More Resistant Bugs With Fewer Effective Antibiotics The Future For Infectious Diseases
Australia risks a return to the dangers of the pre-antibiotic era unless greater attention is paid to infection control. A renewed interest in research and development of new antibiotics is also urgently needed, according to an article published in the current issue of the Medical Journal of Australia.
The authors, Dr Patrick Charles and Professor Lindsay Grayson of the Infectious Diseases Department, Austin Health, say that following the rapid development of antibiotics between the 1950s and 1970s our antibiotic development pipeline has been reduced to a trickle.
The emergence and spread of multidrug-resistant pathogens, largely due to inappropriate antibiotic prescribing, has increased substantially over the past 20 years, but the development of new antibiotics has decreased alarmingly.
Many pharmaceutical companies, who are largely responsible for new antibiotic development, are pulling out of antibiotic research in favour of developing 'lifestyle' drugs, which involve less financial risk.
The authors say pharmaceutical companies are also withdrawing from antibiotic development because of changes in regulations requiring larger drug trials and prolonged post-marketing surveillance, clinical preference for narrow-spectrum rather than broad-spectrum agents, and high new-drug purchase costs.
There must be a change in the health and research culture to improve cooperation between public, academic and private sectors, particularly with pharmaceutical companies. The authors suggest broadening the funding base for research and development and fast-tracking drug licensure when needed.
In the short term, governments must fund better infection control measures in hospitals, such as greater access to single rooms and the use of alcohol and chlorhexidine based handrub to minimise the spread of resistant pathogens.
"Major improvements in infection control in Australia are needed to prevent further spread of resistant clones, buying some time to develop urgently needed new antibiotic agents", say the authors. "But, given the lag between antibiotic development and eventual availability, we need to develop a sensible strategy soon to avoid problems in the next one to two decades."
The Medical Journal of Australia is a publication of the Australian Medical Association.
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Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471