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Medicine Idle

Spoonful of Sugar Helps the Persistent Bacteria Go Down 166

Doctors have discovered that adding sugar to antibiotics increases their ability to knock out persistent staph infections (abstract). Certain types of bacteria called persisters shut down their metabolic processes when exposed to antibiotics. Adding sugar keeps the bacteria feeding, making them more susceptible to drugs. From the article: "Adding such a simple and widely available compound to existing antibiotics enhances their effectiveness against persisters, and fast. One test showed that a sugared up antibiotic could eliminate 99.9 percent of persisters in two hours, while a regular antibiotic did nothing. Doctors believe that this discovery will help treat urinary tract infections, staph infections, and strep throat, but its most life-saving application may be against the age-old disease tuberculosis. This infection of the lungs kills many people, and is hard to fight off. A little sugar could help save a lot of lives."
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Spoonful of Sugar Helps the Persistent Bacteria Go Down

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  • by Rie Beam ( 632299 ) on Monday May 16, 2011 @04:15AM (#36138432) Journal

    I'm taking this with a grain of salt.

    • by TheLink ( 130905 ) on Monday May 16, 2011 @04:27AM (#36138488) Journal
      Just wondering how long it would take for the bacteria to become resistant to this technique.

      Is there a reason why it would remain hard for the bacteria to stay dormant in the presence of antibiotics as long as there is sugar around?

      Might be trivial enough for the bacteria to evolve around this by next month ;).
      • Re: (Score:3, Insightful)

        by cripkd ( 709136 )
        Well, wouldn't that mean the bacteria would have to learn NOT to feed on sugars? How would it know when is it safe to consume it ? Or it would have to learn to not feed on sugars as long as antibiotics are present.
        • by TheLink ( 130905 )
          Oops I meant to say this instead:
          "Is there a reason why it would remain hard for the bacteria to stay dormant in the presence of sugar as long as there are antibiotics around?"
      • by TheRaven64 ( 641858 ) on Monday May 16, 2011 @05:25AM (#36138664) Journal

        Is there a reason why it would remain hard for the bacteria to stay dormant in the presence of antibiotics as long as there is sugar around?

        Yes. Bacteria are simple. Feed in presence of food, dormant in absence of food is simple behaviour that can be trivially implemented using some chemical signals. Feed in presence of food and absence of antibiotic, dormant in presence of antibiotic is harder. You have to process two signals, do some weighting, and then select the correct behaviour.

        You also need to think about the intermediate steps. A bacterium on the way to evolving this behaviour would almost certainly not get it right first time. If it doesn't feed in the presence of sugar and the presence of non-fatal doses of antibiotics (or the absence of antibiotics), then it will be selected against in favour of ones that do. If it does feed in the presence of antibiotics, then it will die.

        Remember, evolution is only good at selecting local maxima, not global maxima, and the path to this involves jumping from one local maximum to another. If someone were intelligently designing bacteria, then it would be a lot easier...

        • Re: (Score:2, Funny)

          by Anonymous Coward

          If someone were intelligently designing bacteria, then it would be a lot easier...

          Many a fundies head would explode, as this would simultaneously prove that there is a creator and that she's malevolent.

          • Bacteria both having been intelligently designed and causing disease doesn't necessarily imply a malevolent Creator. It only means that they've microevolved from the bacteria that the Creator put in mammals' intestines.
          • by TheLink ( 130905 )
            That's only assuming the Creator is solely on our side ;).
            • That's only assuming the Creator is solely on our side ;).

              If the creator isn't fully on our side, our creation would be proof of malevolence or incompetence.

              • by TheLink ( 130905 )
                That's a stupid remark. By your logic the creator of the game of chess/football would be malevolent or incompetent.

                It's just hubris to assume that if there is a creator he/she should be on our side otherwise that creator has to be malevolent or incompetent. Also shows narrowmindedness and a lack of imagination.

                Humans should grow up, just like babies and toddlers should grow up- the world isn't about catering to their every whim and fancy.
          • If someone were intelligently designing bacteria, then it would be a lot easier...

            Many a fundies head would explode, as this would simultaneously prove that there is a creator and that she's malevolent.

            You are assuming that creation exists as it was intended. Many Christians believe that man's fall from grace also caused the corruption of creation around him. For example, with the right genes turned on, humanity could live forever because the signal to induce Telomere shortening would never trigger and you would see virtually unlimited cell repair and regeneration. The reason why we grow old and die is because the telomeres eventually wears out and your cells stop dividing. Google for "immortal cells" and

            • Yeah, but once you get to the point where (s)he's intelligently 'designing' (more like modifying) bacteria to be more resistant to our attempts to keep ourselves alive, you've definitely crossed the line into malevolence.

              • Yeah, but once you get to the point where (s)he's intelligently 'designing' (more like modifying) bacteria to be more resistant to our attempts to keep ourselves alive, you've definitely crossed the line into malevolence.

                I think you are missing the point. The Christians believe that creation was perfect and that original sin created the corruption of creation. That corruption would include bacteria that mutates into harmful bacteria. Our digestive system contains a lot of bacteria which is beneficial to our bodies but even that bacteria can become harmful if it gets into the water supply. Disease along with death is seen as a side effect on the fall of man.

                • Yeah I get that point. We were discussing the possibility of that bacteria evolving to become resistant to the treatments we have developed for it. It would be quite unlikely for there to be a viable evolutionary pathway for bacteria to become resistant to this new tactic of including sugar in the treatment, so to 'evolve' resistance it would require the help of a greater being to guide it along the right path.

                  I'm cool with a divine being that let's us face the consequences of our own actions, but if it sta

              • Not if the creation was for the sake of the bacteria. Just sayin'.

        • by wamatt ( 782485 ) *

          Thanks that pretty interesting. I didn't make the connection before between global and local maximisation.

        • Incidentally, I haven't designed any bacteria myself, but I've worked with people who have. All things considered, creating such a bacterium should just be putting a few pieces together. [partsregistry.org] And then waiting overnight. Twice.
        • by JoeMerchant ( 803320 ) on Monday May 16, 2011 @08:05AM (#36139260)

          A bacterium on the way to evolving this behaviour would almost certainly not get it right first time.

          You need to get a grasp of Carl Sagan's "Billions and Billions" when thinking about bacterial evolution.

      • by _0xd0ad ( 1974778 ) on Monday May 16, 2011 @06:21AM (#36138834) Journal

        Personally I'm wondering just exactly how much sugar they were planning on adding to the typical American diet.

        It's not like antibiotic prescriptions always used to come with strict instructions to not eat any sugar...

        • by aug24 ( 38229 )
          This is sugar *in the right place*. It'll likely be useful for topical applications only.
          • And that's the real point. Most of these infections can't use topical application. Are they going to rub it on the insides of your urinary tract, your lungs, your throat?

            So what's the point? Yes, superficial infections might be better treated, but this really won't impact most serious infections.

      • by DontBlameCanada ( 1325547 ) on Monday May 16, 2011 @08:29AM (#36139416)

        The wild card here is the immune system. If the presence of antibiotics switches bacteria to dormant mode - that may give the immune system time to create sufficient antibodies to wipe them out.

      • We need ways of measuring the willpower of these bacteria.

    • by jittles ( 1613415 ) on Monday May 16, 2011 @05:02AM (#36138600)
      All I have to say is this: It looks like Mary Poppins was right.
      • It's a jolly 'oliday wiv you Dr. Poppins!

        Oh, don't be such a chav'vy pratt, Bert, and hand me the scalpel.

        All right! It was a 'oliday! Now I'm callin' me barrister and
        it'll be the high jump for you when 'e's done with the discrimination and
        harrasment suit!

      • For those of you who've never seen Mary Poppins [youtube.com], and, thus, don't completely understand the reference..
    • Yes, I get the joke, but the usual disclaimer for these kind of results applies: did this work in vivo or just in the test tube? The abstract shows one experiment done in vivo: they introduced infected catheters into mice, then treated the mice with 1) nothing, 2) antibiotic, and 3) antibiotic plus mannitol (a sugar alcohol). Option 3) killed substantial amounts of bad bacteria, while the others did not. So that's good. But... they used kind of a lot of mannitol - 1.5 g/kg - which would be the equivalent of

  • Hunting (Score:1, Offtopic)

    by blinkwing ( 1687842 )
    Don't hunters already use this method, somehow? Bait an animal with food to lure it out in the open and then kill it?
  • Maybe some sugar in my coffee will help get rid of the bone infection in my jaw after the dentist screwed up my root canal. They got me on 2 types of antibiotics the infections hurts my face up to my eye. Funny thing is I try and avoid sugar even though I really like sweet coffee. Doubt it is that simple though.
    • Re: (Score:3, Interesting)

      by Dunbal ( 464142 ) *
      If it was that simple then it would fail to account for the fact that diabetics (who go around with high blood sugar levels almost all the time) are more prone to all types of infection than non diabetics.
      • by DarwinSurvivor ( 1752106 ) on Monday May 16, 2011 @05:20AM (#36138642)
        High blood sugar does not necessarily mean you ate a lot of sugar, in fact, the summary sounds like they are talking about white sugar. White sugar is far from the only sugar out there. The basic rule of thumb is: if the ingredient ends with "ose", it's a sugar (sucrose, dextrose, lactose, fructose, etc). Btw, I come from a family with a long history of Diabetes (both type 1 and 2).
        • It doesn't even need to be sugar really, just a simple carbohydrate. You could use vodka for the same effect, it's a somewhat popular, but controversial method of fighting algae in reef aquariums. Feed the bacteria so they outcompete the algae.

        • If you read the abstract, one of the ingredients they used was mannitol, which isn't strictly speaking a sugar at all - it's a sugar alcohol.
      • The sugar and the antibiotic have to be present at the same time. Hitting the bacterium with sugar and then antibiotic will have the opposite effect - it will feed, divide, and then go dormant, so you'll end up with more bacteria, not less.
      • If it was that simple then it would fail to account for the fact that diabetics (who go around with high blood sugar levels almost all the time) are more prone to all types of infection than non diabetics.

        With diabetes one could have a triple blind study.

    • I think your issue is less the resiliency of the bastards, and more the difficulty in getting to them.

  • A spoon ful of sugar helps the medicine go down or in this case more effective.
    • I always thought n/t meant "no text", indicating the post itself was empty (which isn't possible with /.)
      Could you please enlighten me?
  • Discovered? (Score:5, Interesting)

    by Dunbal ( 464142 ) * on Monday May 16, 2011 @04:25AM (#36138478)
    Discovered? No, we've known this and used this for years. It's a typical procedure to treat difficult wounds that are failing to close by 2nd or 3rd intention with sugar or honey. We also grind up fenitoin pills (used to treat epileptics) and add them to the wound, since fenitoin stimulates fibroblasts and helps with would healing. Of course this is not an FDA approved use of the drug, but it works.
    • by Anonymous Coward

      ...the reason why we currently think honey works is not because of sugar, but because of enzymes in it which produce hydrogen peroxide.

      • ...the reason why we currently think honey works is not because of sugar, but because of enzymes in it which produce hydrogen peroxide.

        Wrong. Honey is a natural antibiotic because it contains an antibiotic which is produced by the honey bee's own immune system. In fact, its one of the primary factors of a honey bee's immune system. The fact sugar empowers antibiotic effectiveness is likely why honey is such a decent antibiotic for external wounds; having commonly been used on livestock for ages.

    • Re:Discovered? (Score:5, Informative)

      by Anonymous Coward on Monday May 16, 2011 @04:35AM (#36138520)

      We use honey because it's antibiotic(kills bacteria) and it's contains sugar that just kill everything by osmotic pressure.

      The part about bacteria keeping their metabolism going untill they die if you add sugar to the antibiotic is new.

      • Re: (Score:2, Redundant)

        by Dunbal ( 464142 ) *
        It also fails to explain why diabetics have higher infection rates than non diabetics... there's something missing.
        • I'm not an expert, but it seems to me that since diabetics have high sugar levels constantly, the periods during which the antibiotics are not present will feed the bacteria without killing it, reversing the effect.

          Seems common sense to me that for this to be really effective, you need to keep sugar levels low when the antibiotics are not present.

        • Re:Discovered? (Score:5, Informative)

          by woolpert ( 1442969 ) on Monday May 16, 2011 @07:12AM (#36139012)

          Diabetics have higher infection rates because they have worse circulation and lower-functioning immune systems. Neither of which have anything whatsoever to do with this discovery.

          • by Mr Z ( 6791 )
            They also don't normally have antibiotics in their bloodstream. It's not the sugar that's killing the bacteria, it's the fact that the sugar tricks bacteria into letting the antibiotics in. Even if elevated blood sugar could help this process, you still need an antibiotic.
        • You're right, there is something missing. The missing part is, the gp poster is completely wrong. You are correct, contrary to moderation ignorance. Honey is an effective antibiotic specifically because it contains an antibiotic produced by the honey bee's own immune system. The fact its coupled with a source of sugar, apparently makes it all the more effective.

          I have no idea why so many people keep pushing the factually incorrect crap surrounding honey, as the AC did, as this has been well known for a fair

    • Discovered? No, we've known this and used this for years.

      True, but the pahrmaceutical industry can't make money with mere table sugar. What will be new here is the discovery that only a patentable sugar analogue or derivative is truly effective, at a cost of around $1,000 per dose.

      • You see, this is a new and novel use for an existing compound so it is patentable.

        In other news, the price of table sugar spiked to nearly $1K/ounce today. Corn syrup producers were seen dancing in the streets.

    • Well, it may now turn out that, beyond the direct antibiotic effect of sugar an honey, the sugars in both have the added effect of intensifying the effectiveness of the hospital antibiotics in the patient's system. It could make for an interesting research project for a graduate student somewhere.
  • by swell ( 195815 ) <jabberwock@poetic.com> on Monday May 16, 2011 @04:51AM (#36138570)

    Xylitol is another form of sugar that in addition to low calories and insulin response, kills bacteria and the evil Helicobacter pylori that causes cavities and ulcers. Stay tuned for the 2027 study that will prove it effective!

    • Not sure you are understanding what this is about.

      Bacteria will essentially "turtle" in the presence of antibiotics. It lays dormant with its shell closed. But in the presence of food, it wants to open up to consume the food and perform cellular divisions. It is during this time that the bacteria are vulnerable. I get the feeling Xylitol won't be as effective.

    • I was actually reading about this this morning. Sugars have 6 carbon atoms, while Xylitol has 5. Bacteria and yeasts only consume sugars that have 6 carbon atoms, so effectively Xylitol would not have the same effect.
      • Not quite (Score:4, Interesting)

        by Anonymous Coward on Monday May 16, 2011 @09:10AM (#36139806)

        Studies have pointed to the fact that many bacteria still "eat" the Xylitol -- they just can't digest it, and starve, or are otherwise impaired. Not a bad thing in these cases.
        http://www.ncbi.nlm.nih.gov/pubmed/21037297 for one of many cromulent studies out there involving bacterial uptake of Xylitol.

      • Actually, several sorts of bacteria (notably including those responsible for tooth decay), are attracted to xylitol, will attempt to eat it, and and then starve. [wikipedia.org]
        • Interesting. From http://www.xylitol.org/questions-about-xylitol [xylitol.org] : "Sugar feeds bacteria in your mouth, causing them to multiply rapidly. This metabolic process produces acids that cause cavities to begin to form. When you use xylitol gum or mints, the acid attack that would otherwise last for over half an hour is stopped. Because the bacteria in the mouth causing caries are unable to ferment xylitol in their metabolism, their growth is reduced. The number of acid-producing bacteria may fall as much as 90%
  • by man_of_mr_e ( 217855 ) on Monday May 16, 2011 @04:56AM (#36138584)

    How exactly can this technique be used to fight tuberculosis, which lives in the lungs? The sugar in the antibiotic would be absorbed into the blood stream before the antibiotic could get to the infection. Unless they're talking about inhaling the antibiotic with the sugar.. which I suppose is a possibility.

    Maybe it's some kind of bonding process that bonds the sugar to the antibiotic? I suppose I could read the article if I was that curious.

    • by bytesex ( 112972 )

      Probably safer to just inhale the sugar at the right time.

    • How exactly can this technique be used to fight tuberculosis, which lives in the lungs?

      The summary says they've been working on staph (Staphyllococcus) bacteria, which are very different to the Mycobacterium tuberculosis causative organism of tuberculosis. Staphyllococcus is a Gram-positive bacterium ; M.tuberculosis is Gram-negative ; the Gram stain adheres to some components of the wall of a bacterium and so the reaction of a bacterium to the Gram stain divides the bacterial world into a small number of c

      • Bollocks.

        I read TFA instead of TFS. TFA(bstract) specifically contradicts what TFS says :

        Here we show that specific metabolic stimuli enable the killing of both Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) persisters with aminoglycosides.

        They then go on to discuss the aparrent mode of action as not being relevant to growth issues (and therefore not necessarily limited to antibiotics which interfere with bacterial cell wall growth). Which kind-of blows my argument out of the wa

  • Most antibiotics are to be taken just after a meal , when your blood sugar levels are peaking.
    However , maybe a little more sugar wouldn't be a bad idea.
    • I always thought that the reason certain antibiotics are to be taken with food is that the food has a moderating effect on the body's absorption of the drug - the concentration of the drug in the bloodstream takes longer to peak, and longer to drop, leading to a more even concentration in the bloodstream wrt. time.

      A quick bit of googling turned up this, [fpnotebook.com] which suggests that perhaps the issue is more complicated. It seems that the presence of food increases absorption rates for some antibiotics, and decreases

  • Let's patent it! (Score:2, Insightful)

    by gte275e ( 91656 )

    I can see it now. Drug companies will take their existing antibiotics, add a bit of sugar, and then upcharge $5 per fill for Sugarfukitol over normal Fukitol.

    • Yes, pretty please with sugar on top?

    • by sjames ( 1099 )

      Only $5? They're much greedier than that!

  • by Boombox2003 ( 1352089 ) on Monday May 16, 2011 @06:41AM (#36138912)
    Can people please read the article before making inane comments, we are talking about aminoglycosides here not glucose, fructose or sucrose. This is a amino-modified sugar that are not absorbed in the gut. They have been around for a long time but until now they had not been used in conjunction with specific metabolites. So this has nothing to do with diabetics or blood sugar.
    • Re: (Score:2, Insightful)

      by Anonymous Coward

      Can people please read the article before making inane comments, we are talking about aminoglycosides here not glucose, fructose or sucrose. ...
      So this has nothing to do with diabetics or blood sugar.

      Err, the antibiotic they tested with was gentamicin, which is an aminoglycoside. The metabolites they tested with it were sugars like glucose and fructose, as well as stuff like glycerol and pyruvate.

      So yes, they actually *are* talking about adding sugar.

    • by Anonymous Coward on Monday May 16, 2011 @08:24AM (#36139386)

      The glucose is the metabolite and is used alongside an aminoglycoside antibiotic. It is aminoglycoside dependent because adding the sugar only works with aminoglycoside antibiotics: mannitol (the sugar) was tested with gentamicin (an aminoglycoside antibiotic), ofloxacin (a quinolone antibiotic) and ampicillin (a beta-lactam, specifically a penicillin antibiotic) and the only one which showed an improved response was the mannitol + gentamicin combination.

      Glucose, mannitol and fructose then showed the greatest response with gentamicin (ribose, glycerol etc were much lower).

      Have you read the article?

  • combo (Score:3, Interesting)

    by uncanny ( 954868 ) on Monday May 16, 2011 @07:07AM (#36138990)
    So apparently a placebo (sugar pill) actually CAN have real effect!
    • No, the placebo pill has no antibiotic within, so simply feeding the bacteria sugar would do more harm than good.

      What is interesting, however, is that this proves that homoeopathy works. When the sugar pill, combined with the _memory_ of an antibiotic is administered, the combination of extremely low dosage, magic water AND the sugar provides unparalleled healing potential.

  • It is hardly surprising this method works. It is one man has used for several millennium or more when making beer. Once yeast is pitched it will consume all or a good portion of the existing sugars. Once the alcohol content reaches a certain level or there is no more sugars left, they will go dormant. You can reactivate them by adding more sugar; there is of course a limit to the amount of additional sugar that can be added and the yeasts alcohol tolerances; some yeast strains are more tolerant of high alco
  • Just a spoonful of sugar makes the medicine go down!

    In this case that old adage happens to apply to both the host and the invader.

  • When preserving food by heating it, it makes a difference whether the bacteria are active or dormant. You kill them much more effectively, if you catch them feeding. If you do other preserving steps (like unfavorable pH or osmotic conditions) too early, bacteria go dormant and survive the heat much better.
  • "but its most life-saving application may be against the age-old disease tuberculosis." What a tragedy. Tuberculosis was practically unheard of in the U.S. by the 1970s and 80s, but experienced a resurgence due to failure to care for cases occurring among AIDS patients, the homeless, the poor, and illegal immigrants. Tuberculosis was once treatable--not at great expense, but not with one cheap vaccine shot, either; careful treatment and followup was needed to make sure that the infection was completely cure

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