[WildUtah]

Antibiotics are a renewable resource. If we could prohibit all use of a class of antibiotics for a time, probably decades, bacteria will stop spending energy on resistance and become vulnerable again.

Antibiotic resistance is a problem with a political solution. It just takes coordination and cooperation worldwide to do the right thing instead of chasing short-term profit.

So I guess we'd better hope for a technological solution instead.

[saycheese]

Unable to edit my prior comment, but found research that appears to dispute your claim; citing notable research might help me better understand your claim.

It is very possible that I'm missing something, but that's not how evolution works to my knowledge, adoption of substantially new genetic features is rapid, but refinements or removal of unrelated genetic code is slow if it is not impacted by the substantive mutations.

For more information, see "Long-term phenotypic evolution of bacteria":

http://www.columbia.edu/~gap2118/papers/nature13827.pdf

[chamoda]

"bacteria will stop spending energy on resistance and become vulnerable again."

Correct me if I'm wrong but ones bacteria modified by natural selection they will continue the resistance (genes) in future bacterial generations.

[glormph]

No expert, but theoretically new mutations that eliminate resistance may be beneficial by allowing the newly mutated bacteria to outgrow the resistant ones if the mutation leads to spending less energy. Edit: there will also be non-resistant bacteria in the population so the mutation to remove resistance may not even be necessary.

[majkinetor]

You are wrong.

'Use it or loose it' apply to bacteria far more then for example humans.

Evolution doesn't work the way you think it does. Its not an adaption to something to all eternity but adaptation for current surroundings - once the context is changed, the genome will change too.

The process is simple - the first bacteria that ditch the antibiotic resistence gene will multiply more and use more available resources so other bacteria that have that gene gene (witch becomes resource hog since it doesn't contribute to survival any more) will die out.

[ansible]

And you are also wrong.

Antibiotic resistant genes don't just disappear when we stop using antibiotics. They will remain in the gene pool effectively forever at low levels.

After the first time antibiotic resistance is developed, the gene frequency in the bacteria population may drop to nearly zero after it isn't so useful. But it will come back again very quickly with the reintroduction of that antibiotic. The time scale will be much quicker than when the bacteria first developed antibiotic resistance.

Widespread use of antibiotics (especially at low doses) was and is a criminal mistake.

[majkinetor]

You are right, but perspective is needed. How quick is quickly ? Is it quicker to return then they loose it ? Or is it slower to return then to loose it ? If so, we can circulate certain types of ABs effectivelly.

> Widespread use of antibiotics (especially at low doses) was and is a criminal mistake.

This is not only human made thing. Widespread AB use is common in nature. But AB use for growth promotion IS criminal. And AB should be given as last resort not as usual practice. Good nutrition and adequate supplemenation can cover the rest:

- Retynol is epic for mucosal layer protection.

- Vitamin D is great anti-infective agent.

- Vitamin C is awesome prevention and potential cure for helicobacter pylori.

- Many spices are fantastic as ABs.

- Fermented foods such as kefir and stuff like spirulina are great addition.

- High carb diet reduces immunity a lot.

You don't really need ABs every freaking day - its typical that kids have 6 or more tours in a year. My kid is raised with above principles and more and never had an AB even with kindergarten (7 years now).

There were also some other problematic procedures such apendixtomy that influence this or usage of ABs with viral diseses (typial to prevent opportunistic infections) or for disease that it doesn't affect much and even makes the organ worse, such as otitis.

NSAID use is also contributing A LOT to this. People now bring down temperature on 37.5 and if you don't do it on 38 you are considered lunatic. I simply do no do it up until 40.5 (talking about kids, the exact protocol is contextual and depends on age, length etc). The science showed that when you do that, the disease last longer and mortality is proved to be higher on animals. Brain knows perfectly well when to stop it unless it is broken itself (i.e. meningitis).

[ansible]

You are right, but perspective is needed. How quick is quickly ? Is it quicker to return then they loose it ? Or is it slower to return then to loose it ? If so, we can circulate certain types of ABs effectivelly.

You are proposing coordination at the national or international level, among many different companies, medical institutions, and governments.

Just getting a ban on the use of antibiotics for non-infection related reasons will be difficult enough.

[majkinetor]

I am not proposing anything that radical. The first thing I would probably do is to stop using subtherapeutic ABs to grow animals. That would reduce 50% or more of the world AB usage and is certainly the easiest thing to try.

[yborg]

It would appear that the science is still not decided on this. If the resistance is carried on plasmids, it may disappear relatively rapidly from a population if the selection pressure for it is removed:

https://link.springer.com/article/10.1007/BF02017169 http://bmcevolbiol.biomedcentral.com/articles/10.1186/1471-2... https://www.ncbi.nlm.nih.gov/pubmed/1944394

There are other studies indicating that in the wild plasmid loss is a slow process:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966108/

And resistance expressed by genes that become part of the core genome of a bacterial species would presumably be much harder to lose.

[majkinetor]

Thanks for the links. This stands out:

>. The presence of ascorbate induced a 50-75% decrease in minimal inhibitory concentrations of different antibiotics for resistant strains. When ascorbate is added, formerly subinhibitory concentrations of penicillin or tetracycline have an increased inhibitory effect on resistant strains and even induced the death of 25-93% of the initial population. These results suggest that ascorbate can induce the loss of several plasmids of S. aureus, and that the levels of antibiotic resistance are also affected by the presence of this compound.

Vitamin C saved the day again ! This level requires intervenous treatment tho, something considered frindge science at this moment for lame reasons.

[BurningFrog]

> Antibiotic resistant genes don't just disappear when we stop using antibiotics. They will remain in the gene pool effectively forever at low levels.

They very likely already were in the gene pool before we went on the antibiotics binge. Remember that our antibiotics were discovered in nature. They're used by other species to fight bacteria. Penicillin was used by moulds for unknown millions of years before we coopted it.

Since bacteria multiply within days or even hours, evolution works very fast in them. This is why they develop resistance within a few decades. How fast they would lose the resistance if we stopped is AFAIK not something we can know until we do it and see what happens.

[ansible]

They very likely already were in the gene pool before we went on the antibiotics binge. Remember that our antibiotics were discovered in nature. They're used by other species to fight bacteria. Penicillin was used by moulds for unknown millions of years before we coopted it.

Those antibiotic resistant genes likely weren't in pathogenic bacteria that affect humans though. And by improperly using antibiotics, we've created an environment where those genes cross species boundaries from where they originated.

[chrishynes]

What makes you think that pathogenic bacteria never contained antibiotic resistant genes before humans developed antibiotics? I've never seen a study that proves that antibiotic resistant genes were never in pathogenic bacteria.

Seems quite possible that antibiotic resistant genes were in all types of bacteria and the volume thereof responds to selection pressure.

[cwmma]

You would be right if the antibiotics resistance was 'free', i.e. had no downside, but IIRC it does pose a cost of some sort so when not in an environment with antibiotics there is evolutionary pressure to lose the resistance.

[saycheese]

>> "...bacteria will stop spending energy on resistance and become vulnerable again."

Source?

[kwhitefoot]

Standard theory of evolution: organisms that spend energy on features that do not contribute to their fitness will be at a disadvantage in the long run compared to others of otherwise similar type that do not. The others will have more energy to devote to reproduction.

[saycheese]

Citing notable research might help me better understand your claim; it is very possible that I'm missing something, but that's not how evolution works to my knowledge, adoption of substantially new genetic features is rapid, but refinements or removal of unrelated genetic code is slow if it is not impacted by the substantive mutations.

Source: http://www.columbia.edu/~gap2118/papers/nature13827.pdf

[gerbilly]

Resistant bacteria usually become resistant by giving up a metabolic pathway.

[a-saleh]

I wish I could have read more than the abstract, but maybe this [1] ... I would especially like to know what do they mean by "Unfortunately, the available data suggest that the rate of reversibility will be slow at the community level"

[1] http://www.nature.com/nrmicro/journal/v8/n4/pdf/nrmicro2319....

[smhost]

From that same paper:

> In hospitals, both modelling and analysis of the correlations between antibiotic resistance and variation in antibiotic use show that alterations in antibiotic use can cause rapid changes (in the order of days to months) in the frequency of resistance. By contrast, when the fitness cost of resistance is the main driving force behind its reversal, the rate of change is expected to be much slower (months to years).

I think what that means is that hospitals are able to create more selective pressure by rotating through different kinds of antibiotics.