It would be nice to be able to report that the much trumpeted “end of antibiotics” is just a slice of media alarmism. But it isn’t. The danger that just about all our existing antibiotics will soon be powerless against resistant bacteria, as recently claimed in the journal Lancet Infectious Diseases, is all too real. A paper in that journal reports the emergence and spread of strains of common pathogens, such as E coli and the pneumonia bug K pneumoniae, containing a gene that confers resistance even against current last-resort antibiotics called carbapenems. Such bacteria, Chris Walsh of Harvard Medical School confirms, “are on the brink of being impossible to treat with existing antibiotics.” And without antibiotics, even routine surgery could cause fatal infections.
Antibiotic resistance has been with us since penicillin revolutionised medicine. So why the problem now? Partly, it’s simply becoming harder to find new drugs to expand
STEPHENA_GOULDEN
Ball is right to point out that this is not a new problem but he could emphasise more that it is the responsibility of “Big Pharma” that this field of research has been so poorly addressed. Even before it was so “Big”, the pharmaceutical companies had little patience with their biological researchers, who saw this problem coming, as Ball points out, at the beginning of antibiotic usage. I can member trying to gain attention for this point in the mid ’60s, when the Director of Veterinary Sales for the company I then worked for suggested that one of our goals should be a cheaper process for the production of penicillin, so that it would sell more easily as a prophylactic for cattle – he told me that I didn’t know what I was talking about!
The pharmaceutical companies have always had more confidence in their chemists, giving them all the time they wanted, to play with their chemistry sets, ringing all the changes they could imagine to keep the basic old antibiotic molecule active; this game is now exhausted. No truly new antibiotic molecules have been found for decades.
These companies could never face the long time scales real biological research requires. And still can’t, hence the failure to develop the full potential of genetic engineering: they searched for the quick objective of a “magic bullet”, and when this failed to emerge, they fell back on sponsoring academic research (in PhD sized grants, which are unlikely to make true discoveries), and hope for some serendipitous outcome.
State funded research centres are a great idea, but in this economic climate? Better to do what was done for vaccine production (which was never a big earner), and put pressure on Big Pharma to do what they should have been doing for the last 50 years – long term research into the use of Biologicals, not Chemicals.
Neil_Sheppard
There are major disincentives to developing new antibiotics at the moment due to the way society regulates drug development and rewards those who bring new drugs to the market. The antibiotic market is saturated with a panoply of cheap generic drugs with long standing safety profiles from which doctors are normally able to select an agent that will work against their patient’s infection. It is extremely difficult to justify the $0.5-1 Bn investment needed to bring a new antibiotic market when it will be held in reserve for use only by patients infected by ‘superbugs’ or who cannot tolerate other more widely available antibiotics. By the time the new drug is more widely prescribed the patent will be close to expiry. We need new economic models for reimbursement to fix this problem. Perhaps extended patent periods for new antibiotics could be considered, or a 2-3 year patent extension transferable to a drug of company’s own chosing.