8 ms·

It's nice to know that despite all the alarmist articles about the end of antibiotics, good progress is being made. If this works, it could completely replace

It's nice to know that despite all the alarmist articles about the end of antibiotics, good progress is being made. If this works, it could completely replace traditional antibiotics. In that case, I could see dozens of new drugs in this class developed by the antibiotic companies. This would be similar to the race to develop new antidepressants, HIV drugs, and erectile dysfunction drugs. Any drug you have to take over and over again is a huge draw for the pharmaceuticals.

zabraxias 13y ago
This is really fantastic news but I too am skeptical of the drug companies being interested in a cure as opposed to a repeatable treatment. As a side note the article seems very well written for non-medical folks like myself.
- Fomite 13y ago
  This line of reasoning doesn't really apply to antibiotics - because you're likely to get another infection in your lifetime, and many people have infections at any given time, they're perfectly fine eradicating this one. Believe me, in the infectious disease space, drug companies tend to look for cures and prevention. For example, Merck and GSK spent staggering amounts of money on the HPV vaccine.
giarc 13y ago
This won't completely replace traditional antibiotics. As the article states this acts on Gram positive persister cells (a very specific group). The coming storm is from Gram negative bacteria such as Klebsiella, Actinetobacter and Pseudomonas. There is actually very little activity occurring in the field of antibiotic drug discovery and you identified the issue; no money in drugs that someone takes for 14 days and stops. Pharmaceutical companies are driven by stockholders and therefore they want them developing drugs that someone takes for the rest of their life (anti-depressants). Much of the research for abx discovery comes from academia who struggle with budgets that are pennies compared to what Pfizer, GSK, Wyeth, Astra can afford.
- im3w1l 13y ago
  The scary thing is what would happen if these bacteria fell into the hands of terrorist extremists. They could potentially create bio-weapons of mass destruction. Or imagine if some suicide cult decided that the time has come for the doomsday of reckoning. Al-Qaeda anthrax letters are nothing compared to this. It could also be used to threaten mutually assured destruction in asymmetric warfare. Iran could probably develop it more easily and stealthily than their (not very) secret nuke program. Developing countermeasure to this is a matter of national security. Insha'Allah people will come to their senses and please think of the children: We must secure the existence of our people and a future for white children before it is too late. -----BEGIN PGP MESSAGE----- . jA0EAwMCRocgNS5lXxmuyT+0aXL2u7pKyJ0+BNTpPRy33dvnVrD4SVfqcF+oTDUx vLOi4p3oM6sJn80NnTUCGjqlpEPuekIIRXWAjOtq+P4= =+4PK -----END PGP MESSAGE-----
- JunkDNA 13y ago
  You're right that it's about profits when pharma is involved, but you are wrong about the reason (otherwise vaccines would not exist). I can tell you from firsthand experience that the length of time someone is on a drug makes almost no difference in where research priorities are. The primary issue with antibiotics is that since the late 1990's, if you succeed, and you develop the best antibiotic the world has ever seen, the FDA will require it to be a "drug of last resort". It will therefore sit on the shelf and be guaranteed to not be prescribed very much during the life of its patent. Once enough time goes by, and other drugs come out if (and that's a big if) it is no longer a drug of last resort, it is likely off patent and therefore can be made in generic form for pennies by generic manufacturers. Regardless of what you think about patents, these incentives are completely misaligned with companies going all-in and taking a risk on new antibiotics.
  - maxerickson 13y ago
    Do you know if NIH uses any of their funding in a DARPA like manner?
    - JunkDNA 13y ago
      They do this to a certain extent, but the problem here is that the "R" part of "R&D" is not really at issue. While there's a lot of focus in the popular press on "finding" new antibiotics, that part can be addressed by basic research grants. I don't believe we're wanting for proof of concept kinds of things. Unlike with engineering, where once you've got a proof of concept, you can refine and iterate to make it production quality, biology is completely arbitrary. The issue comes with the "D" part of R&D. That is the expensive part with drugs because you start having to do very tightly controlled animal model studies progressing further into clinical trials with humans. The popular notion that you "discover" a drug is not how things work in reality. Often you discover a whole raft of closely related chemical entities that appear to do what you think they do. You tweak based on further studies in order to improve efficacy and safety. But the system is sort of nondeterministic in the sense that even altering the structure slightly often has knock-on effects you can't predict. Assuming you get something decent, that's what gets made into the an actual medicine. There's a whole branch of applied chemistry that specializes in this called medicinal chemistry. In many cases, you'll read about some promising new antibiotic that has been discovered in an academic lab, but once the chemists take a look at it, you realize there's no way to make a drug out of it. The reasons can be any or all of: the therapeutic dose would be too high, it blows out the liver, it can't be made into pill, the compound is unstable and can't have a good shelf life, it can't be taken orally, etc... Working out all those kinds of problems has always been the realm of pharmas and biotech startups. Academics aren't interested in that stuff because it's not basic research, it's highly applied and is mostly trial and error based on decades of doing this kind of work. At a macro-level, this is fundamentally what ails the entire pharma sector right now. The development part of making drugs is so expensive and such a complete and utter crap-shoot, that few new drugs of any sort are actually being produced. The last decade has been one of prolonged decline in the industry in terms of truly new drugs and there is no obvious mechanism available to us to make it less so.

zabraxias 13y ago

This is really fantastic news but I too am skeptical of the drug companies being interested in a cure as opposed to a repeatable treatment. As a side note the article seems very well written for non-medical folks like myself.

Fomite 13y ago
This line of reasoning doesn't really apply to antibiotics - because you're likely to get another infection in your lifetime, and many people have infections at any given time, they're perfectly fine eradicating this one. Believe me, in the infectious disease space, drug companies tend to look for cures and prevention. For example, Merck and GSK spent staggering amounts of money on the HPV vaccine.

giarc 13y ago

This won't completely replace traditional antibiotics. As the article states this acts on Gram positive persister cells (a very specific group). The coming storm is from Gram negative bacteria such as Klebsiella, Actinetobacter and Pseudomonas. There is actually very little activity occurring in the field of antibiotic drug discovery and you identified the issue; no money in drugs that someone takes for 14 days and stops. Pharmaceutical companies are driven by stockholders and therefore they want them developing drugs that someone takes for the rest of their life (anti-depressants). Much of the research for abx discovery comes from academia who struggle with budgets that are pennies compared to what Pfizer, GSK, Wyeth, Astra can afford.

im3w1l 13y ago
The scary thing is what would happen if these bacteria fell into the hands of terrorist extremists. They could potentially create bio-weapons of mass destruction. Or imagine if some suicide cult decided that the time has come for the doomsday of reckoning. Al-Qaeda anthrax letters are nothing compared to this. It could also be used to threaten mutually assured destruction in asymmetric warfare. Iran could probably develop it more easily and stealthily than their (not very) secret nuke program. Developing countermeasure to this is a matter of national security. Insha'Allah people will come to their senses and please think of the children: We must secure the existence of our people and a future for white children before it is too late. -----BEGIN PGP MESSAGE----- . jA0EAwMCRocgNS5lXxmuyT+0aXL2u7pKyJ0+BNTpPRy33dvnVrD4SVfqcF+oTDUx vLOi4p3oM6sJn80NnTUCGjqlpEPuekIIRXWAjOtq+P4= =+4PK -----END PGP MESSAGE-----
JunkDNA 13y ago
You're right that it's about profits when pharma is involved, but you are wrong about the reason (otherwise vaccines would not exist). I can tell you from firsthand experience that the length of time someone is on a drug makes almost no difference in where research priorities are. The primary issue with antibiotics is that since the late 1990's, if you succeed, and you develop the best antibiotic the world has ever seen, the FDA will require it to be a "drug of last resort". It will therefore sit on the shelf and be guaranteed to not be prescribed very much during the life of its patent. Once enough time goes by, and other drugs come out if (and that's a big if) it is no longer a drug of last resort, it is likely off patent and therefore can be made in generic form for pennies by generic manufacturers. Regardless of what you think about patents, these incentives are completely misaligned with companies going all-in and taking a risk on new antibiotics.
- maxerickson 13y ago
  Do you know if NIH uses any of their funding in a DARPA like manner?
  - JunkDNA 13y ago
    They do this to a certain extent, but the problem here is that the "R" part of "R&D" is not really at issue. While there's a lot of focus in the popular press on "finding" new antibiotics, that part can be addressed by basic research grants. I don't believe we're wanting for proof of concept kinds of things. Unlike with engineering, where once you've got a proof of concept, you can refine and iterate to make it production quality, biology is completely arbitrary. The issue comes with the "D" part of R&D. That is the expensive part with drugs because you start having to do very tightly controlled animal model studies progressing further into clinical trials with humans. The popular notion that you "discover" a drug is not how things work in reality. Often you discover a whole raft of closely related chemical entities that appear to do what you think they do. You tweak based on further studies in order to improve efficacy and safety. But the system is sort of nondeterministic in the sense that even altering the structure slightly often has knock-on effects you can't predict. Assuming you get something decent, that's what gets made into the an actual medicine. There's a whole branch of applied chemistry that specializes in this called medicinal chemistry. In many cases, you'll read about some promising new antibiotic that has been discovered in an academic lab, but once the chemists take a look at it, you realize there's no way to make a drug out of it. The reasons can be any or all of: the therapeutic dose would be too high, it blows out the liver, it can't be made into pill, the compound is unstable and can't have a good shelf life, it can't be taken orally, etc... Working out all those kinds of problems has always been the realm of pharmas and biotech startups. Academics aren't interested in that stuff because it's not basic research, it's highly applied and is mostly trial and error based on decades of doing this kind of work. At a macro-level, this is fundamentally what ails the entire pharma sector right now. The development part of making drugs is so expensive and such a complete and utter crap-shoot, that few new drugs of any sort are actually being produced. The last decade has been one of prolonged decline in the industry in terms of truly new drugs and there is no obvious mechanism available to us to make it less so.