Subject: Antibiotics

From: Chen Shapira <[email-masked]>
Date: Sun, 14 Jan 2001 18:18:34 +0200

Hi,

It is considered a well-known fact that antibiotics are becoming less and
less effective and that more bacteria are developing resistance. 
So I thought it would be a good idea to see how the research for diffrent
treatments against germs is advancing.
Unfortunatly most of the information I found was regarding Homeopathy, and
the research didn't seem to have any disease it cures as reliably as
antibiotics (Actually I'm highly biased in this regard - I'd rather not
trust my life to dilluted water. But I'm trying to keep an open mind here
incase some compelling evidence pops up)

So it seems like its one of the following (take your pick!):

1) Antibiotics are doing better than ever and I've research to prove it.
2) There is research demonstrating the effectivity of homeopathic therapy
which you overlooked
3) There is a diffrent alternative which I overlooked (genetic therapy?
Interlukines?)
4) The age of effective medicine is over, be prepared for higher death
rates.

---

From: "Nadav Har'El" <[email-masked]>
Date: Mon, 15 Jan 2001 10:21:42 +0200

"I am not a doctor", and all the usual disclaimers.

> less effective and that more bacteria are developing resistance. 

Is this _really_ true? Sure, antibioticis that used to be very effective
a generation ago (e.g., Penicillin) is no longer 100% effective. But
other antibiotics, such as Methicillin and Vancomycin have been developed
that are still very effective. To prevent, or delay as much as possible,
the appearance of germ strains that are immune to these antibiotics, their
use is carefully controlled by the appropriate authorities (see for example
the CDC's "Recommendations for Preventing the Spread of Vancomycin Resistance",
http://www.cdc.gov/ncidod/vancom.htm).

Unfortunately, it is exactly the use of Vancomycin in hospitals, which are
huge germ breeding grounds, which led to the appearance of VRSA (Vancomycin
Resistant Staphylococcus Aureus) in 1996, and of similar menaces. But luckily
such germs are still very rare. They are a great risk for the future, however:
the Johns Hopkins policy (available online) states that "Vancomycin-Resistant
Staphylococcus Aureus has the potential to become a prevalent, virulent and
transmissible bacterium for which no effective therapy would be available."

But I wonder if new antibiotics couldn't be developed to kill such new
germs. Is there some reason why such antibiotics cannot be found, or will
be very very hard to find? If I compare this to the computer industry (and
I probably shouldn't), I remember having a 16 MhZ 386sx, and someone convincing
me that 50 MhZ was the absolute limit for a CPU, and any lower than that will
cause quantum effects and so on and so on. In the current technology, people
keep finding new solutions which make the old "limits" seem irrelevant. I'm
not sure how well it applies to medicine, but I guess it probably does, at
least a bit.

Another example of drug resistant germs is in Tuberculosis (see a nice
overview in http://www.priory.com/cmol/TBMultid.htm): before the development
of streptomycin, para-aminosalycilic acid, and finally Isoniazid in the 1950s,
mortality rate from lung TB was 50%. In the late 1960s Rifampicin was
discovered which allowed killing of the infection faster (6 months, rather
then 18 months). This reduced mortality from treated TB to go down to 2%!
So we were winning, at least for the moment. However, recently multi-drug
resistant tuberculosis appeared. These strains have a 30% mortality... Is
there a specific reason why researchers can't develop new drugs to kill TB,
like they did in the 50s and the 60s? I don't know... I hope not.

> 1) Antibiotics are doing better than ever and I've research to prove it.

It is not doing better than ever, but it is certainly doing better than 50
years ago. Is there a reason to suspect it will only get worse from now on?
I don't know.

> 2) There is research demonstrating the effectivity of homeopathic therapy

Are you kidding? ;)

> 3) There is a diffrent alternative which I overlooked (genetic therapy?

I don't know anything about these, but I guess they are just experimentations,
like sheep cloning - there's no immediate application for human health.

> 4) The age of effective medicine is over, be prepared for higher death

There's also the question of viruses, to many of which cures were never known
(e.g., HIV, the flu, Ebola, and so on), and of parasites (e.g., malaria).
We'll just have to keep working hard and not give up... AND, we'll need smart
policies made by governments and world organization to eradicate diseases
completely, like we did for smallpox (see
http://www.who.int/archives/who50/en/smallpox.htm) and the Bubonic Plague
(which killed of ONE THIRD of Europe's population in 1347-1352), and we're
close to doing that for Polio. We'll also need to cure the diseases in "poor"
countries, because the ineffective treatment of Malaria and Tuberculosis
there is one of the reason the resistant strains appear. Of course, better
treatment in poor countries is not the silver bullet here: VRSA will not
be eradicated like that, because it SA is omnipresent, present on every
person's skin.

-- 
Nadav Har'El                        |       Monday, Jan 15 2001, 20 Tevet 5761
[email-masked]             |-----------------------------------------
Phone: +972-53-245868, ICQ 13349191 |Drink varnish and you'll get a lovely
http://nadav.harel.org.il           |finish.

---

From: <[email-masked]>
Date: Mon, 15 Jan 2001 10:54:45 +0200

I have heard somewhere that you can catch Tuberculosis from Aquariums, is
that true?
Sorry if off topic.

ishay

-----Original Message-----
From: Nadav Har'El [mailto:[email-masked]]
Sent: Monday, January 15, 2001 10:22 AM
To: [email-masked]
Subject: Re: [hackers-il] Antibiotics

the CDC's "Recommendations for Preventing the Spread of Vancomycin
Resistance",

Unfortunately, it is exactly the use of Vancomycin in hospitals, which are
huge germ breeding grounds, which led to the appearance of VRSA (Vancomycin
Resistant Staphylococcus Aureus) in 1996, and of similar menaces. But
luckily
such germs are still very rare. They are a great risk for the future,
however:
the Johns Hopkins policy (available online) states that
"Vancomycin-Resistant
Staphylococcus Aureus has the potential to become a prevalent, virulent and
transmissible bacterium for which no effective therapy would be available."

But I wonder if new antibiotics couldn't be developed to kill such new
germs. Is there some reason why such antibiotics cannot be found, or will
be very very hard to find? If I compare this to the computer industry (and
I probably shouldn't), I remember having a 16 MhZ 386sx, and someone
convincing
me that 50 MhZ was the absolute limit for a CPU, and any lower than that
will
cause quantum effects and so on and so on. In the current technology, people
keep finding new solutions which make the old "limits" seem irrelevant. I'm
not sure how well it applies to medicine, but I guess it probably does, at
least a bit.

of streptomycin, para-aminosalycilic acid, and finally Isoniazid in the
1950s,

Are you kidding? ;)

> 3) There is a diffrent alternative which I overlooked (genetic therapy?

I don't know anything about these, but I guess they are just
experimentations,
like sheep cloning - there's no immediate application for human health.

> 4) The age of effective medicine is over, be prepared for higher death

There's also the question of viruses, to many of which cures were never
known
(e.g., HIV, the flu, Ebola, and so on), and of parasites (e.g., malaria).
We'll just have to keep working hard and not give up... AND, we'll need
smart
policies made by governments and world organization to eradicate diseases
completely, like we did for smallpox (see
http://www.who.int/archives/who50/en/smallpox.htm) and the Bubonic Plague
(which killed of ONE THIRD of Europe's population in 1347-1352), and we're
close to doing that for Polio. We'll also need to cure the diseases in
"poor"
countries, because the ineffective treatment of Malaria and Tuberculosis
there is one of the reason the resistant strains appear. Of course, better
treatment in poor countries is not the silver bullet here: VRSA will not
be eradicated like that, because it SA is omnipresent, present on every
person's skin.

--
Nadav Har'El                        |       Monday, Jan 15 2001, 20 Tevet
5761
[email-masked]
|-----------------------------------------
Phone: +972-53-245868, ICQ 13349191 |Drink varnish and you'll get a lovely
http://nadav.harel.org.il           |finish.

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---

From: Alex Shnitman <[email-masked]>
Date: Mon, 15 Jan 2001 14:52:12 +0200

Hi, Chen!

> treatments against germs is advancing.

The cover article of the last Time magazine was exactly about this
topic. It's archived on the web (http://www.time.com/time/magazine/archive/, 
click the January 15th issue), so you may want to take a look.

-- 
Alex Shnitman                            | http://www.debian.org
[email-masked], [email-masked]   +-----------------------
http://alexsh.hectic.net    UIN 188956    PGP key on web page
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