Perhaps I lack proper context, but drug-resistance terrifies me significantly more than global warming. Primarily, I think, because we are still speculating about the consequences of climate change - if not so much its causes. In contrast, we know what a world without antibiotics looks like, and it's pretty horrifying.

Assuming everyone understands that, it's an interesting case study in psychology as to why the second one might be scarier than the first one.

I don't buy that. Beginning of a new dark age with a breakdown of civilization and loss of advancements? Yes. Extinction-level event? No.

> The worst case scenario for antibiotic resistance is that people live with the medical uncertainties our grandparents and great-grandparents lived with.

No, actually the worst case is that the antibiotic period breeds superbugs that are both more virulent and harder to kill than those that came before. Antibiotic resistance comes about because of unintentional selective breeding of bacteria. We don't really know what other traits we are unintentionally selecting for. We could potentially be breeding a wordwide pandemic and not realize it. Which could bring about a new dark age with a breakdown of civilization and loss of advancements.

>I don't buy that. Beginning of a new dark age with a breakdown of civilization and loss of advancements? Yes. Extinction-level event? No.

Extinction-level event is a scientific term which refers to the rate of extinctions and the associated loss of biodiversity, it doesn't necessarily mean that we all die. And if you think there's a meaningful distinction between "civilization ends" and "breakdown of civilization"... wow, okay.

By the scientific definition, I will agree that climate change can be an extinction event. However, I still stand by my assertion that it will not end civilization.

> And if you think there's a meaningful distinction between "civilization ends" and "breakdown of civilization"... wow, okay.

"Civilization ends" is total and permanent. "Breakdown of civilization" is partial and temporary. That is why I referenced a dark age. We have been through civilization breakdowns before, albeit not since we became globally connected.

If anything, antibiotic-resistant strains of bacteria would generally be less fit in a world without antibiotics. E.g., sulfa drugs inhibit DHPS which is involved in producing what eventually becomes formic acid. Bacteria can resist sulfonamides by eliminating their dependence on DHPS, but then they depend on folic acid being present in their environment, and it won't always be available in human blood.

- Venus is about 3/4 the distance from the Sun as Earth.

- Venus has slow, retrograde rotation that leaves a given portion of the surface exposed to the Sun for 56 Earth days at a time.

- Venus has no magnetic field, which causes the loss of water vapor and other light gases due to the solar wind

> Assuming everyone understands that, it's an interesting case study in psychology as to why the second one might be scarier than the first one.

It doesn't make sense to base decisions on a worst case scenario without taking probability into account.

I'm sure you can find some individual scientists who want to get in front of a camera tot ell us it's the end of the world, just like you can some individual scientists who say it's all crap. I want to see what's in the IPCC's 99.9th percentile of things going wrong.

I am also not aware of how climate change could lead to human extinction.

The last scenario talks about, if I recall correctly, the oceans becoming more welcoming to bacteria that produce hydrogen sulfide. Sorry, I don't remember the details, but will update tonight from the book at home if I remember.

Thumbnail sketch of the event: something (possibly massive volcanic eruptions near in time to a significant meteorite impact) deoxygenated the water enough to cause a substantial marine life die-off. The death of so much marine life in such a short time encouraged sulfate-reducing bacteria, which would have released significant amounts of hydrogen sulfide into the atmosphere. Hydrogen sulfide would have killed plant (and, therefore, animal) life and weakened the ozone layer, exposing the suriving flora and fauna to further UV radiation.

"96% of all marine species[5] and 70% of terrestrial vertebrate species becoming extinct."

There is some concern regarding a risk (I have no idea how big the risk is) that anthropogenic global warming could "tip the scales" of the global ecology towards the conditions that allow for a Permian-Triassic-style cascade.

[0] http://www.ornery.org/essays/warwatch/2014-03-20-1.html

Antibiotic resistance, on the other hand, kills our wellbeing and lifespan by making common medical procedures/surgeries impossible, and does so permanently.

WHAT?? What kind of nonsense have you been reading?

The worst case is coastal flooding, some people have to move inland, and some plant and animal species go extinct. Perhaps some areas become desert (but people live in incredibly hot areas now, so those places will still be habitable).

Other plants and animals will move into the now vacant environment niches. Yes, it's a loss of a species, and yes, a loss of coastal land.

But civilization ends??

The distinction between "best case" and "worst case" is meaningful and I'm not sure you understand it.

What you're describing is a credible best case scenario - basically a very gentle extrapolation of what's happening right now into the future - and not the worst case.

Something like the clathrate gun effect playing out in one of the very bad ways that's hypothesized (or one of the many other hypothesized killers which we believe we've observed in the fossil records, in the earth's crust, in ice, and so on - there's too much to discuss here), and the subsequent effects of that on our environment and later on our politics as the bottom falls out of everything, represents a worst case.

If you just go ahead and decide all those hypothesis are bullshit, well, ok. In that case the notion of a worst case doesn't have a lot of meaning.

Otherwise things like: Atmospheric expansion from heat could increase the drag on the moon causing it to fall on us, could be considered worst case scenario too.

People really really love thinking of all possible things that could go wrong - the more disastrous the better (see: Hollywood; black holes from the super collider; or the atmosphere igniting from nuclear tests). But the earth is rather large, it's rather resilient, it's been through a lot and it's still here and working.

It really only takes one war to escalate too far to bring about a nuclear conflict, which could clearly have significant effects on the viability of civilization.

This is factually untrue. There is a greater scientific consensus on the origins of anthropogenic climate change than there is on the origins of many common diseases.

The climate change trends are very well known, the models that existed 15 years ago have worked extremely well at predicting current climate trends, and the impact in the food supply chain is being well documented, not to mention the myriad other observed changes in ocean acidity, coastal degradation, Arctic and Antarctic surface ice, Andean permafrost, and desertification, just to name a few areas studies by completely different specialties which are confirming the predictions.

You are misrepresenting my statement. I specifically referred to consequences, not origins.

Since you mention consensus (is that how to do science? Maybe we should introduce elections for new theories) - but still let's proceed; only 64 (or 0.5%) of 11,944 scientific abstracts published since 1991 state that most of the global warming since 1950 is manmade.

And at any rate, if we want to make it a war or words, at least all the statements that refute your contrarian assessment actually seem to get into the nitty-gritty details of their statistical analysis and comparison between multiple proposed models, instead of the purposeful misrepresentation of the climate denialist that say that there is a single unique IPCC model, when that is laughably false.

For the second statement, again: the meta-analysis performed on the research papers shows a 98% consensus rate.

From personal experience, I've spent 8 years in a University where exact and natural sciences are the main focus, and I have yet to hear a single climatologist, oceanographer, or physicist say that there is insufficient evidence of anthropogenic global warming.

The only people who seem unusually unconcerned about it are geologists, however there is an interest bias in them: A) they don't deny it, but they consider the global timescales and for them another mass extinction event like the one that is inevitably coming is just business as usual, B) there's an extraordinarily high number of geologists working in the mining and oil business and their bottom lines would be clearly affected more than any other industry of researchers.

[1] http://www.nejm.org/doi/full/10.1056/NEJMoa060775

[2] http://www.sciencedirect.com/science/article/pii/S0264410X02...

http://www.nytimes.com/2013/12/18/opinion/bittman-the-fdas-n...

In California, though, there is much stronger action stirring in the state legislature, although it will need far more public support to become a possibility:

http://www.sfgate.com/health/article/Ban-sought-on-animal-an...

There are health benefits to the animals (the drugs prevent 'bloat'), but they also increase the weight gain per pound of feed, which the farmer (rancher? lot manager?) is going to take into account.

[1]http://en.wikipedia.org/wiki/Ionophore

So the label has changed, but the end effect of pouring tons of antibiotics into conditions that breed resistance is still there unless we change conditions in feedlots.

Nobody's going to fund or approve this in the West anytime soon:

- phage therapists often use cocktails of phages to treat their patient. This type of treatment isn't even on the FDA's map - it even takes years for compounds of conventional drugs to be approved.

- phage therapists often prepare customized phage cultures to treat a specific patient's infection. The FDA would likely view this a a crime and prosecute anyone trying it.

- phage therapies have been around for over 100 years and are likely unpatentable. No drug company will fund R&D on the technique and no venture capitalist will fund a scrappy startup.

[1] http://en.wikipedia.org/wiki/Phage_therapy

For those with a computational/hacker background wanting to make a difference:

There is actually a lot of opportunity in the Computational Biology/Drug Development/Genomics space, with the caveat that it is a very difficult field (especially for company creation). It's a lot easier for CS folks to build another no-SQL database than it is to build a ML framework for, say, cancer prediction, but the opportunity is there. A lot of folks in this space come from the bio side, and teach themselves programming. Very few folks come from the CS side, and partner with the biologists. As a result, there is a giant gap between what is possible for a computer scientist and what is currently being executed. The state of the art in this space will probably make you all very sad.

I will pay $$ for engineers to work on this:

I have a side project working with an academic lab to develop a new antibiotic to target drug resistant beta lactamase (the primary protein associated with drug resistance) using a relatively novel computational approach. Sadly I've been distracted by my primary job, but if you are interested let me know. I am based in SF.

Therefore, much like the potentially developing WW3 in Ukraine, or Ebola outbreak in Africa, or rape culture in India, this kind of news is fairly useless. It just creates negative feelings with no positive outcome.

I'm happy to be convinced otherwise - what can I do about this?

If more informed I feel like the public could do a bit better at turning down Antibiotics when they aren't necessary, and using them properly when they are. Just that action would go a long way.

Edit- I would also like to add that a lot of people don't realize just how easy it is to get an infection, and education could go a long way in keeping it from happening in the first place. It reminds me of that guy on reddit with the horrible case of necrotizing fasciitis that he ended up with after retrieving a football from a koi pond. His day by day imgur chronicle was both interesting and horrifying.

Call your representatives [US: 0,1] or regional government representative (I just called my senator, and on hold for house rep now), tell them we need an emergency crash program to develop new, tightly-regulated antibiotics so that infection doesn't become the leading cause of deaths in 2025. Because it takes years and billions to develop new antibiotics, this is something companies will not pursue on their own initiative. If not, it'll be a return to the 19th century. Good luck with that.

[0] http://www.house.gov/representatives/find/

[1] http://www.senate.gov/general/contact_information/senators_c...

The government needs to provide incentive for antibiotic research, right now regulatory and reimbursement issues are making the therapeutic area very unattractive.

The misuse that terrifies me the most are antibiotics used on livestock. Particularly the antibiotics that are also used on humans. In my opinion antibiotics should not be used as a growth promoter and only used to help sick animals.

The issue is that a lot of animals get sick from being crammed together in small areas, unable to move, while living in their own feces and urine. If we regulated animal treatment better and required certain living conditions for animals they wouldn't get sick nearly as often and wouldn't need nearly as many antibiotics.

As it stands, regulating antibiotics to be used only on sick animals wouldn't change much since an incredibly large percentage of livestock are often sick (as a consequence of living conditions).

New mechanisms of action are needed, more specifically, mechanisms that evolution cannot biologically defeat. Consider an agent like bleach, 99.99% effective because the makeup of a cell does not really permit it to protect against such a caustic agent. Clearly bleach can't be used as an antiobitic but I use it to illustrate the point that a evolutionary-unlikely antibiotic mechanism would be worldly profound.

This is really the alpha and the omega of antibiotics and antiviral research: finding the specific lethal target that can't easily be changed. It's damned hard, and it's why most of our antibiotics have been generated by nature, not by rational design.

I'll go so far as to say that we've found all of the important bacterial targets (e.g., ribosome, peptidoglycan, DNA gyrase & a few others).

That's probably an overstatement....but I (and many others) spent a large amount of time/$/effort looking for antibacterial targets that might have been overlooked. In the end, my conclusion was that we've already found the softest, most vulnerable targets within bacteria and we've known about them for a long time.

What to do? I think 2 things. Find new ways to hit the existing validated targets (people are doing this, but it ain't easy). The only other "idea" that I've had (and I'm sure others have had it, too), is that maybe we can find multiple "weak" targets that, when hit in combination, are just as good at inactivating a single "thing" like the bacterial ribosome. But that's probably even more difficult than finding new ways to hit well-validated targets.

https://xkcd.com/1217/

It's easy to kill bacteria, viruses, cancer, you name it. We have lots of tools that can kill them, from guns to flame throwers to acid. The trick is killing them without also killing the patient, as you say.

Do you really want to help? Start eating less meat, and tell others to also do so. Tell them why. Tell them to also tell others. When there is less demand for meat, then there will be less land devoted to animal feed/grazing, and more to food crops. Less animals that can be infected, less antibiotics used, etc, etc.

Want to really help solve it? Don't eat meat. Get others to stop eating meat.

Invest in faux/lab-grown meat companies. Disease free meat can be grown. We just need to make it profitable.

Honestly, this is the future. Farming like this is unsustainable, not only for the antibiotic reasons.

(I'll spare everyone the ethical/transhumanist discussion.)

Why not just get meat from farms that treat their animals properly (no cramming, free-range, etc)? I don't think it should be this extreme.

"People were generally aware of the link between overuse of antibiotics and increased resistance. Only 8% of respondents did not agree that if antibiotics are taken too often they are less likely to work in the future. But many people (43%) incorrectly believed that antibiotics were effective in viral conditions."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1934431/

I'd like to believe that buying meat / other foods that aren't treated with antibiotics could make a difference as well, but I'm not sure how much impact that would have.

I think you can help by informing others. If you know a family member not completing their course of antibiotics for example explain to them why it's so important.

What can the general public do about this? It's not like I can go to my family physician and tell him to use less antibiotics (he already doesn't; I'm in the Netherlands), and expect to make any kind of meaningful difference. This is one of those "tragedy of the commons" kind of problems that can only be solved if everybody cooperates.

[1]: https://en.wikipedia.org/wiki/DRACO_(antiviral)

1) I stopped taking most medicines awhile ago because I realized that by relying on symptomatic relief, I wasn't actually listening to the needs of my body. Now when I feel a cold coming on, I start sleeping at 9pm, eat healthier, and reduce stress levels. Instead of popping a pill, I've learned to recognize that I'm deviating from "healthy" activity and had better get on track. The result? I haven't been sick in years and years, and am probably overall a more healthy, less stressed out person.

2) I often wonder to what degree language affects perception. Like the word dirty having such a negative stereotype yet so associated with dirt (i.e., soil). I feel like we often want such high levels of sterility that are just absurd, and do more to harm us in the long run. As part of a project, I interviewed farmers who said food safety experts are so draconian they expect cannons that shoot into the air to prevent birds from flying over with the risk of droppings. One food safety inspector commented that the farm was too "dirty." Can you imagine? I understand we don't want to get sick, there are bad things in the world, but I think we're pushing too far into the other end of the spectrum.

AB's should be saved for those few moments in life where you really need them and is not something you want to do every few months like majority of people, particularly kids.

There are far better ways to strengthen your body and immune system without risks that are overwhelming with AB's (which are way better known today after we have some bits of microbiome) - nutrition and supplements. Even measures like using viruses as antibiotics are probably better then popping AB's like candies.

This news is probably beginning of the "next big big pharma thingy" that will come to rescue and will typically, yet again, use inappropriate tool for the job. The only good that will come out of it are probably not going to be, however, lives saved but science advancement.

Some of the other comments posted here ask, well, what can we do about this? A submission to Hacker News from 189 days ago linked to a PBS report about the views of a Centers for Disease Control and Prevention epidemiologist in the United States[5] who advocated specific policy changes, some of which have been adopted since then. The discussion of that submission (including one of my highest-karma-ever comments[6]) provides more perspective on some biological evolution issues that are being brought up again in today's discussion here.

[1] http://www.who.int/mediacentre/news/releases/2014/amr-report...

[2] http://www.who.int/mediacentre/factsheets/fs194/en/

[3] http://www.who.int/drugresistance/documents/surveillancerepo...

[4] http://online.wsj.com/news/articles/SB1000142405270230344420...

http://articles.economictimes.indiatimes.com/2013-06-23/news...

http://www.iom.edu/Reports/2012/Facing-the-Reality-of-Drug-R...

http://www.tbcindia.nic.in/pdfs/RNTCP%20Response%20DR%20TB%2...

[5] https://news.ycombinator.com/item?id=6599040

[6] https://news.ycombinator.com/item?id=6599795

In America, the number one thing you can do is stop eating factory farmed meat. That is a huge contributor to antibiotics resistance.

goes beyond the available evidence. But props to you for saying "In America," in that statement, because it is plain that in some other parts of the world, where the problem of antibiotic-resistant bacteria is most severe, the main cause of the problem is misuse of antibiotics in human medicine rather than meat production. (India especially is an example of that kind of problem.) More details of course can be found in the report. Methinks the statement is based just a bit too much on propaganda by vegan activists. I encourage everyone in our community of thoughtful discussion here to check the fine article and the linked references before radically altering their personal diets.

[1] http://www.who.int/drugresistance/documents/surveillancerepo...

Edit: here's one article about the use of fluoroquinolones on poultry contributing to the increase of fluoroquinolones-resistant Campylobacter http://www.sciencedaily.com/releases/2012/04/120405131431.ht...

This, like most stereotypes, is built around a core of experience, and then expounded. With a lot of vegans, its often not that they're wrong about what they say, its how they convey it. This came up today in another HN discussion on smoking as well. Its ok for them to not like things, just don't be a jerk about it.

On topic, while I agree that we may very well all die, this can also be looked at in a different perspective. When the antibiotic in question was first introduced, it had effectively a 5/5 chance of working. After ten years, it then had a 4/5 chance of working. Like most power laws, in maybe 10-20 years, it will have a 3/5 chance of working, ect... with a decay rate that slows with time.

Like all evolution, antibiotic resistance is driven primarily by the rate of survival and reproduction in the population. If resistance against AntibioticA is a strong predictor of survival (like when its newly introduced, and highly effective), then lots of bacteria will develop the immunity. As it gets used less, due to limited effectiveness, then it will become less of a predictor, and less bacteria will multiply with that as a trait.

Its not like evolution is "free" either. Often times, if an organism becomes heavily specialized in fending off one threat, then they leave themselves open to invasive species or perpendicular threats. I firmly believe that we have intelligence (I really do) and that while natural evolution is powerful, we already have many of the tools necessary to understand, and adapt along with it. We just need to be able to understand why they're changing, how they're changing, and how we can exploit that process for our gain.

There just isn't any way to be politely vegan. Everyone else automatically assumes that you care why they aren't.

Most of my friends are well-educated secular urban middle-class 30-year-olds who are somewhat left-wing by U.S. standards. Most of them know dozens of vegetarians and at least several vegans. On average, they seem to view my veganism somewhere on a spectrum from "mildly eccentric" to "extremely admirable".

When I go to other countries, I'm more likely to meet people who are surprised that I'm vegan. Some of them say that they didn't know that that was possible (!) or that they have never met a vegan in person before.

I have also met some vegetarians and vegans, mostly from immigrant families, who said that they had to hide their dietary practices from their families because their families would be so upset about it. (When I went vegetarian 26 years ago, my grandmother expressed a fair amount of concern for my health, although she'd at least met other vegetarians before.)

I think it's easy to generalize from our experience about how other people "normally" react to particular dietary practices, but our experiences with people's reactions (positive, negative, confused, hostile, indifferent, curious) may be a narrow local view.

One time I had a discussion in Latin with a Catholic priest who worked at the Vatican. (I don't speak Italian and he doesn't speak English, so Latin was our best common language.) When he learned that I didn't eat animals, he cited Genesis 9:3 as a reason that vegetarianism was faintly ridiculous. It took me a minute or two to understand that he was absolutely, completely serious.

But I also live in a rural Texas town, and when I was in college, yes, there were very real social pressures not to be vegan, from family to social groups.

It is easy enough to just discount these pressures, but like most choices that marginally impact the folks around you (what are you really going to order at the steakhouse where you've gone for your brother graduation? Oh you're just gonna not eat? "How fucking rude", says your uncle.) these force are real and impact folks choices.

That calf is immediately separated from its mother, and usually shipped straight into a veal crate. If you consume dairy you support this.

The mother is milked for as long as she can be, but eventually she'll need to be impregnated again. This is a traumatic experience, but it's not like animal agriculture industry tries to make it better. The devices they use are called "rape racks" in the industry.

If your vision of dairy production is a straw-hatted farmer sitting on a three-legged stool milking Ol Betsy you're delusional. But you're also pretty common. Most people have the same sort of view of animal agriculture that non-technical people have about the Cloud.

When I was a vegan, I would typically mention that fact, and then also add, "but I don't mind if you eat meat and I won't criticize you for it". Lots of people didn't believe me at first, having been on the business end of a lot of criticism from "well meaning" vegans and vegetarians.

No, like other stereotypes, it is wrong, and mostly perpetuated by the same myth-engines that power urban legends.

>With a lot of vegans, its often not that they're wrong about what they say, its how they convey it. This came up today in another HN discussion on smoking as well. Its ok for them to not like things, just don't be a jerk about it.

I've had people go off on me just for saying that I was vegan. It has nothing to do with what, how, when, or why you say it; it has to do with what people hear.

This is a common misconception. You can't get antibiotic resistance from eating meat that was treated with antibiotics.

The resistance occurs at the farm, and is washed into sewage etc. It does not occur in your body (from eating meat).

Avoiding meat raised with antibiotics might (slightly) help slow resistance, but it won't have any direct effect on you.

Remember it's the bacteria that become resistant not the person.

> When you have a routine infection that can't be cured with antibiotics, the hospital bills will be far more then the few dollars you saved. Eat less meat.

It is like saying don't drive a car, because in the long run it will cause you to die of global warming.

Eating factory farm meat contributes to the cultural acceptance of such goods being produced in the way they are, that produces bacterial immunities to antibiotics due to the mass utilization of factory farmed meat.

And:

Driving gasoline powered automobile contributes to the cultural acceptance of such goods being produced using the engine technology they are, that emits greenhouse gases that cause global warming due to the mass utilization of gasoline powered vehicles.

An individual won't have a significant impact on either, but if you aren't swayed (the guy reading this on HN) we are completely fucked, because the community here is supposed to be one of the more rational and long term considerate groups of people. To expect average joe burger flipper to stop eating meat and driving cars because of the long term macroscopic ramifications of their usage is hypocritical if we don't practice what we preach.

I never understand how "Stop eating factory farmed meat" means you have to "eat less meat" - why not just eat better sourced high quality meat?

It seems especially strange in a place like HN where you'd think that supporting the alternative grass-fed, non-factory farmers would be the entrepreneurial thing (and encourage more farmers to do it).

Meat is not the problem. The quality of the meat is. There are ways to solve that problem outside of eating less meat.

Because it's more expensive. Most people can't afford to eat large amounts of high quality meat.

I do, but it means I can afford to eat far less meat. Like, twice a week. Which is fine, and also I enjoy it more[0].

Organic chicken is stupid expensive here (compared to pork or beef) and so is bacon (compared to factory bacon, which I agree is in fact stupid cheap). So I get mainly sausage and other cheaper cuts like pork belly.

But if you have the money to spend, go for it, vote with your dollars or something? :)

[0] unlike organic vegetables, the flavour difference of organic meat vs factory meat is (to me) extremely noticeable.

I'm sorry for linking to a PETA page (especially since it's a very buzzfeed-y one), but [this page][1] has links to a lot of good sources.

[1]: http://www.peta.org/features/meat-climate-change/

https://www.extension.purdue.edu/extmedia/ID/ID-420-W.pdf

This is because antibiotic resistance has a high biological cost to the bacteria, and they get out competed by bacteria without that adaptation when antibiotics cease being present.

The bacteria are also less competitive, so all you have to do is stop using the antibiotics and you will make it less likely for them to survive in the hyper competitive farm waste.

As long as you stop making them the resistance will die off as "not worth it".

I hate to be so negatively argumentative, and I especially hate having to defend McDonald's, but I honestly think you are trying to make an association that does not exist based on information that was not factual. Or you're trolling, in which case congratulations are in order for getting me to type all of this.

This is an assumption I have which is in no way scientifically proven.

I read an article a few years ago about McDonalds drastically reducing the amount of Penicillin used in its cows which lead me to believe that my consumption prior to that may have caused it.

I may have just become allergic to Penicillin for no reason but I do find it coincidental.

We don't yet know all of the ways that allergies are "activated" but we've yet to record an antibiotic allergy developed from consuming meat. Antibiotics get metabolized by the organism they are given to, they don't get magical protection from oxidation or other chemical processes, and they sure as hell can't survive the insane heat meant to kill all living organism on it when it is cooked (especially at McDonalds).

Although parent's claim is difficult to confirm, it's not impossible.

It may be rare, but I don't think we can dismiss it just because it's rare.

Seems to me the salient question is whether any of the antibiotics that are used on livestock are even related to penicillin. I don't know the answer, but if they're not, that would certainly cast doubt on the claim.

If you have a noticeable reaction, it's because your immune system mistakenly (or properly) identifies the ingested substance as harmful and is being overzealous about fighting it. But how your immune system will react to any particular foreign body is already established prior to ingestion.

So, could someone develop a more severe reaction after such prolonged exposure and stress being put on their immune system? No doubt. But the over exposure did not create the intolerance, it just temporarily exacerbated it.

All that said, I just looked up whether antibiotics from the penicillin family are used in livestock. It seems that regulations require any poisons, drugs or other contaminants with the potential to be passed to the consumer through ingestion, must both be a relatively low dosage and completely out of the animal's system prior to slaughter.

Aren't they? I had no trouble finding an example to contradict you: http://en.wikipedia.org/wiki/Allergy#Non-food_proteins (first paragraph)

In general I'm not aware that we know all the causes of allergies.

> It seems that regulations require any poisons, drugs or other contaminants with the potential to be passed to the consumer through ingestion, must both be a relatively low dosage and completely out of the animal's system prior to slaughter.

What do you think "completely" means? It doesn't mean zero or even "undetectable"; it means there's some threshold level, anything below which is considered acceptable.

If you trust the people who are setting those thresholds, you have a lot more faith in the system than I do.

As for the livestock regulations, I completely agree with you. I'm still going to eat steak every day, but I agree nonetheless.

This is really quite frustrating. This whole argument is about you clinging to this pedantic distinction between "causing" an allergy and "exacerbating it to the point that you could notice it", as if that were somehow critical, when it has no practical impact at all.

As far as I can see, nothing you've said has had anything to do with the original hypothesis. 'sschueller said "I became allergic to penicillin because of U.S meat." We have no idea whether that's true -- as 'sschueller him/herself subsequently admitted -- but I still don't see that we can dismiss it out of hand. Your argument amounts to saying that the claim can be dismissed because it was improperly phrased. That's pointless pedantry at best.

The thing you're having trouble accepting is that we actually do know that his statement is false, because it's literally not possible, because that's not a physiological thing that happens. I don't understand how many different ways I can explain this to you.

It's not pedantry, it's a pretty important distinction. Spreading the disinformation that exposure can cause the development of allergies has potential to create confusion and even be harmful to the public. Take, for instance, the anti-vax movement. It was started by small bits of disinformation and ballooned into something with deadly consequences.

You are having a semantics argument that doesn't exist. I am explaining physiology to you, which you are not accepting. So you're right, this has been pretty pointless. But that doesn't make you any less wrong.

Let me say this as clearly as I can. For the purpose of setting public policy on how much of what antibiotics may be used in livestock, your precious distinction is of no consequence. It doesn't matter whether exposure to low levels of penicillin, or related compounds, causes a truly de novo allergy, or merely exacerbates an existing one that was so mild as not to be noticeable. The sufferer does not know the difference, and from the point of view of public policy, either outcome, in significant numbers, is unacceptable.

If you have a counterargument to this point, make it. Otherwise I will take it as agreed.

1. Person makes claim that an allergy was developed by ingesting meat.

2. I inform claimant that is not possible.

3. You declare that it is.

4. I debunk this declaration using well known and understood science.

5. You deny this science, while providing evidence that backs up the science.

6. I try to explain science again.

7. You change your stance from "it's possible" to "okay, it's not possible, but there's no difference."

8. I explain to you why there is a difference.

9. You not only disregard that difference, but all of a sudden decide that we're talking about public policy instead of debunking the original claim that a person developed an allergy by ingesting meat.

Do you really not see how unreasonably difficult you're being? You have twisted things at every turn.

My entire point from the beginning has been that allergies are not developed through exposure, which is a very important distinction. Just because you, personally, don't want to believe that the distinction is important, doesn't mean it isn't. Disinformation is always harmful, and I find your indifferent attitude toward perpetuating disinformation quite disturbing.

You are claiming that someone who develops an allergy must have had an allergy to start with. But the only thing that backs up this claim is your own definition.

I would suggest that allergy ought instead to have a clinical definition: if you can observe symptoms, you have an allergy. This definition is the only one that makes practical sense: if you could not observe symptoms, why would you care? The immune response definition that you give does not match up well with what medical professionals would call allergies - not at all.

It's clear that repeated exposure can cause an allergy in this sense, and you have presented no valid argument to debunk that.

I'd like to know the relationship there. I'm not knowledgeable in the area.

They have nothing to do with eating meat - especially because meat doesn't have any penicillin it in.

> The European Centre for Disease Prevention and Control estimates that antimicrobial resistance (AMR) results each year in 25 000 deaths and related costs of over €1.5 billion in healthcare expenses and productivity losses.

http://ec.europa.eu/health/antimicrobial_resistance/policy/i...

No, the problem is not that severe right now. In fact, some of the antibiotic resistant infections have decreased over the last few years.

This is something we need to worry about 5-10+ years from now. It is inevitable that bacteria will become resistant to current antibiotics. The only way to keep ahead of them is to create new antibiotics.

(1) You say it can't be left up to market economics, but two of the big hurdles to new antibiotic development are government regulations: (I) In the past the FDA was not very responsive to the resistance problem, if you had a new drug, you went through a normal review; luckily they have changed their approach recently (II) The way that Medicare and Medicaid pays for antibiotics doesn't encourage investment in novel agents

(2) I have to push back on the "going to the moon" type thing. This is more like we've already been to the moon and we need to go back and do something different. Drug companies know how to develop new antibiotics (not to say it's easy, but they have ideas) and they know how to get them approved. There are new discoveries all the time. We just need to create an ecosystem that encourages further investment.

Isn't this exactly what people used to say about the food supply?

FYI: One of the last-ditch antibiotics (I forget the name) has a side-effect of permanently damaging hearing. I have to basically yell at 95 yo grandmother for her to hear me. :)

It's not to streamline drug development, the deal is a tax dodge in its entirety. Some lovely commentary down the hallway, in the Pipeline: http://pipeline.corante.com/archives/2014/04/28/pfizer_and_a...

Scientists worry about the cuts to NIH funding, but the cuts to pharmaceutical research are ten times more worrying - who is going to develop the compounds to replace the current set of antibiotics when they have become useless? Wall Street is entirely unequipped to deal with this question; there are things that cannot be bought with money or at market, and scientific progress is one of them.

And I have to take issue with your comment "scientific progress can't be bought with money". What do you call all the new drugs that have been produced in the last century? It wasn't done by the government. Yes, basic research funded by the NIH advanced basic science, but it didn't put those pills in a bottle.

IBM, with nanotech PET - http://www.research.ibm.com/articles/nanomedicine.shtml#fbid...

And I know it is viruses, not bacteria, but MIT's DRACO is also pretty cool - http://www.ll.mit.edu/news/DRACO.html

Patents on antibiotics last no longer than on any other type of medicine (20 years, minus the substantial time taken to test it, jump through regulatory hoops, and bring it to market -- typically 8-14 years). The cost of meeting those regulatory prerequisites is measured in the hundreds of millions of dollars in the USA alone -- more if you want to get a product license everywhere worldwide. So you need to earn back several hundred million bucks in profit in a single-digit period of years ...

But antibiotics are unprofitable. A typical AB course lasts 5-14 days after which the patient is completely cured. Compare with antidepressants or ADHD drugs -- where you get a customer for life! Which would you invest in, if you were in that business -- a product 10% of the population will use annually for a week, or a product 10% of the population will be hooked on for life?

It's not a coincidence that research into new antibiotics ground to a halt in the 1970s around the time that the regulatory barriers to entry rose so high that small and medium scale pharmaceutical companies were frozen out of the business and the surviving operators were the large conglomerates.

(Disclaimer: wearing my ex-pharmacist hat here.)

It is not so in the case of medicines for BP, diabetes etc.

We may eventually need to have a compulsory hospital stay (or something else) for antibiotic treatment so that a patient treated with an antibiotic does not have any leftover resistant pathogens to transfer to the public.

I expect this is at least one explanation for why (as the article notes) antibiotics are ineffective at treating more than half of urinary tract infections caused by E. Coli. One standard treatment for persistent, recurrent UTIs in women is to prescribe a prophylactic antibiotic to be taken post-coitally, which typically means that a woman takes a pill irregularly--either every time after she has sex or once a week. This can last for years, without the doctor reevaluating the necessity of the treatment. While this is completely necessary for truly severe, recurring cases, I've seen several doctors prescribe this casually to women who don't have recurring UTIs but request it anyway. This is detrimental for the community and the patient, who has a higher risk of developing drug-resistant infections.

I think one way to address this problem is making doctors more aware of the community-wide effects of aggressive courses of treatment, informing them about alternative treatments that don't involve antibiotics, and encouraging them to use aggressive courses of antibiotics (such as prophylacticly for recurrent UTIs) as a treatment of last-resort.

The other problem that exists in the US is that the "family doctor" has an incentive to pack his schedule full of as many people as he can to collect as much money as possible. If someone comes in complaining that they have had a sore throat for a day, then they are going to get a pill; regardless of whether or not the infection is viral or bacterial. It is way, way faster to send the patient out the door with a pill that they think will make them feel better than it is to educate them about the macro effects of improper prescription of antibiotics. The only thing they care about is missing another day of work because they have a big deadline and the boss is breathing down their neck.

That being said, a few new legislative changes have happened and will happens (GAIN Act approved, DISARM Act being considered) that will change the economics of antibiotic research and have already prompted drug companies to get back into the field.

You'd have to find a new class of drugs that is safe for humans at the toxic dose for bacteria.

[1]http://www.sciencedaily.com/releases/2014/04/140414154454.ht...

Perhaps there are some new antibiotics to be found, perhaps there aren't; but in any case there's an end of the road somewhere. After that, only radically different mechanisms would work - vaccines, phages, nanobots, something else, but not antibiotics.

New antibiotic classes are hard to find. You need to find compounds that are lethal to bacterial cells (but not our cells) that there's no pre-existing immunity to. That's an extremely tall order, and we've run out of easy sources for those compounds.

We spend tax money on defense because it's a public good and in the absence of tax dollars there's no money in it. The same applies here.

This is the bacteria that caused the post surgery infection

http://en.wikipedia.org/wiki/Acinetobacter_baumannii

Here is a relevant article on how Homeopathy provides an alternative to antibiotics

http://aurumproject.org.au/homeopathy-alternative-antibiotic...

I did come across (I forget where) a very interesting talk which was outlining new techniques in antibiotics. The basic idea was that instead of straight out killing them (in which some breed resistance) instead you get in the middle of their chemical signals and basically tell them to attach before they've reached the point where the immune system won't win.

Still, bacteria being bacteria they'll probably work their way around it, but maybe rewriting your messaging system is a little harder than breeding resistance.

It would probably be a better use of time engineering the bacteria to be harmless to humans, negating the need for a course of drugs to kill it off.

It's frightening when this becomes the norm, not the exception because we're basically running out of options by natural selection moving faster than research.

We need a crash program to develop antibiotics before it's too late.

As an interesting aside, more and more copper is being used in medical equipment as it is naturally antibacterial.

http://en.wikipedia.org/wiki/Antimicrobial_properties_of_cop...

Think of it as a very slow arms race where on the one side there is intelligence and design and on the other there is the lottery driven mechanism of evolution that rewards the solver of the newly posed problem with a very large number of offspring.

The sides are surprisingly well matched and short of total eradication this is likely going to be the game for the next foreseeable future.

The bigger challenge will be to restrain ourselves to consume much more limited amounts if and when we do find antibiotics that work again in order to lengthen the time that we're 'on top'.

I saw a TV programme where scientists had a big tray of nutrient gel. They divided the tray into sections. The fist section was normal nutrient gel. The next contained a normal dose of antibiotic. The next section was 10x, the next section was 100x and the final section was 1000x a regular dose. This was far more than humans could tolerate. They stopped at 1000x because that was the limits of solubility - they couldn't disolve more antibiotic into the gel.

Scientists then dropped a bit of e.coli on the normal gel and set their time lapse cameras.

In just a few weeks the bacteria had evolved to live on all sections of the gel.

(This was a BBC 'Horizon' programme called "defeatng the superbugs")

Antibiotic acts on a particular mechanism to kill the bacteria. In order to overcome an antibiotic threat, bacteria have to either modify or drop any functions associated with that mechanism.

If any of those functions help them to infect humans, then the bacteria at the end of the process will be generally less able to infect humans.

http://www.dailymotion.com/video/xz0yb2_bbc-horizon-defeatin...

The other thing to remember is international travel. It's pretty easy for someone in North America, who has a resistant bacterial infection, to hope on a plane and spread it around Europe.

- bacteriophages (viruses that kill bacteria) - vitamin C for some bacteria, vitamin D, other supplements like MSM. Most must be used in megadoses for this effect. - plant AB's (onion, black pepper, curcumin, the list is enormous and probably infinite)

http://www.youtube.com/watch?v=U6sZ7E9Hh-Y

It's history is muddied, mainly because of money & politics.