While Humans slept, bacteria were evolving
One drug-resistant strain took 18,650 lives in 2005.
The Philadelphia Inquirer
October 24,2007
Page A11
By: Trevor Trust

A government report released last week essentially confirmed what many in the medical community already knew: With each passing day, more bacteria become resistant to our arsenal of antibiotics, and we have no new and effective drugs to fight the microbes.

The report by the U.S. Centers for Disease Control and prevention estimates that 18,650 people died in the United States in 2005 after being infected with a drug-resistant bacteria known as methicillin-resistant Staphylococcus aureus (MRSA) - more deaths than those attributed to HIV-AIDS, Parkinson's disease, emphysema or homicide. Even more alarming are recent reports of some pathogenic bacteria that are resistant to virtually all modern antomicrobials. This means that for some patients, there simply are no current treatment options.

Following this report, healthcare experts listed the specific actions society must take to help slow the development and spread of antibiotic-resistant bacteria. Improving infection control in hospitals and enforcing appropriate use of antibiotics were the most commonly cited measures.

The good news is that awareness of bacterial resistance is growing. Many states now mandate public report cards that track hospital infection rates. In August, the U.S. Centers for Medicare and Medicaid drafted new rules indicating that the government program will no longer pay hospitals for the costs of treating "conditions that could reasonably have been prevented," such as hospital-acquired infections.

Separately, the National Council on Patient Information and Education recently documented the consequences of poor medication adherence, a problem that also contributes to the formation of so-called super-bugs. Often when an antibiotic is not taken for the full amount of time prescribed, some bacteria that were weakened, but not killed, can begin to multiply again. The next time the bacteria are exposed to the same medication, they will be able to fight it more effectively and become resistant. The report identifies key steps that patients, policy makers and the health-care community must take to change behavior, particularly with regard to antibiotics.

These are good first steps, but to effectively combat super-bugs, the research community must do everything in its power to discover, develop and deliver to patients the next generation of novel antibacterial medicines. We must address this crisis with urgency and a willingness to explore innovative ways to expedite the delivery of new medicines.

As an industry, we have been ineffective in combating recent bacterial resistance, even as history has taught us that bacteria have always adapted to survive - and will continue to do so. At the same time, because of the difficulty in discovering novel antibacterials, many anti-infective research programs have focused too heavily on delivering so-called me-too drugs, which are essentially reformulated and renamed existing drugs that may provide incremental improvements over existing medicines but do little to address resistance in the longer term. The urgent need now is for new medicines that employ new biological mechanisms to kill the bugs.

Fortunately, talented researchers in industry and academia have for some time recognized this burgeoning problem and are committed to finding solutions. Working at my comment in infectious-disease research, and we continue to see investment and engagement in antibacterials by other large pharmaceutical companies, such as Pfizer, GlaxoSmithKline, Merck and Novartis, as well as by biotechnology companies.

In addition, there are promising signs that our partners in government are prepared to help expedite the delivery of novel medicines. President Bush and Congress recently approved specific clinical trial guidelines for antibacterials, a move that will greatly improve drug companies ability to conduct efficient and effective testing.

Antibiotic resistance is a crisis that affects everyone and is a challenge that is here to stay. All of us - health-care professionals, researchers and patients - need to do our part to keep it at bay.