CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

Additionally, don't forget that phages are not all lytic and not all are effective (i.e. look at C. difficile) and that phages won't affect intracellular pathogens (i.e. Salmonella, to my knowledges phages don't work but please share as you say you have experience with this).

So while phages can be useful (I never said they weren't) their use is limited and has it's own drawbacks.

How do you prevent the phage from evolving to target the human cells?

I think the main thing is to challenge them to explain why. If they can't give a coherent explanation, ask them to explain to you what they think the risks are of waiting.

Most of the time when doctors here want to prescribe anti-biotics their answer is pretty much "just in case I missed something and it's actually a bacterial infection", and usually they'll then concede that if I'm ok with it, I can wait it out a couple of days and only take antibiotics if things doesn't start to improve with minimal risk. A couple of times the explanation has been that they've often seen specific symptoms exacerbated by a simultaneous bacterial infection, but again their response has been the same: if I don't keep getting worse, I'm fine to wait.

The only time I've ended up taking the antibiotics on offer was when I came in once spitting blood and with massive white lumps at the back of my throat (from whence the blood came, as they were ripped open when I coughed). Yay. Even then the doctor assumed, probably correctly, that it most likely was a viral infection that was making the rounds - she had a steady stream of the same symptoms that week -, but pointed out that given that my throat was so swollen and painful that I could hardly even drink, and the coughing of blood, if she was wrong and it got worse without antibiotics, next stop might be the hospital.

But of course few people care - they don't question the reasons for prescriptions at all.

Part of the high level of prescription of antibiotics in the UK is because of the health system here - they're paid per roughly per patient (adjusted for patient age, morbidity levels in the area they operate in, and a number of other factors meant to adjust for the cost of providing service, but the point is they are not paid per patient visit). If they get me out the door quickly and I don't come back, that's a win for them, so they are incentivised to get me well, but there's no downside to them short term from doing so by prescribing me something there might only be a 5% change that will make a difference to me at all - that's five percent fewer repeat visits at no real risk to them.

Few patients will complain, as the prescription cost is low, and when they get better in a few days, many of them will assume it was the antibiotics and so assume the doctor was right.

It's hard to set rules that prevent these kind of incentives, other than monitoring of whether or not they are in line with guidelines and/or whether or not they prescribe grossly more than the baseline.

I did though.

In the meantime, I will keep buying antibiotic-free meats whenever I can.

That's a strawman fallacy [1].

> If people were willing to pay for antibiotic-free meat, then farmers would produce it.

Seeing as most farming in the United States is done on megafarms owned by large corporations [2] that have historically shown to be (to put it mildly) lax on their focus on serving healthy and nutritious products to their customers [3], and that "farmers" in the traditional colloquial sense are now only 2% of the population [4], you'll hopefully understand if I say that your statement has little relevance in the United States in 2013.

[1] https://yourlogicalfallacyis.com/strawman

[2] http://thecabin.net/stories/091001/wor_0910010048.shtml

[3] http://en.wikipedia.org/wiki/Smithfield_Foods#Environmental_...

[4] http://www.epa.gov/agriculture/ag101/demographics.html

Also, I've noticed that some of my fellow Generation Y'ers have arrived at similar opinions by observing the issues that come with the over-medication of their parents/grand parents into old age. Doctors love to prescribe stuff, and sometimes the interactions between drugs is so bad that it can be pretty scary. Observing this as a third party can be enough to make you wary about over-using medication. It's also expensive and our health insurance situation over here is awful.

tl;dr, Yes, that's a huge generalization. I think a lot of younger Americans are starting to bend back the other way towards only medicating when necessary after seeing how much a can of worms it can be when used as a crutch.

We walked to the office without umbrellas, in light clothes, and hardly got wet. It was well over 20 degrees celsius, and a pleasant enough 15 minute walk despite the light drizzle.

We got into the office to find people in what looked like full survival mode, with raincoats, and hairdryers to get dry and warm. These were people who had driven right up to the office door.

When they saw us they were horrified and worried we'd get pneumonia and wondered how we could have chosen to walk 15 minutes through the "storm". Of course it did rain slightly more some other places - causing mud slides that closed a couple of roads and cut off the gas supply for a couple of days. But for us it was all terribly amusing.

After we went swimming in "only" something like 22 degrees in the water the following weekend, they got equally shocked (some of them asked if we'd used wet suits). I pointed out the coldest water I've been swimming in was 12 degrees, but I'm not sure they believed me.

Warning: Generalisations ahead

And even in the countries you include as exercising care, we still have a significant number of people who do not finish their antibiotic courses.

Tis a bit of a quandry, people tend not to be altruistic if they cannot observe the effect of their altruism.

That effect might even have helped in conquering the Americas, because the conquerors where used to such diseases and the natives where not.

I'm not sure there will be many political effects - unless of course people are going hungry, however the economic effects might be interesting. If intensive meat production stopped then perhaps there would be more free-range or extensive meat available (certainly at a higher price). Environmentally this might not be a bad thing, for example, the integrated olive/chestnut, goat/pig agriculture we have here in Portugal is pretty good for wildlife. More animals wandering over a wider area would be good for vultures as well (which are in rapid decline globally). Admittedly this is probably a limited scenario but it illustrates that there are desirable alternatives to highly intensive agriculture.

Aside: The economics of meat production seem pretty crazy to me. I can go to my local supermarket and purchase several meals worth of fatty pork for less than the price of a couple of heads of broccoli and and few carrots. Given it takes a lot more resources to produce the pork that suggests that the system we have is seriously out of whack.

Caveat: Off course, we might not be able to carpet the globe in goats to make this all work. It's just not going to be possible (or at least very difficult) to do this with a population well in excess of 10 billion.