IDSA calls for more antimicrobial research, development

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I was exposed to some of these in Boston City Hall. Perhaps this is why I

don't get better.

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Breaking News & Commentary

IDSA calls for more antimicrobial research, development

IDSA officials identify a target list of six microbes that are in desperate

need of new antibiotics.

by Colleen Zacharyczuk

IDN Managing Editor

March 2006

Officials with the Infectious Diseases Society of America (IDSA) are calling

on government officials to introduce and enact legislation that would offer

market exclusivity to pharmaceutical companies that research and develop

novel antimicrobials for “superbugs,†or highly dangerous, drug-resistant

microbes.

They also identified a representative “hit list†of microbes that are most

in need of research — methicillin-resistant Staphylococcus aureus (MRSA),

Escherichia coli and Klebsiella species, Acinetobacter baumannii, Aspergillus

species, vancomycin-resistant Enterococcus faecium and Pseudomonas aeruginosa.

In a press conference announcing the list, J. Blaser, MD, president

of the IDSA, and colleagues detailed complications associated with these

microbes and the challenges involved in treating them.

MRSA infections constitute the single most important cause of health care–

associated infections, increasing lengths of hospital stay, severity of

illness, deaths and costs. Although these infections occurred primarily in

hospitals, they are becoming increasingly common in communities nationwide,

especially

where groups of people are in close quarters, including military facilities,

sports teams and prisons. The number of infected children jumped 28% between

2001 and 2004, according to Blaser. Although there are treatment options

available for MRSA, most medications need to be administered by injection; oral

drugs are desperately needed.

“[A. baumannii] is a prime example of a mismatch between unmet medical need

and the current antimicrobial research and development pipeline,†wrote

researchers in an article in Clinical Infectious Diseases, which announced the

IDSA

’s “hit list.†The bacterium is a growing cause of hospital-acquired

pneumonia, and the number and hardiness of drug-resistant strains are growing,

researchers said. Soldiers are also returning from Iraq and Afghanistan with

cases of highly resistant Acinetobacter wound infections. In the case of A.

baumannii, physicians have been forced to resort to an old drug, colistin,

which

had previously been abandoned as too toxic. IDSA officials said only one new

drug is on the horizon to treat Acinetobacter infections, and it is

considered to be too toxic for children.

Discussing the other organisms, Blaser and colleagues said that although

there are treatment options for all of them, these bugs’ abilities to develop

resistance have made treatment difficult. IDSA officials said there are

relatively few new therapies in the pipeline for any of them.

A call to action

During the press conference, IDSA officials said that Congress has not

passed the comprehensive legislation needed to stimulate the antimicrobial

research and development that the IDSA called for in its July 2004 report,

“Bad

Bugs, No Drugs: As Antibiotic Discovery Stagnates ... A Public Health Crisis

Brews.â€

In the most recent report, IDSA officials urged Congress to pass

comprehensive legislation to encourage the pharmaceutical industry to re-enter

the

antimicrobial field. They state that members of Congress should establish a

commission to set antimicrobial discovery priorities. They add that companies

that

develop novel antimicrobials should be rewarded with 10-year market

exclusivity rights. Furthermore, IDSA officials said that research, development

and

manufacturing should be encouraged through tax credits. IDSA also is pressing

for funding for antimicrobial resistance efforts at the CDC, including MRSA

extramural research. Congress allocated funding to address potential agents of

bioterror under the Project Bioshield legislation that passed two years ago;

however, naturally occurring infections like MRSA were not included in that

legislation.

“We are very concerned that Congress has not taken action to date or pass

legislative incentives that will spur antimicrobial development or funding for

resistance efforts. These bad bugs won’t wait, neither should we,†said

Guidos, JD, director of public policy for the IDSA.

For more information:

* Talbot, GH, Bradley J, JE, et al. Bad bugs need drugs: an

update on the development pipeline from the Antimicrobial Availability Task

Force of the Infectious Diseases Society of America. Clin Infect Dis.

2006;42:657-668.

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[Guest guest]

I too was exposed to these

Janet