{"621176":{"#nid":"621176","#data":{"type":"news","title":"Antibiotics, Taken Strategically, Could Actually Help Defeat Antibiotic Resistance","body":[{"value":"\u003Cp\u003EIn the war on antibiotic-resistant bacteria, it\u0026#39;s not so much\u0026nbsp;the antibiotics that are making the enemy stronger as it is how\u0026nbsp;they are prescribed. A \u003Ca href=\u0022https:\/\/journals.plos.org\/plosbiology\/article\/authors?id=10.1371\/journal.pbio.3000250\u0022 target=\u0022_blank\u0022\u003Enew study\u003C\/a\u003E suggests that\u0026nbsp;doctors can beat\u0026nbsp;antibiotic resistance\u0026nbsp;using those same antibiotics\u0026nbsp;but in a very targeted manner and in combination with other health strategies.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThe current broad application of antibiotics helps resistant bacterial strains evolve forward. But using data about bacteria\u0026rsquo;s specific resistances when\u0026nbsp;prescribing\u0026nbsp;those same drugs more precisely can help put the\u0026nbsp;evolution\u0026nbsp;of resistant strains in reverse, according to researchers from the Georgia Institute of Technology, Duke University, and Harvard University who conducted the study.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EOne researcher cautioned that time is pressing: New strategies against resistance\u0026nbsp;that leverage antibiotics need to be in place\u0026nbsp;before bacteria resistant to most every known antibiotic become too widespread. That would render antibiotics nearly useless, and\u0026nbsp;it has been widely reported that this could happen by mid-century, making\u0026nbsp;bacterial infections much more lethal.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u0026ldquo;Once you get to that pan-resistant state, it\u0026rsquo;s over,\u0026rdquo; said Sam Brown, who co-led the study and is an \u003Ca href=\u0022https:\/\/biosci.gatech.edu\/people\/sam-brown\u0022 target=\u0022_blank\u0022\u003Eassociate professor in Georgia Tech\u0026rsquo;s School of Biological Sciences\u003C\/a\u003E. \u0026ldquo;Timing is, unfortunately, an issue in tackling antibiotic resistance.\u0026rdquo;\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThe new study, which was co-led by game theorist David McAdams, a \u003Ca href=\u0022https:\/\/faculty.fuqua.duke.edu\/~dm121\/\u0022 target=\u0022_blank\u0022\u003Eprofessor of business administration and economics\u0026nbsp;at\u0026nbsp;Duke University\u003C\/a\u003E, delivers a mathematical model to help clinical and public health researchers devise new concrete prescription strategies and those\u0026nbsp;supporting health strategies. The measures\u0026nbsp;center\u0026nbsp;on the analysis of\u0026nbsp;bacterial strains to determine what drugs they are resistant to, and which not.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\u0022https:\/\/smithfamilyclinic.org\/how-does-whole-genome-sequencing-work-in-the-lab\/\u0022 target=\u0022_blank\u0022\u003ESome medical labs\u003C\/a\u003E already scan human genomes for hereditary predispositions to certain medical conditions. Bacterial genomes are far simpler and much\u0026nbsp;easier to analyze, and though the analytical\u0026nbsp;technology is currently not standard equipment in doctors\u0026rsquo; offices or medical labs they routinely work with, the researchers think this could change in a reasonable amount of time. This\u0026nbsp;would enable the study\u0026rsquo;s approach.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThe researchers published their study \u003Ca href=\u0022https:\/\/journals.plos.org\/plosbiology\/article\/authors?id=10.1371\/journal.pbio.3000250\u0022 target=\u0022_blank\u0022\u003Ein the journal \u003Cem\u003EPLOS Biology\u003C\/em\u003E\u003C\/a\u003E on May 16, 2019. The work was funded by the Centers for Disease Control and Prevention, the National Institute of General Medical Sciences, the Simons Foundation, the Human Frontier Science Program, the Wenner-Gren Foundations, and the Royal Physiographic Society of Lund.\u003C\/p\u003E\r\n\r\n\u003Ch4\u003E\u003Cstrong\u003EQ\u0026amp;A\u003C\/strong\u003E\u003C\/h4\u003E\r\n\r\n\u003Cp\u003EHere are some questions and answers on\u0026nbsp;how the study\u0026rsquo;s counterintuitive\u0026nbsp;approach could beat back antibiotic resistance:\u003C\/p\u003E\r\n\r\n\u003Ch4\u003EIsn\u0026rsquo;t prescribing antibiotics the problem? How can it fight resistance?\u003C\/h4\u003E\r\n\r\n\u003Cp\u003EThe real\u0026nbsp;problem is the\u0026nbsp;broad application of antibiotics. They\u0026nbsp;treat human infections and farm animals, and in the process are\u0026nbsp;killing off a lot of non-resistant bacteria while\u0026nbsp;bacteria resistant to those drugs survive. The resistant strains can then reproduce\u0026nbsp;and with fewer competitors in their space, then they\u0026nbsp;dominate bacterial communities in the host animals and people.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThe resistant bacteria\u0026nbsp;get passed to other hosts and become \u003Ca href=\u0022https:\/\/www.cdc.gov\/drugresistance\/about.html\u0022 target=\u0022_blank\u0022\u003Emore prevalent in the world\u003C\/a\u003E altogether. New prescription strategies would outsmart that evolutionary scenario by exposing through genomic (or other) analysis bacteria\u0026rsquo;s resistance but also their vulnerabilities.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u0026ldquo;Right now, there are rapid tests for the pathogen. If you\u0026rsquo;ve got strep throat, the clinic swabs the bacteria and does a rapid assay that says yes, that\u0026rsquo;s streptococcus,\u0026rdquo; Brown said. \u0026ldquo;But it won\u0026rsquo;t tell you if it\u0026rsquo;s resistant to the drug usually prescribed against it. In the future, diagnostics at the point-of-care could find out what strain you\u0026rsquo;ve got and if it\u0026rsquo;s resistant.\u0026rdquo;\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThen clinicians would choose the specific\u0026nbsp;antibiotics that the bacteria are not resistant to, and kill the bacteria, thus also stopping them from spreading the\u0026nbsp;genes behind their resistance to\u0026nbsp;other antibiotics. So, identifying an infector\u0026rsquo;s resistance hits two birds with one stone.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u0026ldquo;It\u0026rsquo;s great for fighting antibiotic resistance, but it\u0026rsquo;s also good for patients because we\u0026rsquo;ll always use the correct antibiotic,\u0026rdquo; Brown said.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Csup\u003E\u003Cstrong\u003E\u003Cem\u003E[Thinking about grad school?\u0026nbsp;\u003Ca href=\u0022http:\/\/www.gradadmiss.gatech.edu\/apply-now\u0022 target=\u0022_blank\u0022\u003EHere\u0026#39;s how to apply to Georgia Tech.\u003C\/a\u003E]\u003C\/em\u003E\u003C\/strong\u003E\u003C\/sup\u003E\u003C\/p\u003E\r\n\r\n\u003Ch4\u003EAre there enough effective antibiotics left to do this with?\u003C\/h4\u003E\r\n\r\n\u003Cp\u003EPlenty. Antibiotics still work as a rule.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EIn addition, searching out and destroying resistant bacteria could help refresh existing antibiotics\u0026rsquo; effectiveness.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u0026ldquo;The idea is prevalent that we will use antibiotics up, and then they\u0026rsquo;re gone,\u0026rdquo; Brown said. \u0026ldquo;It doesn\u0026rsquo;t have to be that way. This study introduces the concept that antibiotics could become a renewable resource if we act on time.\u0026rdquo;\u003C\/p\u003E\r\n\r\n\u003Ch4\u003EAs mentioned above, prescription strategies by themselves won\u0026rsquo;t beat resistance, right?\u003C\/h4\u003E\r\n\r\n\u003Cp\u003ECorrect. Resistance evolution has some tricky complexities.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u0026ldquo;A lot of bacteria with the potential to make us sick like \u003Cem\u003EE. coli\u003C\/em\u003E spend most of their time just lurking peacefully in our bodies. These are bystander bacteria, and they are exposed to lots of antibiotics that we take for other things such as\u0026nbsp;sore throats or ear aches,\u0026rdquo; Brown said. \u0026ldquo;This frequent exposure is probably the major driver of resistance evolution.\u0026rdquo;\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThe antibiotic prescription strategy\u0026nbsp;needs those\u0026nbsp;additional\u0026nbsp;health care\u0026nbsp;measures to win the\u0026nbsp;fight, but those measures\u0026nbsp;are pretty straightforward.\u003C\/p\u003E\r\n\r\n\u003Ch4\u003EWhat are those additional measures?\u003C\/h4\u003E\r\n\r\n\u003Cp\u003EDiagnostics need to apply to bystander bacteria, too. \u003Cem\u003EE. coli\u003C\/em\u003E in the intestine or, for example,\u0026nbsp;\u003Ca href=\u0022https:\/\/www.cdc.gov\/pneumococcal\/clinicians\/streptococcus-pneumoniae.html\u0022 target=\u0022_blank\u0022\u003E\u003Cem\u003EStrep pneumoniae\u003C\/em\u003E\u003C\/a\u003E living peacefully in nostrils would be checked for resistance, say, during annual checkups.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u0026ldquo;If the patient is carrying a resistant strain, you work to beat it back before it can break out,\u0026rdquo; Brown said. \u0026ldquo;There could be non-antibiotic treatments that do this like, perhaps, bacteria replacement.\u0026rdquo;\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\u0022https:\/\/www.webmd.com\/digestive-disorders\/news\/20170531\/can-you-change-your-gut-bacteria\u0022 target=\u0022_blank\u0022\u003EBacteria replacement therapy\u003C\/a\u003E\u0026nbsp;would introduce\u0026nbsp;new bacteria into the patient\u0026rsquo;s body to\u0026nbsp;outcompete\u0026nbsp;the undesirable antibiotic-resistant bacteria and displace\u0026nbsp;it. Also, people would stay home from school and work for a few days so as not to spread the bad bacteria to other people while their immune systems and possibly\u0026nbsp;\u003Ca href=\u0022http:\/\/www.rh.gatech.edu\/news\/600252\/want-beat-antibiotic-resistant-superbugs-rethink-strep-throat-remedies\u0022 target=\u0022_blank\u0022\u003Ealternative therapies, such as bacteriophages or non-antibiotic drugs\u003C\/a\u003E\u0026nbsp;battle the bad bacteria.\u003C\/p\u003E\r\n\r\n\u003Ch4\u003EThis sounds hopeful, but are there other real-world\u0026nbsp;circumstances to consider?\u003C\/h4\u003E\r\n\r\n\u003Cp\u003E\u0026ldquo;The study\u0026rsquo;s mathematical models are broad simplifications of real life,\u0026rdquo; Brown said. \u0026ldquo;They don\u0026rsquo;t take into account that pathogens spend a lot of time in other antibiotic-exposed environments such as farms. Dealing with that is going to\u0026nbsp;require\u0026nbsp;some more\u0026nbsp;research.\u0026rdquo;\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThe study also purposely leaves out \u0026quot;polymicrobial infections,\u0026quot; which are infections by multiple kinds of bacteria at the same time. The researchers believe that the study\u0026rsquo;s models can\u0026nbsp;still be relevant to them.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u0026ldquo;We expect the logic of combating drug resistance to still hold in these more complex scenarios, but diagnostics and treatment rules will have to be honed for them specifically,\u0026rdquo; Brown said.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EAlso read: \u003Ca href=\u0022http:\/\/www.rh.gatech.edu\/news\/600252\/want-beat-antibiotic-resistant-superbugs-rethink-strep-throat-remedies\u0022 target=\u0022_blank\u0022\u003EWant to beat antibiotic resistance? Rethink that strep throat prescription\u003C\/a\u003E\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cem\u003EThese researchers coauthored the study: David McAdams from Duke University, Kristofer Wollein Waldetoft from Georgia Tech, and Christine Tedijanto and Marc Lipsitch from Harvard University. The research was funded by the Centers for Disease Control and Prevention (grant OADS BAA 2016-N-17812), the National Institute of General Medical Sciences at the National Institutes of Health (grant U54GM088558), the Simons Foundation (grant 396001), the Human Frontier Science Program (grant RGP0011\/2014), the Wenner-Gren Foundations, and the Royal Physiographic Society of Lund.\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EMedia contact\/writer\u003C\/strong\u003E: Ben Brumfield\u003C\/p\u003E\r\n\r\n\u003Cp\u003E(404) 660-1408\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\u0022mailto:ben.brumfield@comm.gatech.edu?subject=Clownfish%20anemone%20story\u0022\u003Eben.brumfield@comm.gatech.edu\u003C\/a\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EResearch News\u003Cbr \/\u003E\r\nGeorgia Institute of Technology\u003Cbr \/\u003E\r\n177 North Avenue\u003Cbr \/\u003E\r\nAtlanta, Georgia\u0026nbsp; 30332-0181\u0026nbsp; USA\u003C\/strong\u003E\u003C\/p\u003E\r\n","summary":null,"format":"limited_html"}],"field_subtitle":[{"value":"The same antibiotics driving antibiotic resistance evolution forward could help put it in reverse."}],"field_summary":[{"value":"\u003Cp\u003EThose same antibiotics driving\u0026nbsp;antibiotic resistance\u0026nbsp;could also help defeat it if\u0026nbsp;used with the right strategy. Making it\u0026nbsp;work\u0026nbsp;would\u0026nbsp;require companion\u0026nbsp;health strategies\u0026nbsp;like staying home from work when carrying resistant bacteria.\u003C\/p\u003E\r\n","format":"limited_html"}],"field_summary_sentence":[{"value":"Those same antibiotics driving the rise in antibiotic resistant bacterial strains could help defeat them if used as part of an informed strategy."}],"uid":"31759","created_gmt":"2019-05-01 16:24:46","changed_gmt":"2019-06-12 18:56:41","author":"Ben Brumfield","boilerplate_text":"","field_publication":"","field_article_url":"","dateline":{"date":"2019-05-20T00:00:00-04:00","iso_date":"2019-05-20T00:00:00-04:00","tz":"America\/New_York"},"extras":[],"hg_media":{"600247":{"id":"600247","type":"image","title":"Group A Streptococci NIAID","body":null,"created":"1514489748","gmt_created":"2017-12-28 19:35:48","changed":"1556728853","gmt_changed":"2019-05-01 16:40:53","alt":"","file":{"fid":"228835","name":"strep2NIAID.jpg","image_path":"\/sites\/default\/files\/images\/strep2NIAID.jpg","image_full_path":"http:\/\/hg.gatech.edu\/\/sites\/default\/files\/images\/strep2NIAID.jpg","mime":"image\/jpeg","size":395322,"path_740":"http:\/\/hg.gatech.edu\/sites\/default\/files\/styles\/740xx_scale\/public\/images\/strep2NIAID.jpg?itok=2wThLDMr"}},"600248":{"id":"600248","type":"image","title":"Associate Professor Sam Brown, bacterial virulence and evolution","body":null,"created":"1514490509","gmt_created":"2017-12-28 19:48:29","changed":"1514490509","gmt_changed":"2017-12-28 19:48:29","alt":"","file":{"fid":"228836","name":"Sam.sm_.holdsfisheye.jpg","image_path":"\/sites\/default\/files\/images\/Sam.sm_.holdsfisheye.jpg","image_full_path":"http:\/\/hg.gatech.edu\/\/sites\/default\/files\/images\/Sam.sm_.holdsfisheye.jpg","mime":"image\/jpeg","size":2911955,"path_740":"http:\/\/hg.gatech.edu\/sites\/default\/files\/styles\/740xx_scale\/public\/images\/Sam.sm_.holdsfisheye.jpg?itok=gz9SR5oM"}},"600250":{"id":"600250","type":"image","title":"Evolution of bacterial resistance to antibiotics","body":null,"created":"1514491473","gmt_created":"2017-12-28 20:04:33","changed":"1514491473","gmt_changed":"2017-12-28 20:04:33","alt":"","file":{"fid":"228838","name":"antibiotic resistance cdc.jpg","image_path":"\/sites\/default\/files\/images\/antibiotic%20resistance%20cdc.jpg","image_full_path":"http:\/\/hg.gatech.edu\/\/sites\/default\/files\/images\/antibiotic%20resistance%20cdc.jpg","mime":"image\/jpeg","size":506855,"path_740":"http:\/\/hg.gatech.edu\/sites\/default\/files\/styles\/740xx_scale\/public\/images\/antibiotic%20resistance%20cdc.jpg?itok=oY4EgVI9"}},"600251":{"id":"600251","type":"image","title":"Antibiotic-resistant bacteria cause horrible infections, lead to death","body":null,"created":"1514492185","gmt_created":"2017-12-28 20:16:25","changed":"1514492280","gmt_changed":"2017-12-28 20:18:00","alt":"","file":{"fid":"228839","name":"resistance deaths cdc.jpg","image_path":"\/sites\/default\/files\/images\/resistance%20deaths%20cdc.jpg","image_full_path":"http:\/\/hg.gatech.edu\/\/sites\/default\/files\/images\/resistance%20deaths%20cdc.jpg","mime":"image\/jpeg","size":505249,"path_740":"http:\/\/hg.gatech.edu\/sites\/default\/files\/styles\/740xx_scale\/public\/images\/resistance%20deaths%20cdc.jpg?itok=su8W9N02"}},"600249":{"id":"600249","type":"image","title":"Sam Brown, associate professor, bacterial virulence and evolution","body":null,"created":"1514490881","gmt_created":"2017-12-28 19:54:41","changed":"1514490881","gmt_changed":"2017-12-28 19:54:41","alt":"","file":{"fid":"228837","name":"Sam.sm_.thru_.bench_.jpg","image_path":"\/sites\/default\/files\/images\/Sam.sm_.thru_.bench_.jpg","image_full_path":"http:\/\/hg.gatech.edu\/\/sites\/default\/files\/images\/Sam.sm_.thru_.bench_.jpg","mime":"image\/jpeg","size":2280236,"path_740":"http:\/\/hg.gatech.edu\/sites\/default\/files\/styles\/740xx_scale\/public\/images\/Sam.sm_.thru_.bench_.jpg?itok=O5KzRWVG"}}},"media_ids":["600247","600248","600250","600251","600249"],"groups":[{"id":"1278","name":"College of Sciences"},{"id":"1214","name":"News Room"},{"id":"1188","name":"Research Horizons"},{"id":"1275","name":"School of Biological Sciences"}],"categories":[{"id":"135","name":"Research"},{"id":"138","name":"Biotechnology, Health, Bioengineering, Genetics"},{"id":"146","name":"Life Sciences and Biology"}],"keywords":[{"id":"174503","name":"antibiotic resistance"},{"id":"178562","name":"antibiotic resistance; 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