Time to act on battle-plan to save antibiotics
They have saved countless millions of lives over their 70 years lifespan, but the vital medicinal tool of antibiotics is becoming increasingly blunted - and may be rendered useless unless serious action is taken transform their management. That's the message from the US Infectious Diseases Society of America (IDSA). They have developed an 'antibiotic battle-plan', published yesterday, and are pressing the US Congress, federal and health agencies to speed its implementation.
Antibiotics, which fight bacterial infections, have prevented deaths from serious infections across the world, and have enabled the safety of a wide-range of medical techniques - from chemotherapy to organ transplantation to general surgery. But the bugs are fighting back - antibiotic-resistant bacteria have become firmly established in hospitals across the US, and now exact a terrifying toll of 100,000 dead patients each year.
The main problem has been inappropriate and repeated prescription of antibiotics, which has spurred the bacteria to quickly evolve countermeasures to them. That has led to the appearance 'super-bugs' such as MRSA and other antibiotic-resistant bacteria like Acinetobacter baumannii and Klebsiella. But the IDSA has identified a lack of commercial R&D resources as a serious risk to resolving this crisis.
They blame fuzzy guidance from the FDA (Food and Drug Administration) on designing new studies for innovative antibiotics - this has made worse a 'market failure' from the drug companies to tackle the development of replacement antibiotics. From there being 20 pharmaceutical companies actively engaged in R&D on antibiotics, in 1990, there are now only 2.
To tackle this, the IDSA is putting forward a plan that would create incentives to bring the big drug company players into the antibiotic markets - with the aim of having 10 new antibiotics on-stream by 2020. That would be supplemented by government funding of antibiotic R&D through existing health bodies, together with an independent strategic investment firm.
There should also be tighter control on the use of antibiotics, more consistent and widespread monitoring of resistant-bacterial strains - as well as the promotion of 'best practices' in limiting their spread. The money to fund this extra research, monitoring and education would come from a Antimicrobial Innovation and Conservation (AIC) Fee, which would be levied on all antibiotic sales, whether for human, plant or animal consumption.
Brad Spellberg - professor of medicine at the University of California in Los Angeles - says that the time for talk has run out. ''We’re facing a day in the not-too-distant future where people will be outraged with our inability to treat infectious diseases, and wonder why something wasn’t done earlier. The IDSA plan lays out innovative approaches that can and should be enacted, but they must be done now.''
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