi](https://boards.straightdope.com/u/Mr.Kobayashi)\ **Post date:** [November 23, 2013, 5:13pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/33 "2013-11-23T17:13:14Z")
[Previously thread](http://boards.straightdope.com/sdmb/showthread.php?t=681095) on the ‘antibiotic apocalypse’, or as I prefer to call it, ‘love in the time of antibiotic-resistant supercholera’. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 23, 2013, 5:40pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/34 "2013-11-23T17:40:33Z")
[Another article](http://www.scientificamerican.com/article.cfm?id=flying-the-coop-antibiotic-resistance-spreads-to-birds-other-wildlife) of interest. Yes we need new weapons, but new antibiotics would only be a band-aid. The overuse of antibiotics is spilling over into the environment. It is tied to [the](http://phenomena.nationalgeographic.com/2012/08/23/antibiotics-fuel-obesity-by-creating-microbe-upheavals/) [obesity](http://www.motherjones.com/environment/2013/11/maps-antibiotics-prescriptions-obesity-states)[epidemic](http://www.nytimes.com/2013/11/10/business/the-co-villains-behind-obesitys-rise.html). The effects of endemic antibiotic exposures may play a role in the rise of [autoimmune diseases](http://www.livescience.com/15740-helpful-bacteria-antibiotics.html) as well. As disc’ed in the thread that **Mr. K.** linked to … we really do seem to benefit greatly from exposure to a variety of the right sort of bacterial diversity, or as phrased in an article linked to there, the right sort of dirt. (Both in our own bodies and in the broader environment.) The benefits of decreased antibiotic use (in medicine and in the animal food industry) go way _beyond_ delaying the emergence of more antibiotic-resistant superbugs. ---
**Author:** ![j\_sum1](https://avatars.discourse-cdn.com/v4/letter/j/8baadc/32.png) [@j\_sum1](https://boards.straightdope.com/u/j_sum1)\ **Post date:** [November 23, 2013, 6:45pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/35 "2013-11-23T18:45:02Z")
> [@Alley\_Dweller](#): > > I don’t understand this article. Why would overuse of triclosan, for example, in household cleaners cause a bacterium to become resistant to methicillin? > [@Canadjun](#): > > I think the article is correct but poorly written. My interpretation is that they are arguing (quite reasonably IMHO) against inappropriate use of all antibacterials and antibiotics and they are mixing the arguments against both together. Agreed. I t is a bit muddled. I posted because I came across it just after having read this thread. I think antibacterial everything, like antibiotic overprescription, is a misguided attempt to help and is actually causing harm. ---
**Author:** ![kaltkalt](https://avatars.discourse-cdn.com/v4/letter/k/bb73d2/32.png) [@kaltkalt](https://boards.straightdope.com/u/kaltkalt)\ **Post date:** [November 23, 2013, 6:49pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/36 "2013-11-23T18:49:48Z")
Actually this is the original article I read: > **[When We Lose Antibiotics, Here's Everything Else We'll Lose Too](https://www.wired.com/2013/11/end-abx/)** > > This week, health authorities in New Zealand announced that the tightly quarantined island nation — the only place I’ve ever been where you get x-rayed on the way into the country as well as leaving it — has experienced its first case, and first... ---
**Author:** ![eschereal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eschereal/32/18939_2.png) [@eschereal](https://boards.straightdope.com/u/eschereal)\ **Post date:** [November 23, 2013, 8:33pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/37 "2013-11-23T20:33:36Z")
> [@dtilque](#): > > Because it costs bacteria energy, time, and materials to maintain that resistance. The actual mechanism of resistance is irrelevant. It may be that they generate a chemical which interferes with the antibiotic or maybe they just pump the antibiotic out of their cells. Whatever, it costs more. So in environments that have little to no antibiotic, bacteria that don’t have the resistance will multiply faster and thus be the dominant bacteria. And such environments are still very common, much more common than those with high levels of antibiotic. > > Note the above applies to any antibiotic resistance, not just for penicillin. Can you support this? Because what I see suggests that once the resistance is in place, it becomes a normal aspect of cell structure. It may involve altered structures that block antibiotics at the membrane or internal binding sites, or changes in the metabolic pathways, or other changes, but mostly, resistance appears to be a passive function rather than an active one. Resistant bacteria do not seem to need to expend additional energy to maintain resistance, AFAICT. ---
**Author:** ![deltasigma](https://avatars.discourse-cdn.com/v4/letter/d/e5b9ba/32.png) [@deltasigma](https://boards.straightdope.com/u/deltasigma)\ **Post date:** [November 23, 2013, 8:50pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/38 "2013-11-23T20:50:18Z")
> [@DSeid](#): > > The overuse of antibiotics is spilling over into the environment. It is tied to [the](http://phenomena.nationalgeographic.com/2012/08/23/antibiotics-fuel-obesity-by-creating-microbe-upheavals/) [obesity](http://www.motherjones.com/environment/2013/11/maps-antibiotics-prescriptions-obesity-states)[epidemic](http://www.nytimes.com/2013/11/10/business/the-co-villains-behind-obesitys-rise.html). Just posting to thank you for those articles. I thought the NYT and Nat Geo ones were quite good and provided some very interesting insights. 🙂 ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 23, 2013, 9:31pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/39 "2013-11-23T21:31:24Z")
> [@For You](#): > > Can you support this? Because what I see suggests that once the resistance is in place, it becomes a normal aspect of cell structure. It may involve altered structures that block antibiotics at the membrane or internal binding sites, or changes in the metabolic pathways, or other changes, but mostly, resistance appears to be a passive function rather than an active one. Resistant bacteria do not seem to need to expend additional energy to maintain resistance, AFAICT. FWIW, not [only](http://www.nature.com/nrmicro/journal/v8/n4/full/nrmicro2319.html) [that](http://www.ncbi.nlm.nih.gov/pubmed/16890008) but there is [even research](http://www.biomedcentral.com/1471-2148/13/163) on why it doesn’t always happen. > [@](#): > > Most antibiotic resistance mechanisms are associated with a fitness cost that is typically observed as a reduced bacterial growth rate. The magnitude of this cost is the main biological parameter that influences the rate of development of resistance, the stability of the resistance and the rate at which the resistance might decrease if antibiotic use were reduced. These findings suggest that the fitness costs of resistance will allow susceptible bacteria to outcompete resistant bacteria if the selective pressure from antibiotics is reduced. Unfortunately, the available data suggest that the rate of reversibility will be slow at the community level. > [@](#): > > antibiotic resistance, whether caused by target alteration or by other mechanisms, generally confers a reduction in fitness expressed as reduced growth, virulence or transmission. These findings imply that resistance might be reversible, provided antibiotic use is reduced. However, several processes act to stabilize resistance, including compensatory evolution where the fitness cost is ameliorated by additional mutation without loss of resistance, the rare occurrence of cost-free resistance mechanisms and genetic linkage or co-selection between the resistance markers and other selected markers. > [@](#): > > The persistence of antibiotic resistance depends on the fitness effects of resistance elements in the absence of antibiotics. Recent work shows that the fitness effect of a given resistance mutation is influenced by other resistance mutations on the same genome. However, resistant bacteria acquire additional beneficial mutations during evolution in the absence of antibiotics that do not alter resistance directly but may modify the fitness effects of new resistance mutations. … **deltasigma** , you’re welcome! ---
**Author:** ![Spoke](https://avatars.discourse-cdn.com/v4/letter/s/a88e57/32.png) [@Spoke](https://boards.straightdope.com/u/Spoke)\ **Post date:** [November 23, 2013, 9:44pm UTC](https://boards.straightdope.com/t/the-post-antibiotic-age/674499/40 "2013-11-23T21:44:05Z")
Yes, thanks for all the information, **DSeid**. [Previous page](https://boards.straightdope.com/t/the-post-antibiotic-age/674499.md?page=1) [Next page](https://boards.straightdope.com/t/the-post-antibiotic-age/674499.md?page=3)