Antibiotics may not bring in oodles of money. But that should not be sufficient reason for drug companies to discontinue research on that class of drugs. For antibiotics remain a critical area for public health, experts stress.
Although new antibiotics have been developed to treat the so-called hospital superbug MRSA (methycillin-resistant Staphylococcus aureus), the pipeline for drugs to treat some other infections was practically dry.
AdvertisementThat is doctors are running out of antibiotics to treat infections that could kill vulnerable people.
"It is vital that the pharmaceutical industry remains interested in this area," said Dr David Livermore, laboratory director of UK's Health Protection Agency's centre for infections.
"Several major companies have pulled out of antibiotic development. They have not been seen as a particularly profitable area. If you develop a new heart drug, the patient is on it for a matter of years and resistance doesn't develop.
"With antibiotics on the other hand, the patient is on it for one or two years and resistance may develop," Livermore points out.
The cost of developing a new drug is usually said to be somewhere between $500m (Ģ285m) and $1bn, depending on whether the many drugs that fail are costed in and whether the marketing budget is included.
Most troubling now is the rise of what are known as gram negative bacteria (MRSA is gram positive). These include E coli, which can cause serious food poisoning, Acinetobacter, which can kill those whose immune system is compromised and Pseudomonas, which particularly attacks cystic fibrosis patients.
The life of a cancer patient whose immune system is compromised by chemotherapy can be threatened by an infection such as Acinetobacter. The last really effective drugs are the carbapanems, but the bacteria are increasingly showing resistance to them.
There are one or two drugs doctors can then use as a last resort, but they are either toxic or do not work well. Antibiotics have always had a limited lifespan because bacteria are proficient at evolving to survive.
Within six years of penicillin's introduction in 1944, 50% of Staphylococcus aureus were resistant.
Doctors and patients can also do their bit to prolong the life of antibiotics by not over-using them. Doctors should never prescribe them and patients should not ask for them to treat coughs and colds, which are caused by viruses, not bacteria, the HPA said.
Professor Peter Borriello, director of the HPA's centre for infections, pointed out that resistance now spread around the world in a way it did not in past decades. "Fifty years ago, resistance that developed in India stayed in India," he said. "Now it can be here that week."
Resistance was inevitable, he said. "This is just evolution in real time. It just happens quicker with germs than in rats and humans."
Alternatives to antibiotics, such as vaccines against specific bacterial infections, had been the subject of research but so far without a great deal of success, he said.
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