Analysis: Develop antibiotics or pay?

[Guest guest]

Analysis: Develop antibiotics or pay?

By ED SUSMAN

Science Daily (press release)

http://www.sciencedaily.com/upi/index.php?feed=Science & article=UPI-1-

20060929-16034900-bc-us-antibiotics-analysis-crn.xml

SAN FRANCISCO, Sept. 29 (UPI) -- Researchers decried Thursday a lack

of research that can fight an epidemic of microbes that have gained

resistance against virtually everything that doctors have in their

pharmaceutical arsenal.

In fact, some are even suggesting that drug companies who refuse to

rise to the new microbial challenge should face a financial penalty.

" Pharmaceutical companies have made billions of dollars turning

human beings into toxic waste dumps, " charged Louis Rice, chief of

medicine services at the Louis Stokes Veterans Affairs Medical

Center in Cleveland, at an infectious disease meeting sponsored by

the American Society for Microbiology.

Rice said that the overuse of antibiotics due in part to over-

prescribing by medical professionals has created biologically

resistant microbes that cannot be killed off by drugs now available -

- especially for bugs known as Gram-negative pathogens.

While the Gram-negative bugs were not considered as important or as

dangerous as so-called Gram-positive bugs such as staphylococci or

streptococci, he said that 25 percent of infections with klebsiella -

- which causes pneumonia, urinary-tract infections and wound

infections -- do not respond to anything clinicians can thrown at it.

" I don't blame the pharmaceutical companies for resistant bacteria

any more than I blame doctors for overprescribing the drugs, " Rice

said. " But the pharmaceutical companies made so much money

developing the antibiotics they have a responsibility to contribute

financially to finding treatments. "

Yet there is a dwindling number of pharmaceutical companies that are

willing to commit funds to developing drugs to overcome resistance,

he said, noting that many companies are merging or are leaving the

development arena.

To those companies that shy away from the challenge, Rice suggested

they should be taxed to finance the work of other companies willing

to find the compounds needed to treat patients with the antibiotic-

created resistant pathogens.

Rice also suggested that studies -- probably under the aegis of the

National Institutes of Health -- should undertake studies to

determine whether it is really necessary for people to take

antibiotics for full courses of treatment. He pointed out that the

recommendations for taking drugs for a full course was based on

clinical trials with set timeframes, not on whether a person was

feeling better.

He said that taking antibiotics longer than necessary only

contributes to creating more powerful, resistant bugs.

" Gram-negative bacteria have a thicker cell wall that prevents drugs

from penetrating and killing it, " Bush, distinguished research

fellow at & Pharmaceutical Research and Development

in Raritan, N.J., told United Press International at the 46th annual

Interscience Conference on Antimicrobial Agents and Chemotherapy in

San Francisco.

" There are now multi-drug resistant acinetobacter strains --

including those brought back to the U.S. from troops and personnel

in Iraq -- that don't respond to any classical treatment, " Bush said

during a news briefing.

, a consultant to pharmaceutical companies from

Flintshire, Wales, United Kingdom, said, " It's a real challenge to

find a wide spectrum Gram-negative antibiotic. "

In another news briefing at ICAAC, a meeting that has attracted

16,000 scientists, researchers and allied healthcare providers,

doctors looked at treatments for fungal infections -- illnesses that

emerged among patients with suppressed immune systems or who are

treated for extended times in intensive care units, attached to

various devices and catheters.

" We now have a number of ways of treating these patients, " said

Elias Anaissie, professor of medicine at the University of Arkansas

for Medical Sciences in Little Rock. For years the mainstay of

fungal infection treatment was use of toxic, intravenous

amphotericin B. Since then, equally effective but more convenient

oral medications have been approved.

" Now the question is whether we can treat those patients by

combining medicines in these groups, " he told UPI. The problem is

that, what looks good in test tube doesn't necessarily work in

patients, and what looks good may work in treating one infection but

not another.

The need for clinical trials in this area, said Johan Mouton,

professor of medicine at Canisius Wilhelmina Hospital, Nijmegen, the

Netherlands, has intensified because there are more patients now who

are at risk of these infections: Transplant patients, cancer

patients, AIDS patients and long-term trauma patients.