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Comment by capkutay | Hacker News Reader

I know there's a lot being said about super bugs...but is the expectation that we just keep developing stronger antibiotics? is this something can be sustained over the next few decades/centuries?

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I think if we ever phase out animal agriculture we will be relatively safe. You don't have to worry about superbugs if you don't create places for them to develop, which we effectively do by giving billions of dirty animals low doses of antibiotics indefinitely.

Serious bacterial illnesses in countries with good health systems are already pretty rare. The vast majority of them come from unsanitary food practices

Won't there always be somewhere though? Until we have a fully developed planet with no empty land, there's going to be swamps, tar pits, decomposition in nature and a plethora of other strange things on Earth that could give bacteria places to grow. Not to mention space-bacteria!

If all of our countries with health systems designed for our bacteria aren't equipped to handle more advanced bacteria, wouldn't it take just one explorer to bring back a species-threatening disease?

Sure, but that somewhere would be very unlikely to have antibiotics, making the development of further antibiotic resistance unlikely. Non-antibiotic resistant bacteria is very easy to treat and is essentially a solved problem.

The space thing is irrelevant. You can't develop pharmaceuticals meant to kill things you don't know anything about

It's naive to believe AB resistance is only/mostly created in agriculture.

There is no evidence to that. Even the existence of resistant bacteria in agricultural animals doesn't prove there is a danger for Humans.

In Human tuberculosis for example, resistance seems to happen de novo in Humans, normally, after the patients go through multiple ineffective or aborted rounds of treatment.

Hopefully some knowledgeable can chime in. I was under the impression that in the long term antibiotics will need to be replaced by something else. I'm 42 and just this year I learned (in a mainstream newspaper) about bacteriophages [1] as a means of combating infections. Does anybody know if we are close to seeing widespread adoption of this approach? Is it too costly? Is there a risk that it may get out of control?

[1] https://en.wikipedia.org/wiki/Bacteriophage

The gist as I understand it was that Western medicine bet the farm on antibotics while Russian medicine went primarily towards phages. Because of it's Not Invented Here status, Western medicine was biased against it for ideological and political reasons.

Using phages to treat infections (phage therapy) has traditionally been suppressed in the West, but is making a comeback with a few high-profile case studies in recent years. Tom Patterson had an atb resistant Acinetobacter baumannii infection that was cured with phages [1]. His wife wrote a book about it (The Perfect Predator) that is a good read review of the field. More recently, a patient with cystic fibrosis was cured of a Mycobacterium abscessus infection with phage therapy [2].

These therapies are currently very expensive and time consuming, as they require custom testing of libraries of phage against the specific microbial isolate. There have not been any successful large scale clinical trials yet.

For a good review of the field (but behind academic paywall), see [3]

[1] https://aac.asm.org/content/61/10/e00954-17 [2] https://www.nature.com/articles/s41591-019-0437-z [3] https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(1...

I cannot find it right now, but I do remember some research using some variant of carbon nanotubes being used as a replacement.

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