AIDS TREATMENT NEWS - September 15, 2004 John S. James
In July 2004 the Infectious Diseases Society of American published Bad Bugs, No Drugs on the lack of new antibiotics being developed by pharmaceutical companies, while drug resistance to existing antibiotics rises rapidly. People should know:
Drug-resistant bacterial infections kill tens of thousands of Americans every year. This year, almost 2,000,000 hospital patients in the U.S. will get these infections, and 90,000 of them will die. But anyone, even adults or children in perfect health, can be killed by antibiotic-resistant bacteria. And catastrophic epidemics could infect millions.
People with immune deficiencies, including those with HIV, are at high risk.
Resistance to antibiotics is greatly increasing now, "almost like a switch got triggered," as one expert put it. Infections once easily curable are becoming difficult or impossible to treat -- meaning that some common bacterial infections will kill most of the patients who get them.
Starting over 10 years ago pharmaceutical companies mostly left the antibiotic field because it is not profitable. Antibiotics are less profitable than other drugs because they work so well so fast, and are usually needed for only about two weeks, while drugs for chronic conditions can be needed for a lifetime. Also, doctors usually reserve new classes of antibiotics for when they really need them, delaying profit -- and when antibiotics are used, they become less valuable as resistance develops. Also, it often takes a long time to test antibiotics intended for use against resistant organisms, because today there is no way to identify the patients in time, so researchers must wait for epidemics to break out in hospitals.
Since 1998, 10 antibiotics have been approved -- but only two of them are new classes and do not have cross-resistance with existing drugs. In the 1950s and 1960s six new classes of antibiotics were approved -- but none were approved in the 1970s, 1980s, and 1990s. The problem is not the lack of new targets, but the lack of companies doing the work.
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