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THE MEDICAL JOURNAL

Bacteria outpaces new drugs
By LEE BOWMAN
Scripps Howard News Service

 

December 02, 2009
Wednesday AM


The medicine cabinet is running bare against some of the world's deadliest drug-resistant bacteria.

Experts say the pipeline for new drugs to meet the threat has slowed to a relative trickle in recent years.

A new report from the European Union says there are just 15 antibacterial drugs that have potential to offer a benefit over existing drugs, and only five of those are at the stage of advanced testing on humans.

That echoes the findings of an Infectious Diseases Society of America report released at the first of the year, which points out that only one new antibacterial drug has been approved in the United States since 2004 and fewer than 20 are in the late stages of clinical development. Only one or two are thought to use a new approach to destroying germs.

"We know from past experience that few of these drugs likely will make it to market. Meanwhile, the antibiotics now in use are in danger of becoming ineffective as bacteria learn to outsmart them. This leaves doctors fewer and fewer options to treat life-threatening infections,'' said Dr. Richard Whitley, president of the ISDA.

The organization is pressing U.S. and European leaders to set up new government programs for antibacterial research and development in collaboration with academic researchers and drug companies.

Noting that the World Health Organization has identified antibiotic resistance as one of the three greatest threats to human health, the society wants the United States and Europe to commit to the development of at least 10 new antibiotics within the next decade.

A survey done by the European Center for Disease Prevention and Control that was released last week found that half of all intensive-care doctors had treated at least one patient in the past six months who had an infection that was totally or almost totally resistant to antibiotics.

The survey found that 55 strains of bacteria had been identified as being totally resistant to antibiotics, including germs responsible for pneumonia, urinary-tract infections, wound and bloodstream infections and meningitis.

"Increasingly, intensive-care physicians in Europe and elsewhere are confronted with patients infected by bacteria for which limited or no adequate therapeutic options are available,'' the report noted.

A study published this week in the journal Emerging Infectious Diseases underscores how commonplace drug-resistant bacteria have become in and out of hospitals in the United States.

The research was carried through a group called Extending the Cure, which studies policy solutions to the problem of antibiotic resistance.

Most of the focus has been on drug-resistant infections acquired in hospitals, which the federal Centers for Disease Control and Prevention says kill more than 63,000 people in the United States each year.

The new study analyzed data from more than 300 microbiology labs serving hospitals across the United States. It found that the amount of "community-associated" strains of methicillin-resistant Staphylococcus aureus, or MRSA, in outpatient hospital settings increased by sevenfold between 1999 and 2006.

The researchers said the proportion of MRSA increased more than 90 percent among outpatients with any type of staph infection and now accounts for more than half of all such infections.

The prevalence of community-associated MRSA strains rose from 3.6 percent to 28.2 percent in the outpatient samples, while similar increases among admitted patients indicated the strains are spreading rapidly into hospitals, too.

Much of the worry about MRSA strains in hospitals has been that patients, staff and visitors might take them home, but the new report shows how hospitals also take in dangerous strains from outsiders.

That shows not only that hospitals have to step up infection-control procedures, but also that hospitals need to use rapid tests to identify which strains of drug-resistant germs they're fighting, so that the most potent drugs are held back for true super-bug infections, while older, cheaper antibiotics are deployed against the bacteria they can still fight.

 

On the Web:

www.idsociety.org

www.extendingthecure.org

 

Contact Lee Bowman at BowmanL(at)shns.com
Distributed to subscribers for publication by
Scripps Howard News Service, http://www.scrippsnews.com



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