Post antibiotic era

Post antibiotic era

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anonymous-user

Original Poster:

54 months

Monday 21st December 2015
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The initial message was deleted from this topic on 07 November 2020 at 04:51

Some Gump

12,688 posts

186 months

Monday 21st December 2015
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^ Not huge insight, only that some of the big pharma boys are suddenly paying attention. One of them just set up a new division to concentrate on antibiotics, and the money is flowing very freely in that direction.

Of course, many on FB etc will hate them anyway, on the basis that they weren't massively interested when there was no money to be made. Personally, I'd rather pay an evil robbing pharma company for a drug than die because no-one developed one in the first place...

Gnits

917 posts

201 months

Tuesday 22nd December 2015
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There is an awful lot of development in genetic alterations to the immune response going on right now to defeat cancers, I don't see any reason why this won't be the replacement for antibiotics too. Given that it is easier for the immune system to detect non-self anyway, I would have thought that would have given that a headstart.

Mojocvh

16,837 posts

262 months

Tuesday 22nd December 2015
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http://www.bbc.co.uk/news/health-35153795


Alliance to Save Our Antibiotics says 837kg of colistin was sold to British farms in 2014.

Coilin Nunan, from the Alliance to Save Our Antibiotics, said: "We need the government, the European Commission and regulatory bodies like the Veterinary Medicines Directorate to respond urgently.

"The routine preventative use in farming of colistin, and all antibiotics important in human medicine, needs to be banned immediately."

Wonder who worked out the price of human life compared to livestock ?????? PETA or similar bizzarians??


OK I made the last word up.

Edited by Mojocvh on Tuesday 22 December 17:47

V8LM

5,174 posts

209 months

Tuesday 22nd December 2015
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Maybe that's the only way forward: Pump the environment with everything we have to kill off everything that could possibly do harm. Reset the evolutionary clock and start again.


Edited by V8LM on Wednesday 23 December 07:57

ATG

20,570 posts

272 months

Tuesday 22nd December 2015
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Zombie apocalypse. I'm retreating to my house up the hill and I'll shoot anyone who comes up the track. Except the Ocado and Amazon delivery drivers, natch.

CoolHands

18,622 posts

195 months

Tuesday 22nd December 2015
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I know it was in the news that Chinese farmers give it routinely to animals. So perhaps British farmers do too. That's the sort of fked up world we live in. It ain't rocket science.

But then they never even tracked down any of the horse meat scandal villains, so to use an americanism, it's all a crock.

Some Gump

12,688 posts

186 months

Wednesday 23rd December 2015
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V8LM said:
Maybe that's the only way forward: Pump the environment with everything we have to kill of everything hat could possibly do harm. Reset the evolutionary clock and start again.
Opposite.

Nature is an amazing beast. Doing what you suggest will create a temporary lull, followed by badness we have no weapons against. Like literally none. Back to Victorian times when a cut could be fatal.

Terminator X

15,054 posts

204 months

Wednesday 23rd December 2015
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I can't even remember the last time I needed them + Doctors do seem to have stopped prescribing them for ailments where they won't work anyway. Is this really such a big deal?

TX.

V8LM

5,174 posts

209 months

Wednesday 23rd December 2015
quotequote all
Some Gump said:
Opposite.

Nature is an amazing beast. Doing what you suggest will create a temporary lull, followed by badness we have no weapons against. Like literally none. Back to Victorian times when a cut could be fatal.
Not if the environment is sterile having killed off all the bugs. wobble

Tetanus is interesting in this discussion as the prevention and first line of treatment is immulogical.

mrtwisty

3,057 posts

165 months

Wednesday 23rd December 2015
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Terminator X said:
I can't even remember the last time I needed them + Doctors do seem to have stopped prescribing them for ailments where they won't work anyway. Is this really such a big deal?

TX.
Yes, it is a big deal. It's a little more complex than just denying antibiotics to people with mild viral ailments.

Simpo Two

85,399 posts

265 months

Wednesday 23rd December 2015
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mrtwisty said:
Yes, it is a big deal. It's a little more complex than just denying antibiotics to people with mild viral ailments.
Antibiotics don't (as far as I'm aware) kill viruses, they kill bacteria.

FunkyNige

8,882 posts

275 months

Wednesday 23rd December 2015
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ash73 said:
Anyone got any insight into research in this area?
I've always been told there's no reason they can't research it now, but with antibiotics there are several "tiers"/lines of defence when they dish them out -
First off a patient will get given the first tier (eg. penicillin), works most of the time and cheap as chips.
Second tier antibiotics don't get used as much so the market is smaller, plus there are plenty of antibiotics already so not much point researching a new one (to get a new medicine approved it has to be shown to be better than the existing medicines)
By the time you get to a tier where you need a new antibiotic medicine the market is so small that in order to get the research cost back you would need to charge a fortune but not many health organisations will pay that.
As the pharma can't make any money from it they don't research it, but now the market is looking like it will get bigger they will start researching some I'm sure.

GnuBee

1,272 posts

215 months

Wednesday 23rd December 2015
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ash73 said:
Anyone got any insight into research in this area?
I work for one of the bigger Pharmaceuticals. The issue is with "new" antibiotics is all about the business side. The situation we find ourselves in, as a civilization, is growing antibiotic resistance due to over exposure across both humans and, as mentioned before, animals involved in our food chain.

So the need is for some kind of "last hope", super-antibiotic that trumps all previous forms and there's no resistance to. Resistance is driven by exposure so in other words a super-antibiotic ideally would never be prescribed or if it was only in very, very limited and specific circumstances.

The problem for a big pharma is this presents a challenging business case; to develop a drug is typically around a ten year commitment prior to releasing it to the market. This initial period is composed of research, trials, process development and compliance activities and at any point can fail for a variety of reasons. Once a candidate compound is isolated/identified the patent is applied for but patents last a finite time and the clock is ticking way before you start selling the drug. Once off patent "anyone" can make the drug so you may, if you're lucky, get 15 years to pay back the cost.

Basically then we're looking at, for example GSK, agreeing to spend for example 25 million US$ developing a drug which has 15 years to pay back in but crucially should not be sold.

Where traction may be gained with the big pharmas is where a different mechanism is looked at and where that mechanism overlaps with far more attractive therapeutic areas (currently sexual health, mental health, cancer are the biggies along with Alzheimers).

Big pharmas may also be attracted by looking at devices that increase the accuracy of diagnosis leading to the prescription of anti-biotics; now this would be a big money earner and a help.

If a big pharma suddenly has a Scrooge moment and has an epiphany and feels all altruistic you may find they'll pump some money into collaborative research projects with small companies or academic institutions.




Edited by GnuBee on Wednesday 23 December 13:20


Edited by GnuBee on Wednesday 23 December 13:29

mrtwisty

3,057 posts

165 months

Wednesday 23rd December 2015
quotequote all
Simpo Two said:
mrtwisty said:
Yes, it is a big deal. It's a little more complex than just denying antibiotics to people with mild viral ailments.
Antibiotics don't (as far as I'm aware) kill viruses, they kill bacteria.
Yes, I'm aware of that. Perhaps my phrasing could have been better. I was trying to convey that better prescribing by gp's (not giving people Abx just to shut them up and get them out of the surgery) is only a very small step in a what could become a rather nasty problem.

Simpo Two

85,399 posts

265 months

Wednesday 23rd December 2015
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mrtwisty said:
I was trying to convey that better prescribing by gp's (not giving people Abx just to shut them up and get them out of the surgery) is only a very small step in a what could become a rather nasty problem.
Agreed. People can get quite cross if they don't get some pills. Maybe dish out some placebos...? It will keep them happy, save A/B use and might even work!

EagleMoto4-2

669 posts

104 months

Wednesday 23rd December 2015
quotequote all
GnuBee said:
I work for one of the bigger Pharmaceuticals. The issue is with "new" antibiotics is all about the business side. The situation we find ourselves in, as a civilization, is growing antibiotic resistance due to over exposure across both humans and, as mentioned before, animals involved in our food chain.

So the need is for some kind of "last hope", super-antibiotic that trumps all previous forms and there's no resistance to. Resistance is driven by exposure so in other words a super-antibiotic ideally would never be prescribed or if it was only in very, very limited and specific circumstances.

The problem for a big pharma is this presents a challenging business case; to develop a drug is typically around a ten year commitment prior to releasing it to the market. This initial period is composed of research, trials, process development and compliance activities and at any point can fail for a variety of reasons. Once a candidate compound is isolated/identified the patent is applied for but patents last a finite time and the clock is ticking way before you start selling the drug. Once off patent "anyone" can make the drug so you may, if you're lucky, get 15 years to pay back the cost.

Basically then we're looking at, for example GSK, agreeing to spend for example 25 million US$ developing a drug which has 15 years to pay back in but crucially should not be sold.

Where traction may be gained with the big pharmas is where a different mechanism is looked at and where that mechanism overlaps with far more attractive therapeutic areas (currently sexual health, mental health, cancer are the biggies along with Alzheimers).

Big pharmas may also be attracted by looking at devices that increase the accuracy of diagnosis leading to the prescription of anti-biotics; now this would be a big money earner and a help.

If a big pharma suddenly has a Scrooge moment and has an epiphany and feels all altruistic you may find they'll pump some money into collaborative research projects with small companies or academic institutions.




Edited by GnuBee on Wednesday 23 December 13:20


Edited by GnuBee on Wednesday 23 December 13:29
Normally drugs do take a long time to develop. But if a situation becomes serious enough, things like the need for clinical trials can be fast tracked to speed the process up. Similar to what was done for the recent Ebola outbreak.

Simpo Two

85,399 posts

265 months

Wednesday 23rd December 2015
quotequote all
EagleMoto4-2 said:
But if a situation becomes serious enough, things like the need for clinical trials can be fast tracked to speed the process up. Similar to what was done for the recent Ebola outbreak.
It makes sense. If the chance of dying is 99%, you'll take anything better than that. And yer average African is, I suggest, less likely to sue if it doesn't work out.

GnuBee

1,272 posts

215 months

Wednesday 23rd December 2015
quotequote all
EagleMoto4-2 said:
Normally drugs do take a long time to develop. But if a situation becomes serious enough, things like the need for clinical trials can be fast tracked to speed the process up. Similar to what was done for the recent Ebola outbreak.
I think the Ebola situation was slightly different in so far as they already had a candidate compound (or compounds) which means they were post discovery phase and almost certainly were moving into the latter stage of clinical trials. There's no mechanism, as far as I'm aware, that fast-tracks a compound from discovery to human use in , for example, a few months or a year.

EagleMoto4-2

669 posts

104 months

Wednesday 23rd December 2015
quotequote all
GnuBee said:
I think the Ebola situation was slightly different in so far as they already had a candidate compound (or compounds) which means they were post discovery phase and almost certainly were moving into the latter stage of clinical trials. There's no mechanism, as far as I'm aware, that fast-tracks a compound from discovery to human use in , for example, a few months or a year.
I believe there is, in that if someone is in such a dire situation they can be offered experimental drugs with the proviso that they understand the risk to their health, taking something that hasn't been fully tested yet.
Future antibiotic candidates could already be in the pipeline, but as an outbreak of antibiotic resistant bacteria hasn't spread to the masses yet, the tabloids havent had the need to pick up and report on them.
To be honest it will only be people with compromised immune systems who will initially be at risk if such a scenario were to take place. I was probably less than 10 years old when I last took an antibiotic for something.