Nevermind the zombies, here comes the antibiotic apocalypseNevermind the zombies, here comes the antibiotic apocalypse
Without urgent action, we are heading for a post-antibiotic era, warns the World Health Organization, in which common infections and minor injuries can once again kill. The misuse of antibiotics has led to the emergence of superbugs that have developed a resistance to the once-lethal drugs. Meanwhile, no new class of antibiotic has been discovered since the 1980s.
July 15, 2014
Without urgent action, we are heading for a post-antibiotic era, warns the World Health Organization, in which common infections and minor injuries can once again kill. The misuse of antibiotics has led to the emergence of superbugs that have developed a resistance to the once-lethal drugs. Meanwhile, no new class of antibiotic has been discovered since the 1980s.
It would be easy to blame big pharma for this perfect storm, but the reality is a bit more complex. Pharmaceutical companies are reluctant to engage in antibiotics R&D because the return on investment can be elusive.
If a novel antibiotic were to be approved for a life-threatening infection such as MRSA (methicillin-resistant Staphylococcus aureus), writes John LaMattina on Forbes.com, federal agencies would try to prevent its overuse so that we don't find ourselves in this vicious circle once again, or at least delay it from happening for as long as possible. "This business model has caused most major pharmaceutical companies to drop their antibiotic R&D efforts," continues LaMattina. "Quite frankly, the financial returns for such R&D don't measure up to the returns that companies can realize in other disease areas such as heart disease, diabetes, and cancer." In his article, he suggests a number of ways in which antibiotics research could be incentivized. Our friends across the pond, meanwhile, have some initiatives of their own.
The Longitude Prize was established in the 18th century by the UK government to encourage the invention of a simple method to determine a ship's location at sea by knowing its longitude. That was the primary scientific challenge of its time. The current competition asked the public to vote on six of today's critical scientific challenges, which included dementia, paralysis, antibiotics resistance, and the production of a nutritious and sustainable source of food. Antibiotics research won.
The Longitude Prize committee will now narrow the challenge into something measurable—a new way of diagnosing a bacterial infection versus a viral infection, for example—that will allow it to determine a winner. (Part of the reason we are in this mess is because of the overuse of antibiotics to combat viruses, such as the common cold, rather than bacteria.) The committee will begin accepting submissions in the fall, and the winner will receive a £10 million award.
Antibiotics R&D is also on the mind of UK prime minister David Cameron, who appointed a review team led by former Goldman Sachs economist Jim O'Neill to lead an investigation earlier this month. "With some 25,000 people a year already dying from infections resistant to antibiotic drugs in Europe alone, this is not some distant threat but something happening right now," he said.
On a related note, healthcare-associated infections (HAIs) have been a subject of concern for some years now, as well. As we reported in "Researchers mobilize to battle hospital-acquired infections," approximately one in 25 patients will contract an HAI, according to the Centers for Disease Control and Prevention. In addition to the widespread use of antimicrobial coatings and additives to combat HAIs, Michael Brady, Director of Microbiology Services at Toxikon (Bedford, MA), argued persuasively at the Medical Design & Manufacturing East conference last month that intelligent device design can be an effective weapon in this battle. "Devices can be designed to minimize disease transmission," he told attendees, citing the Kendall luer access disinfectant cap and neutral displacement needleless connector marketed by Covidien as elegant engineered examples.
Here is how Covidien describes the technology on its website:
The Kendall prefill syringe with a removable luer access disinfectant cap integrates the cap into the plunger of the syringe. This design allows the cap to always be readily available to protect the connector between line accesses. Using a disinfectant cap can help prevent pathogens from entering vascular access devices while promoting compliance with infection control protocols.
The Kendall neutral displacement needleless connector is designed to complement best clinical practices to help reduce the risk of catheter-related blood stream infections and reflux.
"By reengineering the inside of the connector to prevent the septum from losing integrity, there is no internal ingress," explained Brady at MD&M East. "It's a clever example of achieving a meaningful difference through mechanical design."
Norbert Sparrow is Senior Editor at PlasticsToday. Follow him on twitter @norbertcsparrow and Google+.
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