Any sort of improvement over current antibiotics would be a godsend as the idea of antibiotic-resistance "superbugs" is arguably a ticking timebomb that presents an existential threat to modern society.
Right now the most common antibiotics we have (eg penicillin + synthetic derivatives) use a B-lactam ring to disrupt cell wall production. Now we start to see bacteria that are resistant to this attack, eg MRSA (Methicillin-resistant staphylococcus aureus), that in worst-case scenarios make even simple surgical procedures life-threatening.
Then we bring in the big guns, things like Vancomycin that disrupt cell wall production using different methods. But then we start to see Vancomycin-resistant microorganisms. So governments limit Vancomycin use so as to not give bacteria the opportunity to evolve and develop resistance. Thus drug manufacturers are unwilling to research new antibiotics because they can't make a profit off of restricted-access antibiotics.
So it's largely a game of cat and mouse that could very well result in a deadly worldwide epidemic. New ways of looking at the problem such as the one described in the article could, without even being hyperbolic, save billions of lives.
Antibiotic resistance is definitely not an existential threat. Most people do not catch any bacterial diseases that would be fatal if untreated before their reproductive years.
That doesn't mean it's a good situation, but existential threat is greatly overstating the problem. People would have to have an extra baby, MAYBE.
Considering horizontal gene transfer, I would say there most certainly is a route for stated existential threat. Bacteria trade plasmids back and fourth all the time, including those that code for antibiotic resistance. So while you are correct that the most likely outcome is a return to the pre-antibiotic era (still really bad), you underestimate the dangers in the resistance in that all sorts bacteria can become resistent, both against the medications themselves as well as against the body's own immune system.
Also, notice I intentionally said an existential threat to society, not humanity. It's fair to say that no longer being able to perform surgical procedures safely would be very destabilizing to modern society.
It's an existential threat because our modern society is extremely promiscuous, not insular like the world was in the past. The disappearance of antibiotics would put a serious damper on the current trends of globalisation. It's not an existential threat to the survival of mankind, but it is an existential threat to the survival of our modern society.
it is an existential threat to the survival of our modern society
Forget about promiscuity vs. insularity- modern society is not built on the backs of twenty-year-olds. If humans suddenly did not survive much past their prime reproductive age, humanity would survive with absolute ease, but modern society would undergo dramatic change.
I would agree. Humans survived up all the way up until the point antibiotics were discovered, so why wouldn't they survive if all antibiotics suddenly became ineffective?
Sure you'd see average life expectancy drop dramatically, but I don't think you'd see humans die out as a species.
The latter one is obviously wrong. The former, I think it's more likely than not that it's wrong. Sure, globalization would make bacterial outbreaks more likely but simple things like more frequent hand washing and wearing surgical masks any time you're out in public would cut the infection rate down tremendously.
There are many societal things we could do to improve society's chances of survival before antibiotic resistance would become an existential threat to society.
This is probably true for a most infections you encounter in every day life, but the infection rate for surgical procedures is higher, despite reduction through sterilization and antiseptic. There are also a number of professions where the chances of injury, and subsequently infection, are much higher.
It's possible that there would be large societal changes if the ability to undergo surgery or work in risky professions is hampered by an increased risk of lethal infections.
For many years since its initial use, vancomycin has traditionally been reserved as a drug of "last resort"... Recently, however, vancomycin resistant organisms are becoming common. Thus, vancomycin is increasingly being displaced from this role by newer antibiotics
>So governments limit Vancomycin use so as to not give bacteria the opportunity to evolve and develop resistance.
Vancomycin actually has a high hurdle to use naturally. It possesses poor oral bioavailability; it must be given intravenously for most infections. It can't be abused as easily by doctors prescribing it for things like colds because you have to be hooked up to an IV to get it.
Having said that, it is still a very old antibiotic (from 1953) and resistance has built up from its use. A few months ago I had Vancomycin + Ciprofloxacin administered intravenously for four days due to an infection following a severe puncture wound to my foot. It's still prescribed but it's not "the big guns" it used to be.
But the problem is procedural so I don't think this will help at all. The issue is that doctors proscribe antibiotics at the drop of the hat. As soon as hypochondriacs start complaining of their phantom symptoms and the strongest antibiotics aren't working they'll just get the new "super" drugs and become resistant to those too.
The only solution is to get the medical profession to stop shotgunning antibiotics at every problem.
http://topdocumentaryfilms.com/rise-superbugs/ is an excellent and recent Australian documentary explaining the origins of superbugs, just how scary they are, how the present scenario has evolved, and where it is likely going. Well worth a look. Despite the gravity of the subject, it's shot in a refreshingly non-scaremongering style with some apparently honest investigative journalism at its heart. (By contrast, you rarely see that if such documentaries come from the US, IMHO. Declaration of bias: I'm Australian!).
> a ticking timebomb that presents an existential threat to modern society.
If it gets bad enough, outpatient antibiotics use will be a thing of the past. Need antibiotics? You're staying in a facility where someone will monitor you and make sure you take the full course and don't make our resistance problems worse. It won't necessarily be a hospital and you won't necessarily be watched by doctors or nurses, but compliance will be mandatory and enforced. Society has ways of defending itself.
I hope it doesn't get that bad, but needs must, when the Devil calls the tune.
It'd be great if there was a nice infographic that people like me could use to point out the difference between what this paper talks about (real) and colloidal silver (harmful, with a lot of false information) so that when cranks use this paper to peddle lies I can give people simple to understand information.
it's a little silly to believe that the high doses of colloidal silver that the crazies take (enough to make their faces literally blue) doesn't slough off silver(I). The high surface area of colloidal silver means that plenty of it is exposed to oxygen in a highly-reactive surface.
Obviously, it's the colloidal silver version of homeopathy! I just hope the authors of the article haven't lulled themselves into thinking that they've just invented a silver bullet for infections.
The idea of homeopathy tries to make the solutions "stronger" by dissolving them with water. It's the main process behind it - the point where you're pretty much left with just water.
Nothing like that is claimed here. This idea is based on how ions of silver interact with cells which was also described. You may not agree with the article, but comparing it to homeopathy is just silly.
Colloidal silver has been shown to have antibacterial properties in vitro (in a petri dish or test tube), and in fact it is still used by NASA and the World Health Organization as a drinking water disinfectant, but no evidence has ever shown it effective in vivo (used internally in a living being).
Drinking colloidal silver killed my amoebic dysentery - a rather horrible strain from drinking Egyptian water - within a day. That was after a week of very expensive treatment had done nothing - if anything I was getting worse. Three or four glasses of 30ppm silver in water over the course of 24 hours and I quickly recovered. It is very effective in vivo for some things. Is there peer reviewed research behind this? Probably not. But after reading Ben Goldacre's Bad Pharma, I'm of the opinion that my anecdote carries as much weight as the industry's research.
Given how doctors recommend sinus rinses these days, I wonder if adding some silver to it might be effective against ongoing sinus infections, especially since the rinse actually goes in and out, so you're not actually taking in much of it.
It's impossible to find serious information on it though because of all the quackery.
I'd love to not need antibiotics for those things, but they are often very effective: I stop being sick from one day to the next.
Give it a try. I make my own solution from a battery, a resistor, distilled water and some 9999 grade silver wire but your local store should have it.
I've got BMW silver-impregnated socks and they just never smell even after a full day in boots. My wife has used colloidal silver gel on burns (she's a nurse) and it's an incredible anti-bacterial agent. Silver, like ozone, needs to be treated with respect for medical purposes and you're sadly right that there's a good deal of nonsense out there but it does work.
The last guy that I met that talked like you had blue-gray skin. This isn't silly like arguing against thermodynamics, but it is an extraordinary claim and anecdotes are just not going to cut it. This isn't quite 'Nobel Prize' territory but it would be a sea change in the scientific literature and it goes without saying that we can always use a new antibiotic.
If anecdote is all you have to offer, however, please refrain from troubling us with reading it.
On topic, didn't we see some similar claims a few years back about sugar increasing the effectiveness of antibiotics greatly?
The last guy that I met that talked like you had blue-gray skin.
Well then he's an idiot and has been drinking it every day ignoring the MASSIVE ALL CAPS WARNINGS not to. I've used colloidal silver internally maybe three times in the last five years.
This isn't silly like arguing against thermodynamics, but it is an extraordinary claim and anecdotes are just not going to cut it.
It's not an extraordinary claim at all: silver in small concentrations is well known to be an anti-bacterial agent. I've used it against dysentery. It worked. In gel form it heals burns and keeps them sterile with nary a gauze in sight. Motorcycle manufacturers churn out pairs of socks by the million which are polyester impregnated with silver. They stay fresh.
This isn't quite 'Nobel Prize' territory but it would be a sea change in the scientific literature and it goes without saying that we can always use a new antibiotic.
If you think that the scientific literature about pharmaceuticals is this wonderfully neutral repository of human knowledge, untrammeled by commercial interest, bad science, junk test results and plain old fraud, then be my guest.
If anecdote is all you have to offer, however, please refrain from troubling us with reading it.
Naah, I'm just getting warmed up. How about good old oxygen? I have first hand experience of people with full blown AIDS going into full remission after ozone therapy. It's almost trivial to do too: get the patient's blood - if you can call the horrible black sludge that someone with a CD-4 count of 20 has blood, but never mind - ozonate it until it's cherry red, and stick it back in him. Lather, rinse, repeat. No anti-retrovirals or hellishly expensive treatements, just oxygen. Unpatentable and of course not profitable. And therein lies the heart of our problem with modern medicine.
That's just another anecdote, though. Also, a few nose drops seems to be at odds with how much of that stuff that some people seem to quaff prior to turning blue. Who knows... I wish someone would do some actual science. I don't want to randomly ingest stuff, myself, so I'll stick to antibiotics for the time being, but the idea seemed interesting to me.
For that matter, I'm curious why topical delivery of antibiotics via a sinus rinse isn't used either. Maybe it's just not an effective way of delivering them. I don't know, I'm not a doctor.
I'm as big of a skeptic as they come, but after reading the article, I don't think they're talking about colloidal silver. Rather "silver — in the form of dissolved ions".
I fully understand they aren't talking about colloidal silver. It was more poking fun at the article talking about the amazing medicinal effects to be achieved by simply adding silver to stuff.
Legitimate or not, it /sounds/ just like the same bullshit from the 90s.
I've been having a huge argument over colloidal silver in the family. It's hard to stay reasonable when there are family members health possibly at stake. I've kept a very skeptical stance, although I can't really say I can argue from any confidence. It seems obvious that the idea is littered with quackery and hopeful thinking. This article makes me more confused.
> There are many people who are allergic to penicillin. That does not make it any less useful to the rest of the population.
There are tons of delicious foods that you can't buy in any restaurant or store no matter how much you're willing to pay, because a small percentage of people are allergic or whatever. So the entire population gets essentially zero use out of them even though they could be useful to the vast majority of people. (In fact, restaurants/stores/farmers markets only carry only a small percentage of the total foods out there.) Similarly a ride at an amusement park that is safe for the vast majority of people is a ride that no one is going to be allowed to go on.
Medicine is just a special case because doctors generally won't lose their license for killing the occasional patient, whereas, say, a restaurateur probably would.
Peanuts are fatal to some people, yet we eat them all the time. Here's a counter-example to your first claim. Another one is Fugu fish, which I personally ate at a restaurant, and which are known to be deadly if not prepared correctly.
Rollercoaster is dangerous to anyone with weak skeleton, and can likely induce heart attack as can a horror movie. Here's a counter-example to your other claim.
Do you have any examples that support your claims?
> Peanuts are fatal to some people, yet we eat them all the time.
Peanuts are banned from most schools.
> Another one is Fugu fish, which I personally ate at a restaurant, and which are known to be deadly if not prepared correctly.
That applies to most foods, e.g. tomatoes, rhubarb, etc.
When is the last time you had chicken-of-the-woods in a restaurant though? Oh wait, never. Because 90% of people find them delicious, but the other 10% cyanose and then start projectile vomiting and shitting themselves. Of course on your own that's not a big deal because you just bioassay it on yourself first, but in a restaurant that doesn't work.
Well, that's a far cry from you can't buy in any restaurant or store no matter how much you're willing to pay.
So, we have established there are foods that are dangerous and can be had at a restaurant (raw fish, raw meat, peanuts, fugu), and there could be some foods that are dangerous and cannot be had at a restaurant (chicken-of-the-woods).
I wasn't claiming that there are no potentially dangerous foods that you can buy at restaurants, only that there are many potentially dangerous foods that you can't buy at restaurants.
Casu marzu[1] comes to mind, though wikipedia indicates that it's legal(ish) again. Not that I think it would be that great a loss to society if it were unavailable, but there you go.
Kind of an extreme example, though. I don't think that it justifies the notion that society suffers under a tragedy of many useful foods being unavailable. I also would need to be persuaded of that.
Oh yeah, I've seen that, it's like the lemon party of food porn or something. And anyway, it's only dangerous if the maggots are dead! I thought of a more mainstream example (to repeat myself from another reply) - there's a lot of regulations surrounding raw milk and cheese.
I'm more familiar with mushrooms than plants. But are a ton of plants that aren't served for various reasons. In terms of plants that aren't served specifically because they have a high likelihood of causing bad reactions, I'm not sure -- milkweed and certain species of fiddleheads might be good examples. There are lots of different reasons for why certain foods aren't commercially available, and often it's just completely arbitrary. E.g. the reason you can't buy coca tea is that Obama doesn't recognize religions different from Christianity as being valid. (His administration specifically lobbied the UN not to let South Americans use it for religious purposes.)
Interesting, I didn't know about the coca tea. I thought of another health-based one: unpasteurized milk and cheese. Generally not a problem in Europe, but highly regulated in some states (e.g. no raw milk cheese younger than 60 days, no raw milk period).
There are other animal-based ones that aren't really health related. E.g. restaurants aren't allowed to serve meat that's not FDA inspected, but the FDA only inspects a small variety of meats. There was a restaurant in SF that was serving cricket tacos and they got shut down because of this:
So yeah, the FDA caters to big industry, and the meat coming out of feedlots is scarier than your typical roadkill, but this is pretty well-known.
My understanding is that although there are a ton of regulations restricting the sale of food, the health reasons cited are generally dubious, rather than genuine.
The chicken-of-the-woods thing is obviously genuine, and I'd believe the same for a lot of different mushrooms. I've purchased about 20 species of wild fungi and I'm basically content with that variety. Raw milk / cheese I would say was a dubious health reason.
Side note: if a reply link isn't there, you just need to wait a bit longer.
The problem is strong antibiotics are often needed for severe infection outbursts and there isn't enough time to perform blood tests for alergic reactions.
Long before it kills anyone, it may turn them blue. And if that is happening, chances are you are taking way too much. Too much of any good thing is a bad idea.
In fact you don't need to take too much silver to turn gray, it is accumulative so you can not suspect that you are taking too much, and you don't know when the effects will appear. Sometimes may appear many weeks after you take the silver. Is one of its well known dangers.
I read this interesting submission and the comments to date while I thought about this issue. I see the HN participant posting this story is new here, making his first article submission.
Some of the comments surprised me, as they seem to assume that antibiotics as a category of substances are only a few decades old. In fact, many of the first antibiotics in clinical use were "natural" substances, namely mycotoxins secreted by fungi in an endless chemical warfare arms race for living in a world full of bacteria. The reason that antibiotics are useful for human medicine is that fungi are much more biochemically similar to animals (like us) than bacteria are, being our comparatively near evolutionary cousins as fellow eukaryotes, and as such they are naturally selected to produce antibacterial mycotoxins that may be highly effective against broad groups of bacteria while being largely harmless to most animal tissues. But as the article notes, and as we would expect from evolution by natural selection, various strains of bacteria have been selected by differential survival to be more or less resistant to current antiobiotics.
Silver as an adjuvant for antibiotics may have some clinical usefulness. The research reported in the article here is laboratory rather than clinical research. There are many more steps to take before knowing whether or not this is a useful approach for human medicine, including carefully controlled clinical trials of safety and effectiveness. The reporter who wrote this news brief was careful to interview another scientist who warns that silver is toxic to human tissues as well as too bacteria, so dosage will be a crucial issue.
The obligatory link for any discussion of a preliminary research finding like this article is the essay "Warning Signs in Experimental Design and Interpretation" by Peter Norvig, LISP hacker and director of research at Google, on how to interpret scientific research.
Check each submission to Hacker News you read for how many of the important issues in interpreting research are NOT discussed in the submission. Here we still need to wait for actual human clinical trials to know if the addition of silver to antibiotic treatments will have adequate safety and effectiveness.
AFTER EDIT: I'm going to an appointment for my children, so I'll be away from the discussion for a while. I'm not sure what the pattern of upvotes and downvotes on this comment means so far, as replies haven't explained yet what other readers think about this comment.
"Adjuvant"! [C17: from Latin adjuvāns, present participle of adjuvāre, from juvāre to help] Cheers for a new scrabble word for the armory, tokenadult! The fungi point is a good one, well done for bringing it up. Ditto interpretive guidelines. The breadth of your knowledge is, as always, impressive.
Although the title here closely matches the article title, it seems overstated/optimistic. The actual line in the article is "when boosted with a small amount of silver these drugs could kill between 10 and 1,000 times as many bacteria." That's a big range. Of course, this still could end up being quite useful.
Granted, including "could" in the title would have been less misleading, given they indeed mention a "10x to 1000x" range.
But I think readers should focus more on the outstanding scientific progress than on the slightly-overselling title.
Notably, the effect on bacteria membranes, and the ability to make antibiotics-resistant bacterias vulnerable to silver-buffed antibiotics.
(TODAY anchor Matt) Lauer asked him if being on TODAY
helped bring him out of his shell.
“I didn’t have much choice. I couldn’t find the cave I was
looking for,” Karason said with his characteristic
self-deprecating humor.
That will resonate with any introverts who have found themselves in a role that requires speaking in public.
I wonder if copper would also work. Copper is just as toxic to bacteria, but is more "bio-active" in the body.
This can be both good and bad: Good in that the body can actually remove the copper from the body (unlike silver which stays there permanently). And bad in that copper may be more toxic (don't know).
If all the articles saying we're close to making something 1000x more effective, faster, better etc. were true I would probably be writing this comment while driving a solar powered flying car to my home on a moon base.
One important point that seems to be missed is that they really want to isolate what mechanism is causing the effect rather than planning to dose everyone with silver.
you know what else makes antibiotics more effective? bleach. this paper is ridiculous. figure 4: no tested amount of silver nitrate is noncytotoxic. end of story.
I'm unsure what you point is. Our current antibiotics are already producing resistant strains. We can either develop something completely new, or lace existing antibiotics with silver. Unless you are in this field and have some insight to bestow on us, I don't know of any other approaches at the moment. Improving our current methods by bolstering them with silver could be what we need to gain a new advantage against resistant strains.
Is it possible that we will eventually produce strains resistant to even this? Yes. Is the answer to just give up drop all attempts at antibiotics? Probably not.
This prevents production of more resistant strains, but we already have resistant strains out there. (Also, @pearjuice seemed to indirectly imply that the ability to improve our existing antibiotics was a bad thing)
> At least part of the answer is to use antibiotics less, and to do more to ensure that when they are used, the full course is used.
If it gets bad enough, outpatient antibiotics use will be a thing of the past. Need antibiotics? You're staying in a facility where someone will monitor you and make sure you take the full course and don't make our resistance problems worse. It won't necessarily be a hospital and you won't necessarily be watched by doctors or nurses, but compliance will be mandatory and enforced.
Antibiotics are a recent human invention, so it isn't surprising that resistance to them is still increasing. Silver, on the other hand, has been present in the environment since before bacteria evolved. If there was an accessible pathway to silver resistance, it would have been found in several billion years.
Silver may be common in some places, but IIRC it isn't common inside animals or plants. So if you are a bacteria producing an infection, you would not expect to find a lot of silver inside your target. The metabolically paths that have resistance are usually more expensive, so the cheap path is usually selected and the other unused path is lost after some generations lost dew to random mutations.
It's possible that there exist some strange bacteria that feed on sulfur components and live inside mines with high silver concentration that have special mechanism to handle silver, but I think they are not very happy eating meat.
The genes for penicillin resistance predate the use of penicillin as an antibiotic. Perhaps there are genes which confer silver resistance which will be increasingly expressed as silver is used as a treatment.
That sounds interesting, but have you got a link to that paper/explanation? With the mutations happening all the time it seems to me like the question "can you step twice into the same river?" is close to what applies in this case.
Fungus could tell another history, about how they design, make and use exactly the same compounds since thousands, maybe millions of years for the same purposes.
If silver is potent enough, that may not be an issue. While it is hypothetically possible for biotics to develop resistance to sterilization via sulfuric acid, to my knowledge none have. If your treatment operates with fundamental chemistry (rather than complicated interactions between large organic molecules) and is powerful enough, the biotics don't get a chance to develop resistance. Or at least, that's how I understand it.
For example, I would consider osmosis to be a "fundamental chemistry" form of action. The only organisms I know of that can tolerate ridiculously high osmotic pressures are extremophiles. They developed resistance, yes, but they had the opportunity to gradually develop on the fringes of these extreme environments, instead of simply being dropped into a pool of salt.
Right now the most common antibiotics we have (eg penicillin + synthetic derivatives) use a B-lactam ring to disrupt cell wall production. Now we start to see bacteria that are resistant to this attack, eg MRSA (Methicillin-resistant staphylococcus aureus), that in worst-case scenarios make even simple surgical procedures life-threatening.
Then we bring in the big guns, things like Vancomycin that disrupt cell wall production using different methods. But then we start to see Vancomycin-resistant microorganisms. So governments limit Vancomycin use so as to not give bacteria the opportunity to evolve and develop resistance. Thus drug manufacturers are unwilling to research new antibiotics because they can't make a profit off of restricted-access antibiotics.
So it's largely a game of cat and mouse that could very well result in a deadly worldwide epidemic. New ways of looking at the problem such as the one described in the article could, without even being hyperbolic, save billions of lives.