U.S. Experts Worry Antibiotic Resistance May Worsen

Before antibiotics were invented, 30% of US deaths were due to bacterial infections. And in 2018, their market was estimated at $42.6 billion.

The WHO today names antibiotic resistance as one of the top threats to global health. For example, it is becoming increasingly difficult to treat pneumonia, tuberculosis, gonorrhea, and salmonellosis.
By 2050, superbugs are expected to kill more people than cancer – 10 million. Antibiotic resistance now kills 700,000 people every year.

Staphylococcus aureus resistance

Staphylococcus aureus is susceptible to almost any antibiotic ever developed, including Fleming’s penicillin. But by the mid-1940s, the bacteria had acquired resistance to it and for the next ten years was a serious problem in society. This was the first wave of infection control.

The second wave began in 1959 when methicillin was discovered. But resistance to it quickly developed.

Infections caused by antibiotic-resistant strains have reached epidemics worldwide. MRSA – methicillin-resistant staphylococci – pose a threat to the entire population. They are immune to penicillins, cephalosporins, and carbapenems. Fortunately, so far there are other types of antibiotics that fight these infections and consumers can even purchase these antibiotics online.

MRSA was first isolated from a patient in the UK in 1960.

Until the 1970s, clones of the strain circulated in hospitals throughout Europe. There have also been isolated reports of MRSA in US hospitals.
By the 1980s, for no apparent reason, archaic MRSA strains had largely disappeared from European hospitals, marking the end of the second and beginning of the third wave of antibiotic research.

In the late 1970s, outbreaks of MRSA infections were reported in US hospitals. By the mid-1980s, they became endemic. They then swept the world, leading to a worldwide MRSA pandemic in hospitals that continues to this day.

Because the infection was spreading rapidly, vancomycin was widely used against it, the only antibiotic to which Staphylococcus aureus remained susceptible. So the third wave ended and the fourth began.

In the early 1990s, community-acquired cases of CA-MRSA infection were discovered in Western Australia. In the United States, the first such diseases were found in healthy children in 1997-1999. They were not at risk of MRSA and died from overwhelming infections, which suggests that they were more disease-causing strains of MRSA. These CA-MRSA were unrelated to hospital strains and were susceptible to most antibiotics.

CA-MRSA outbreaks and epidemics are currently occurring worldwide and have similar epidemiology, although the emerging clones differ by geographic location.

The average hospital stay with this infection is 76 days, and the cost of therapy is estimated at $33.5 thousand.

The global drug market against MRSA in 2018 was estimated at $922 million. Analysts at Coherent Market Insights predict growth to $1.3 billion by 2026, mainly due to improvements in the formulas of already approved drugs.

In 2016, the pharmaceutical company Allergan received FDA approval to update the Dalvance injection – it is enough to inject a single intravenous dose within 30 minutes to treat acute bacterial skin infections.

These factors are expected to drive the growth of the MRSA drug market. Another reason is the approval and launch of affordable generic drugs.

How things are going now

Today, the choice for the treatment of bacterial infections is limited because of the developed resistance, which leads to high morbidity and mortality.

There are alternatives to antibiotics – passive immunization and phage therapy (treatment with viruses such as bacteriophages), but researchers continue to look for more effective forms of drugs. Most of the antimicrobial drugs in use today were isolated from the soil during the golden era. But further study of this ecological niche did not lead to the emergence of new classes.

Other ecological niches are being explored, for example, the marine environment, animals and plants, fungi.

Unlike new drugs for cancer or rare diseases, antibiotic prices remain low, so pharmaceutical companies have little incentive to develop new drugs. Therefore, investors avoid startups that want to defeat superbug resistance. From 2003 to 2013, less than 5% of venture capital investments were in pharmaceutical research and development.

Four years ago, the pharmaceutical company Tetraphase Pharmaceuticals was valued at almost $2 billion, now its shares are traded for $0.7. To survive, the company cut research, staff, and drug development. It’s focused on promoting a drug that fights severe infections of the abdomen.

Large manufacturers are gradually leaving the antibiotic market leaving many products in the hands of startups. But most of the newer antibiotics are sold poorly, as doctors keep them in stock for more severe cases.

Antibiotic start-up Achaogen filed for bankruptcy a year after receiving approval for a drug to treat urinary tract infections. In a test tube, the drug killed the resistant strains. Once the market value of the company was about $1 billion, and in June 2019 it was sold for $16 million at a bankruptcy auction.

Small-scale manufacturers often focus on developing costly antibiotics against rare resistant strains, which are often reported in the media. But they don’t pay attention to the partially resistant strains that doctors regularly encounter in practice.

Biotech startup Procarta Biosystems is developing new methods to combat antimicrobial resistance. The project attracted 1.5 million euros of investment from the Novo Holdings REPAIR fund. Procarta’s flagship product, PRO-202 is in preclinical development for the treatment of complex urinary tract infections (CUTI) and complex intra-abdominal infections (CIAI) caused by the ESKAPE group of pathogens, including Staphylococcus aureus and Friedlander’s bacillus (causes pneumonia and meningitis).

What can you do to prevent antibiotic resistance?

In order to try to at least partially solve this problem at the moment, the following rules must be observed:

1. Use antibiotics only when they are really needed (they must be prescribed by a doctor);
2. Take antimicrobial drugs in the form and dosage recommended by your doctor. If the doctor has already prescribed an antibiotic, then the full course of treatment should always be completed, even if the symptoms have subsided. If you do not adhere to this principle, the drug can only kill the most vulnerable microbes, leaving others to survive and develop resistance;
3. Never share antibiotics with other people, do not leave them for later, and do not use someone else’s prescription. These medicines may not be suitable for various forms of infection. It makes no sense to use them for viral diseases such as colds or flu because they have no effect on them. In this case, the best option is to get the recommended vaccinations on time, as this will reduce the risk of having to take medications.

Category: General Health

Tags: antibiotic therapy, antibiotics, bacteria, diseases, infection, medication