Age of safe medicine is ending

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http://www.telegraph.co.uk/health/healt ... nding.html

http://s.telegraph.co.uk/graphics/proje ... index.html

Present death rate from "super-bugs" ...

Quoted: "... more than 2 million people get antibiotic-resistant infections each year, and at least 23,000 die because current drugs no longer stop their infections".

source,
http://www.cnn.com/2013/09/16/health/an ... tions-cdc/

Phage based solutions have been used for decades with great success. It will replace antibiotics.

The only reason antibiotics got so out of control was because the fools running the business behind it ignored the scientist's warnings. This was foretold since the early 60s when studies proved how stuff got 100% resistant to even the strongest antibiotics in just under a couple of years of mutations in the lab.

I hope you're right about the phages. the choices now are rapidly winnowing between death or disfigurement/maiming.

thats really a small percentage of the population that dies every year like less than 0.1%

Phages are pretty cool for a virus. I am surprised the west hadn't started using them long ago as they aren't all that new to science/medicine. Some of them look rather strange for an organism, almost like a lunar lander. Compared to most biology, they really look like they are a result of intelligent design. I am an agnostic personally, but when you see something like this makes you wonder....





Now with the genetic manipulation technology we are gaining, might we not be able re-engineer these things to target a bacteria of choice? I am thinking it is just around the corner....

The west sadly didnt adopt them because they can't be bottled and mass produced thus it doesn't work in a capitalist system. You can't make money off a medicine that is ridiculously cheap to make but that requires it to be custom-made for each patient. Aka, mass production is not possible.

Genetic engineering will certainly help it.. though without it the success rate is impressive. The process is simple:

-You get some kind of infection.
-You go to doctor.
-Doctor takes sample from you (aka blood or tissue if its localized).
-Lab isolates the infection, creates a culture of it.
-The culture of your infection is then exposed to several different phages the lab has stored..phages that from experience, trial and error they know tend to work best vs the type of infection you have.
-When the phage that works best vs that infection is found, they let the phage 'consume' several more infection cultures so it improves its ability to eat the infection.
-when that is done, they give it to the patient.
-Patient is sent home... and the phage does not 'cure' the infection..it merely attacks it and by doing so assists your immune system. Once the infection is gone the immune system kills the phage.

simple, elegant, cheap.

why did we abandon phages in the first place? where would medicine be today if we had kept refining the phage technique?

I think in the (hopefully near) future phage therapy will start to be phased in. We are being backed into a corner by antibiotic resistance and we will be forced to.

Phage therapy does have some big limitations. The biggest is that, like Dantac said, mass production isn't possible. Dantac outlined the steps needed for phage therapy. They are straightforward enough. The "how do you do this?" isn't the problem. It's then sheer scale of the operation. Since phages have to be custom made on site rather than mass produced, it would be incredibly labor intensive. The cost of hand making each therapy would be astronomical. Even streamlined (as it would surely become) it could never be as economical as batch production and distribution of antibiotics.

The other big limitation is immune response reaction. The body would make antibodies against it, making it a 'once and done" therapy that couldn't be repeated with that person.

A smaller but still realistic limitation is the specificity of phages. You have to know exactly what organism is causing the infection. You can't make an educated guess (as doctors are often required to do, especially in the emergency room) and give a "broad spectrum" phage since there is no such thing. This limitation could be countered with better, faster diagnostic tools which could help pinpoint the exact organism faster than is currently possible. This currently exists for a short list of organisms. That list will get longer.

What I predict will happen is that phage therapy will get phased in for limited situations. Antibiotics will remain but they won't be the only possibility. This would take some evolutionary pressure off bacteria to evolve resistance and could ultimately restore some of the lost effectiveness of antibiotics. (Maybe that's over optimistic but one can hope.) Phage therapy could really shine in situations where antibiotics are nearly useless, like biofilm infections.

Simple and elegant but not cheap because of the labor costs. Craft production is always far more expensive than mass production and on site production is always more expensive than centralized production with mass distribution. But our hand is getting forced by resistance.

It is quite cheap compared to antibiotic and research into medicines to perform the same job. The labwork does not require PhD's ..just the equivalent of 2-year tech degrees to perform..and the 'tests' themselves are of the cheapest most commonly done labwork tests. Its mostly just ID'ng the type of infection and then doing culture tests. Its less effort than getting a blood test done for your cholesterol level.

What makes it be unable to be mass produces is that its custom-targeted or it wont work. If the right phage type is not fed your particular infection until it becomes good at killing it, it won't do you much good. If you are given the wrong phage it could harm you... so there's no way to make a multi-spectrum phage to kill a broad amount of infections.

The beauty of phage treatments is that the infection has no resistance vs the phage. Its all about getting the right phage that will have an appetite for the particular bacteria thats infecting you.

it is still several times more expensive than a course of antibiotics. for people lacking comprehensive health insurance it will cost somewhere between $300-$500.

The problem of multiply resistant bio organism is troubling but we have a few bullets left in our guns.

1. Viral bacteria phages. Essentially viruses that eat certain bacteria.
2 We can now create synthetic RNA and DNA so it may be possible to custom engineer micro organisms that produce chemicals which kill selected bacterial types.

The "arms race" between medicine and pathogens has always been a problem. The fight will go on as long as the human race exists.

ruveyn

Antibiotics are ridiculously expensive for what they cost to make and transport to you. You have no idea how obscene the profit margins the pharma companies make.

The cost of the doctor check taking your blood and ID'ing the bacteria is not that much. You can get tested for multiple infections for like 80 bucks as self pay. The phage treatment in a system that commonly uses it becomes rather cheap as well...and you only need it once, not keep buying several doses of antibiotics or trying several antibiotics until one actually works.

As someone with a degree in microbiology, I'm absolutely appalled that doctors are over prescribing antibiotics. I've known people that have got prescriptions for simple boils and pimples. This is despicable and Frankly, I think doctors should lose their licenses in these cases!

people liked to prescribed something when they go to the doctor sick instead of getting told to wait it out
a lot of times antibiotics make people sicker if they take them without needing them