I think the UN or governments themselves should get into the business of bad business medicine. The fact drug companies are prioritizing research of chronic medications is an obvious outcome of our current structure. The government or quasi governmental organization can continue to subsidize industry research and buy licenses for discoveries they then productionize at cost. This wouldn’t directly compete with industry and it would incentivize public private research across large areas of otherwise unprofitable areas of medicine such as this.
Overuse and misuse of antiobiotics isn't really a US thing. <a href="https://resistancemap.onehealthtrust.org/AntibioticResistance.php" rel="nofollow">https://resistancemap.onehealthtrust.org/AntibioticResistanc...</a> is a nice, interactive map showing where the majority of the resistant strains are found. Any effort to curtail the emergence of antibiotic resistant bacteria will require coordinated global action, which means it's highly unlikely to happen.
Sad that the article is not talking about bacteriophages[1]. Basically viruses that infect other bacteria. The world is full of them (and even virophages: viruses that infect other viruses). The soviet union started experimenting them, and they seem to be used to treat hard-to-cure infections like Staphylococcus aureus, but I guess it died down somehow?<p>[1]: <a href="https://en.wikipedia.org/wiki/Bacteriophage" rel="nofollow">https://en.wikipedia.org/wiki/Bacteriophage</a>
Stop administering them whenever anyone gets a sniffle so they stay effective longer. Also firmly separate veterinary antibiotic classes from human antibiotics so that the ones intended for humans stay effective longer.
The comments on this article take for granted that agricultural use of antibiotics is a key driver of the emergence of antimicrobial resistance (AMR). This is an intuitive and popular explanation, but the magnitude of this effect is not well established.<p>As an example, [0] is of the best reviews available on the contribution of non-therapeutic antibiotic usage in animal feeds to AMR. Despite the large amount of evidence cited, the authors can't conclude that a ban on animal use of antibiotic class X would lead to Y more years before resistance to X emerges/spreads.<p>It seems well established that banning use of certain antibiotics as a feed additive would slow the emergence of resistance, but that magnitude of that effect seems totally unknown. There is perhaps a strong precautionary principle argument to be made for banning use of medically important antibiotics as feed additives, but we should be cautious in making any firm conclusions about how much that would impact the medically useful lifetime of existing or new antibiotics.<p>In a similar vein, the idea that commercial prospects for antibiotic development are limited because agricultural use would cause fast emergence is not supported from what I can find. A very good recent paper [1] discussing failures of antibiotic development in the US in the last 20 years highlights trial, regulatory, and commercial hurdles as key roadblocks to successful commercialization of antibiotics.<p>[0] <a href="https://journals.asm.org/doi/full/10.1128/cmr.00002-11" rel="nofollow">https://journals.asm.org/doi/full/10.1128/cmr.00002-11</a>
[1] <a href="https://www.nature.com/articles/s41599-024-03452-0" rel="nofollow">https://www.nature.com/articles/s41599-024-03452-0</a>
Most new antibiotics come from soil bacteria. We got all the low hanging fruits, now you need to dig through tons of soil to find something new., Better culture methods would make it easier to run experiments instead of relying on genome rather than relying on /cloning/expression in E. coli.
I posted to HN an article about 3 new antibiotics discovered in India and it didn't get much attention :-(.<p><a href="https://www.bbc.co.uk/news/articles/c80vrjkkrero" rel="nofollow">https://www.bbc.co.uk/news/articles/c80vrjkkrero</a>
I believe that this is a <i>technical</i> issue now. In a more ideal world, procedure, legislation, regulation, protocols would be followed to slow the growth of antibiotic resistance, but there are just too many Defectors for that approach.<p>It's in nerd hands now ...
We have a whole arsenal of old antibiotics no longer in use that are candidates for redevelopment. As bacteria develop resistance to newer antibiotics they make evolution tradeoffs which bring back into play older antibiotics.<p><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4242550/" rel="nofollow">https://pmc.ncbi.nlm.nih.gov/articles/PMC4242550/</a><p>I think cocktails will be used (if they are not already in use) to attack the bacteria from different angles at the same time reducing the likelihood of developing resistance.<p>Another thing is better protocols. More quick testing before prescription so you use more targeted antibiotics and reduce the use of wide spectrum antibiotics.
Doctors and their 'fee for service' mentality are, in part, at the roof of this. They know an antibiotic is a waste of $$ for a viral disease, but the money meter ticks upwards.
This article misses several new antibiotic classes that are emerging: macrocyclic peptides, and a bunch of compounds from unculturable soil bacteria (clovibactin, teixobactin, etc.)