A recent article in the British Medical Journal set off a bit of a firestorm with its claim that "the antibiotic course has had its day." The authors challenged the very widespread belief that you should keep taking every last dose of antibiotic prescribed by your physician even after you feel better. This advice has long been claimed to be key to preventing antibiotic resistance. The challenge to that claim has sparked a backlash, with physicians and public health officials expressing concern about an overly complex message that could result in encouraging patients to go rogue and ignore their doctors' prescriptions. All of this is a bit amusing to experts like me, who have been actively challenging this silly dogma for a long time, but without the recent media attention.
This question was originally published on Quora. Doctors are taught that it is important to finish out a course of antibiotics, and they dutifully relay this information to their patients. But the determination of therapy duration is usually based on almost no evidence at all. This is especially true for our understanding of the risk of the development of resistance, which is rarely a measured outcome in the clinical testing of antibiotics. As one review of the subject puts it "Therapy duration is one of the major understudied areas of infectious diseases therapeutics.".
Over the past quarter century we have come to realise that through overprescribing, lack of alternatives and lack of understanding, we've used up much of the bandwidth of our existing array of antibiotics. These weary soldiers in the army of medicines, many of which date back decades, have been diminished in their effectiveness by the natural agility of bacterial pathogens which rapidly evolve and develop resistance. Historically, we have looked in the same places to identify replacements for old, decreasingly effective antibiotics. And to no great surprise, we've mostly come up with dead ends or, at best, minor improvements (with very occasional outliers such as Colistin, reserved as weapons of last resort only). And because the pathogens we are facing will evolve to render any new antibiotics ineffective, new approved treatments will have a limited useful life in which to recover the cost of development.
Artificial intelligence (AI) has proved to be a useful ally in the battle against antibiotic resistance. A powerful antibiotic that's even able to kill superbugs has been discovered thanks to a machine-learning algorithm Researchers from MIT used a novel computer algorithm to sift through a vast digital archive of over 100 million chemical compounds and spot those that were able to kill bacteria using different mechanisms from existing drugs. Reported in the journal Cell, this method highlighted a molecule that appeared to possess some truly remarkable antibiotic properties. The team named the molecule halicin, a hat tip to the sentient AI system "Hal" from Stanley Kubrick's film 2001: A Space Odyssey. When tested in mice, halicin was able to effectively treat tuberculosis and drug-resistant Enterobacteriaceae, the family of bacteria that includes E. coli and Salmonella.
Researchers in the US have used artificial intelligence (AI) to discover a powerful new type of antibiotic capable of killing drug-resistant bacteria. Scientists at MIT trained a machine learning algorithm to analyse the molecular structures of chemical compounds and pick out potential antibiotics. The deep learning model was designed to identify compounds capable of killing bacteria using different mechanisms to those of existing drugs. After analysing some 2,500 different molecules, the AI system identified a new antibiotic compound which, in lab tests, killed many of the world's most problematic disease-causing bacteria, including drug-resistant strains. The new antibiotic compound has been dubbed halicin, named after the the rogue AI system, Hal 9000, from 1968 film 2001: A Space Odyssey.