Should we fear the loss of antibiotics?

Antibiotics save thousands of lives for over half a century. But today, bacteria are the resistance and sometimes put in check these treatments. How to find new antibiotics? What solutions to this phenomenon could be dramatic? Some answers.

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The first use of antibiotics occurred in 1941. For 50 years, these drugs have experienced a golden age. But the early 90s was marked by the appearance of the first resistance of bacteria ... Does this mean the end of antibiotics? Several experts, including Dr Trémolières, Dr. Cohen, Dr. Schlemmer1Antoine and Michel ANDREMONT Tibon-Cornillot2 sounding the alarm.

Antibiotic resistance: an overview alarming

We measure how often antibiotics have revolutionized medicine, totally changing the prognosis of infectious diseases. When used, they almost always die of bacterial meningitis, pneumonia or sepsis (generalized infection), in 2007 it is normal to completely cure these diseases. Died of bacterial infection would fall elsewhere in the collective mind of the malpractice.

But we quickly learned that the bacteria know to defend themselves against antibiotics by developing resistance. Accrued medical research always innovate to counter these new defenses. In short, medicine have always thought ahead.

Victims of their success, antibiotics were prescribed widely and sometimes inappropriately: for infections of non-bacterial, as part of treatment for too short or mild infections ...

We know now, it would have been preferable to reserve them for severe cases.

The search for antibiotics is stalled

In 1990 there were approximately 120 molecules antibiotics in our armamentarium. Between 1980 and 1994, only 30 new drugs were patented between 1994 and 2007, there were only 7. Innovation stagnation besides former antibiotics whose profitability is more appointments threaten not to be produced. Why Research Is more able to deliver new antibiotics? As part of an information workshop organized by the Leem (drug companies), two major reasons have been advanced:

The analysis of bacterial genes helped to identify any weaknesses that antibiotics could be targeted for killing. But these targets need to be absolutely different human genes in order not to attack human cells but only the harmful bacteria. But today, experts estimate that all the weaknesses of bacteria and therefore almost all of these possibilities have already been exploited to produce antibiotics;
The rules for authorizing the marketing of these new antibiotics by the health authorities are very strict. They require testing a large number of patients in clinical studies to prove their safety and effectiveness. But it is easy to prove the effectiveness of an antibiotic on a routine infection, it is more difficult to do on multi-resistant bacteria because the search for voluntary patients is often an obstacle course. A renovation of these rules could make things easier ...
Emergency plan to save antibiotics
According to experts meeting June 8, 2007 at a workshop for health information3 organized by the Leem (drug companies), certain measures would improve the situation:

The main based on improved diagnostic efficacy. The test, which can now detect strep throat in minutes at the doctor's office is the first step towards this efficiency. We must develop numerous similar tests can confirm the bacterial origin of disease and possibly avoid unnecessary prescriptions;
A second line of work is the development of vaccination. We know that 5 to 10% of antibiotic prescriptions are due to influenza. Faced with this viral disease, antibiotics are useless and rapid diagnostic test can identify. Finally, there is an effective vaccine against influenza;
Another issue to consider is the veterinary antibiotic. Indeed, the volume of veterinary antibiotics produced in the world is much greater than the amount used in human medicine and no work on the often abusive use of antibiotics in the veterinary world, all other measures will prove woefully inadequate.
Anne-Aurélie Epis de Fleurian, Pharmacist

Sources

1 - "Requiem for antibiotics. Should we fear a loss of antibiotics?" François Trémolières, Robert Cohen, Benoît Schlemmer. Therapeutic medicine. Volume 12, Number 3, 154-9, May-June 2006
2 - "The Triumph of bacteria. The end of antibiotics?" Antoine ANDREMONT Michel Tibon-Cornillot. Editions Max Milo the unknown - January 2007
3 - Health Information Workshop LEEM, June 8, 2007. Speakers: Professor Anthony ANDREMONT, Mr Didier Cochet, Dr. Robert Cohen, Nathalie Dartois, Dr. Chrystel Jouan-Flahault, Dr. Francis Trémolières

 

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