Thanks for sharing. Multiresistant bacteria are high on my list of slow-mo crashes happening before our eyes that no one seems to be talking about (compared to eg climate change, which is also a slow-mo catastrophe, but at least one that people are talking about). And it's always puzzled me how little I hear about work being done on phages, which pose an interesting approach to tackle the problem (compared to eg quantum computing, where commercialization potential seems to be a lot further out).
At least in France, a series of antibiotics are not allowed to be used/sold outside of hospitals. This is to ensure that hospitals have some last resort antibiotics in hard cases. But even with that, they have issues.
In Germany, where I live at the moment, the risks and issues are well known and talked about. I have seen a large reduction of the prescription of antibiotics. The younger the MD, the less antibiotics are given.
But 80% (maybe even more) of the antibiotics are used by animal farming...
> But 80% (maybe even more) of the antibiotics are used by animal farming...
This is what needs to be talked about more. Like guns in the US, or telecom oligopolies in Canada, it seems animal based agriculture gets the “thoughts and prayers” treatment rather than any substantive discussion about what harm it is causing the planet, human health, and biological safety via antibiotic resistance.
1ml of sea water will contain billions of phages, but its pot luck if you get the right strain.
Another thing not mentioned with antibiotics is man y are penicillin based that when metabolised become penicillamine which is used to treat copper toxicity or Wilson's disease, ie it makes the liver dump copper out of the body. Copper is needed to produce Interleukin-2, a naturally occurring chemo drug, most effective when injected into tumours, but having naturally high levels circulating can be helpful as a prevention measure.
Creatine when metabolised becomes creatinine which in sufficient qty can kill gram positive and gram negative bacteria. If you get 3rd degree burns, the muscles catabolise to release creatine and then the creatinine helps to keep bacteria at bay with the wounds.
It probably also explains why the US military are reportedly the only one's to use copper sulphate to debride battlefield wounds. Even the WHO dont recommend using it! Copper sulphate will dissolve skin though.
Vitamin D also increases creatinine, and because creatinine is used for estimated glomular filtration rate kidney tests, high levels of creatinine can make you appear to have various stages of kidney disease. Medical lab tests (human and veterinary) can not tell if you are supplementing so dont get an inaccurate diagnosis.
It kind of worries me when people talk about reduction in prescription of antibiotics. If we are talking about primarily about false diagnoses and prescription of antibiotics when there exist equal or better treatment plans, then a reduction in antibiotics is good. The day when people got antibiotics in order to treat a cold is hopefully over.
The cases that worries me most is however debilitating chronic illnesses (where antibiotics is used as a stop gap until medical science find a cure), and illnesses which if let untreated might turn into a debilitating chronic problem. I hope they are keeping a close watch on the outcomes from those younger MDs.
Antibiotics in animal farming is obviously terrible. Animals should not be allowed to be kept unless it is in an environment that is safe and healthy for them. Antibiotics is a tool used to fix how poor some large scale farmers treat their animals.
Many doctors don't bother to test if the infection is bacterial or viral or fungal (outside of covid, flu, rsv, and some others). My wife had an outer ear infection. The doctor confirmed it was an outer ear infection, then prescribed antibiotic drops. They didn't do any test. It could be bacterial or it could be fungal. If fungal, the antibiotics will actually make it worse.
So my wife uses the drops for several days and gets worse. What's the solution? Mix half distilled white vinegar (5% concentration) and half 91% isopropyl alcohol (or 190 proof ethanol). This is a cheap solution which is generally effective for both fungal and bacterial outer ear infections. She was better in less than week.
Over 90% of outer ear infection is caused by bacterial infection, with 10% being fungal (and then, those are more liekly in tropical environments). The risk of fungal infection in non-tropical environments is thus fairly low probability.
There has also been several (4 that I can find myself) studies done on using acidic drops as the only treatment for ear infections, all which has shown them non-effective to clear an infection. Alcohol can also irritate the skin further, increasing inflammation.
Ear infections are however complex since most of the studies are either done on children, commercial or military divers. The military protocol in the Netherlands is to start with an acidic solution and then if the inflammation get worse introduce steroids. If that doesn't clear it, then add a combination of antibiotics and steroids. Steroids has the problem of increasing risk to bacterial infection, but the combination of using antibiotics with the steroids reduces that risk. It is this combination that doctors use in post surgery.
The Dutch protocol seems like the optimal treatment protocol for now, but it assumes you got a doctor to monitor it. My guess is that regular doctors jumps to the last step with the assumption that it is bacterial infection in order to minimize the need for further visits. One study I read also mentioned that adherence to correct application of the drops was one of the most significant factor in outcomes, which might imply an other reason to go for the strongest treatment first.
One thing that favors alcohol however is that keeping the ear dry is extremely important in addressing outer ear infection and preventing bacteria from growing. The theory behind vinegar and alcohol does thus seem quite sound from a theory perspective, stopping the bacterial infection before it get a chance to grow.
The US military does, or at least used to, use the alcohol/acid drops prophylactically - whenever you'd get out of the water you'd put some drops in.
It's interesting that the studies show that solution as ineffective. It cured my wife. Then someone at work had an outer ear infection that recurred after two treatments with antibiotic drops. This solution also solved their problem.
As a side note, my wife was on steroids when she contracted the infection. So I think that contributed to her catching it.
I am not aware of any study on prophylactically use, but I am cautiously hopefully that it work based on personal experience and from what I hear. For water sport activities, flushing with clean fresh water, dry it, and then spraying an acid solution seems to give some defense in keeping outer ear infections at bay. Alcohol could help drying it out, through because of the risk of triggering inflammation in the middle ear I personally avoid it.
I don't know why the studies shows them to be ineffective. Since they include acid drops in the studies it seems to be a well known home remedy, and given that it used prophylactically by the military in several countries there seems to be some reason for it. I could make a guess that doctors in the military/pediatric care are already keeping the ear of the patient dry so that alcohol don't provide any additional benefits, and they remove vax/debri in case those prevent the ear from drying.
+1 on the alcohol/vinegar. If you've had one of these outer ear infections you'll remember what it felt like early on, so you're probably able to tell when it feels like you might be getting another one. Start using the alcohol/vinegar mixture immediately, and you might avoid the infection altogether.
If you've never had one of these - you do not want to get one. They can be extremely painful.
I remember from high school organic chemistry that an acid combined with a base yields a water and a salt, but and acid combined with an alcohol yields a water and an ester.
"Esterification is the general name for a chemical reaction in which two reactants (typically an alcohol and an acid) form an ester as the reaction product."
Esters tend to evaporate quickly, right? That's part of the benefit of the drops is to dry the ear out. I haven't heard of them being applied separately. I would be a little careful since applying them separately means increasing the strength of the acid and alcohol.
iirc antibiotics in cows are not principally used as medicine. it's because chronic antibiotic use makes cows put on weight faster. I don't know the mechanism.
It would be interesting to know of this mechanism has any effect in humans, being that humans are eating more meat that's been treated with antibiotics and were also gaining weight at rapid levels at society wide levels.
I'm curious also. Could it be that antibiotic meats affect the gut / microbiome? Perhaps creating an environment favorable to certain gut bacteria that lead to increased appetite or fat?
Similar recollection here. So, obvious question - would it work to standardize on giving the cows some old, seldom-useful-in-human-medicine antibiotic? If yes, that would seem to minimize the resulting harm to human health...
If these older antibiotics would stop being used, they could eventually be used on humans again. Maintaining chemical defenses is an evolutionary disadvantage compared to populations without them if the antibioticum is not present in the environment anymore.
Controversially but famously, "chronic Lyme disease" involves course of multiple super strong antibiotics over potentially years. Then things to try to save your organs from antibiotics. Then pills to help you digest those. Taking 50 pills on regular basis is apparently common enough.
Any non-treatble illness that causes a buildup/environment for bacteria that trigger debilitating symptoms.
The human body has many defenses and mechanics to keep bacteria in balance. I would point particularly towards the gut/intestant, the skin, ears, anus, bladder and genitalia for places where bacteria need to be constatly kept at the correct balance. Some things are treatable. Some things are possible to cut off. Some things are less known/fixable, in which case symptoms is the only thing possible to addressed at this time.
acne is bacterial but chronic. it's standard practice for dermatologists to prescribe long-term antibiotics for severe acne, rather than turn to accutane.
I have rosacea and it of course goes up and down. used tgel for a while then decided to only apply it to my right side of face. After a ~year there was never ever difference between two sides of my face, they went up and down together depending on temperature, environment, sweat, stress, food, etc. My doctor could not believe that I would try that, but it seemed a super simple way to check if all those antibiotics actually Did anything. For me at least they didn't.
Depends on the economic value of the livestock. For example, a milk cow is probably economically worth being treated. Even if there are regulations that ban selling their milk, they can still be used for breeding.
I have a collection of antibiotic prescriptions that were routinely given to my kids at the public clinic (South American country here) at the smallest sign of a sore throat or some other infection. I didn't give them the antibiotics and my kids got well after a few days (they did take antibiotics whenever it was more serious). At the other end of the aisle, I have friends who will switch doctors if they don't prescribe their kids an antibiotic whenever there's a simple sore throat. A lot of doctors here will prescribe them right and left, just to be safe from any later criticism of not giving their patients enough medication. Oh, and I never had a doctor here ask for a test to see wether a throat infection was viral or bacterial.
These measures that disallow use of antibiotics by humans are inhumane.
For example, a chart in the article below shows huge growth in number of admissions after 2002 guidelines to replace full antibiotic therapy for acute UTI with 3-day antibiotic treatment.
There are plenty of people/companies working on phage therapies, and there are clinical trials happening now [1]. In some eastern European countries you can buy phage solutions over the counter. It just doesn't get much press - though I'd speculate that's because phage therapy clinical trials have been pretty lackluster so far.
Really I feel like this has been a hot topic for at least 15 years.. for example 5 years ago this https://youtu.be/plVk4NVIUh8 was on hacker news and got a lot of discussion as I recall…
Ok maybe you are right my search yielded few posts that got any traction - so maybe it was just me sharing with people I know!
