Antibiotic arsenal needs new drugs, more education

Antibiotic resistance is still outpacing researchers’ ability to develop new types of antibiotics, according to a policy brief released this week by the Health Affairs journal.

Antibiotics, once viewed as the miracle of the World War II generation, are losing ground in their effectiveness, thanks to decades of overuse and misuse. In a 2013 report, the Centers for Disease Control and Prevention (CDC) estimated that up to half of all antibiotic prescriptions are inappropriate or unnecessary, a situation that contributes to the rapid development of microbial resistance. At least two million people contract drug-resistant infections every year, and at least 23,000 of them die. Methicillin-resistant Staphyllococcus aureus (MRSA), just one type of resistant super bug, claims more lives each year than emphysema, HIV/AIDS, Parkinson’s disease and homicide combined, the Health Affairs brief noted.

Hospitals and nursing homes are prime environments for microbes to flourish and mutate, because these settings include large groups of people with compromised immune systems.

“The development of resistance is an evolutionary inevitability, even where antimicrobials are used properly and sparingly. All microbes have the potential to mutate and render drugs ineffective,” the report explains. “The more antibiotics are used, the more opportunities bacteria have to evolve to defeat them.”

As the “bad bugs” get stronger, recent initiatives are attempting to incentivize the development of new types of antibiotics. The Generating Antibiotic Incentives Now (GAIN) Act of 2011 gave pharmaceutical companies an additional five years to sell their antibiotics under a more lucrative brand name before competing companies would be permitted to sell a generic version, hoping to lure more pharmaceutical companies down the expensive drug-development path. Unfortunately, the chance of developing a drug that will get all the way to Food and Drug Administration (FDA) approval is less than three percent.

The FDA and the CDC have enacted a “full-court press” on re-educating consumers, nurses and physicians on the dangers of overprescribing antibiotics and not monitoring residents for medication adherence. “With so many agencies involved in the regulation and use of antibiotics, comprehensive solutions must focus on creating a coordinated plan that touches on aspects of research and development as well as enhanced infection prevention and control, and stewardship to ensure the proper use of these drugs across different settings,” the report warns.

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