We may soon have 'no useful antibiotics left': expert
A McMaster University medical researcher says the World Health Organization’s new “priority pathogens” list is a reminder that the world is “getting to the point where we have no useful antibiotics left.”
Lori Burrows told CTV News Channel that the misuse of antibiotics has caused so many bacteria to develop drug resistance that people are dying of formerly curable infections.
Doctors have long known that bacteria can become drug-resistant when antibiotics are not used for a long enough period of time to completely wipe out an infection, allowing the most resistant to multiply. The fact that antibiotics are often prescribed for viral infections that antibiotics cannot cure only speeds up the process of drug-resistance.
No new class of antibiotics has come onto the market since the mid-1980s, according to a 2016 Roadmap for Antibiotic Discovery from Pew Charitable Trusts.
Burrows says doctors are trying to use the newer, more effective antibiotics as sparingly as possible but that has only made it less financially attractive for drug companies to invest in developing new antibiotics.
Either way, she says, drug companies would rather develop medicines for diseases like diabetes and heart disease that patients take for the rest of their lives than antibiotics that can cure a disease within a week.
“They have shareholders and they want to make some money, so you can’t blame them for that,” Burrows said. “But it’s left us in a position where we’re now running out of drugs.”
Earlier on Monday, the World Health Organization published a list of "priority pathogens" it says pose the greatest threat.
The list was created to encourage both governments and the private sector to invest in more R&D of new antibiotics that could tackle the bacteria that are posing the biggest threat to global health.
New treatments are critically needed for three bacterial families that pose a threat to patients in hospitals and nursing homes. These include various species of Enterobacteriaceae (including E. coli); Acinetobacter; and Pseudomonas.
These bacteria cause hundreds of thousands of infections a year and several species have already grown resistant to most of the antibiotics that once were able to cure them easily.
Bacteria considered a high priority that are increasingly becoming drug-resistant include Neisseria gonorrhoeae, which cause gonorrhoea, Helicobacter pylori, which cause stomach ulcers, and Salmonellae, which cause food poisoning
Tuberculosis was not included on the list because the problems with drug resistant TB has been well-known for some time and there are already programs in place looking into new treatments for the disease, WHO’s Assistant Director-General for Health Systems and Innovation, Dr Marie-Paule Kieny, told reporters Monday.
Kieny said the list was not meant to scare people about new superbugs, but rather to signal to governments and the scientific community which bacterial families require the most urgent action.
“We are asking governments to commit funds to R&D to address antibiotic resistance now, in order to reduce the amount of resources that they will need to spend later when resistance to antibiotics develops into an even bigger crisis,” she said.
The team of international experts who created the list broke it into three categories: critical, high and medium priority. The team tried to take into account and balance several criteria, including:
- how deadly the infections that the bacteria cause are
- whether their treatment requires long hospital stays
- how frequently they are resistant to existing antibiotics when people in communities catch them
- how easily they spread between animals, from animals to humans, and from person to person
- whether they can be prevented through such things as proper hygiene and vaccination
- how many treatment options remain
- and whether new antibiotics to treat them are already in the R&D pipeline.
The WHO experts say research is now urgently needed into new treatments, particularly given that it would take several years for any newly discovered antibiotics to reach the market.
“Waiting any longer will cause further public health problems and dramatically impact on patient care,” list co-author Prof Evelina Tacconelli, Head of the Division of Infectious Diseases at the University of Tübingen said in a statement.
Priority 1: CRITICAL
- Acinetobacter baumannii, carbapenem-resistant
- Pseudomonas aeruginosa, carbapenem-resistant
- Enterobacteriaceae, carbapenem-resistant, ESBL-producing
Priority 2: HIGH
- Enterococcus faecium, vancomycin-resistant
- Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
- Helicobacter pylori, clarithromycin-resistant
- Campylobacter spp., fluoroquinolone-resistant
- Salmonellae, fluoroquinolone-resistant
- Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant
Priority 3: MEDIUM
- Streptococcus pneumoniae, penicillin-non-susceptible
- Haemophilus influenzae, ampicillin-resistant
- Shigella spp., fluoroquinolone-resistant