Life Sciences

November 18, 2014

Education and funding are fundamental in fighting the war on antibiotic resistance


By Sue Charles, Managing Partner and Gemma Howe, Senior Account Manager, Instinctif Partners’ Life Sciences Practice

Today – 18th November – European Antibiotic Awareness Day, the world comes together in coordinated public health initiatives that highlight the issue of antibiotic resistance and encourage responsible use of antibiotics. It’s also a day to lobby governments and the pharmaceutical industry to ensure the economics of the drug industry work such that innovators are incentivised to discover and develop new antibiotics for the future, and pharmaceutical companies are rewarded for their decades of investment in development. Currently the reimbursement system is broken.

Without a change of behavior, antibiotic resistance is an increasingly serious threat to global public health, posing a ‘catastrophic threat’ that could return us  to an era where deaths due to common infections are rife. Global leaders set antibiotic resistance as its number one priority at the G8 summit last year.

The threat from bacteria becoming resistant to antibiotics knocks diseases like Ebola and HIV or even influenza into touch.

The problem

Liberal prescribing and overuse of existing antibiotics, a decrease in the development of new antibacterial therapies due to other therapies (with higher profits being prioritised) and a decrease in education from governments and healthcare professionals are contributing to the problem of antibiotic resistance.

The likelihood of costly clinical trials for potential new therapies failing to deliver the necessary results, combined with a lack of incentives from governments, means that pharma companies are not prioritising development on new antibiotic therapies and alternatives.  Because of this, there have been significantly fewer antibiotic trials in recent years and there has not been a new antibiotic on the market since the 1980s.

For years, countries have been aware of the impact of the use of antibiotics outside of human medicine, for example, in animal husbandry and agriculture – antibiotics have in the past been prescribed like Smarties as growth promoters in cattle.  In March this year, the US Food and Drug Administration (FDA) announced that it would be cracking down on the use of antibiotics in animals.

It has also been acknowledged that poor infection prevention and control practices contribute to further emergence and spread of antimicrobial resistance.  However, it is only recently that governments have started to take a hard line on the issue and have started to impose bans and guidelines on the use of antimicrobials in order to curb the issue.

Getting to grips with the issue

Across the world, countries are now creating taskforces to specifically deal with the issue – in 2012 the US introduced the Generating Antibiotic Incentives Now (GAIN) Act to promote commercial development of new antibiotics. The European Unions’ Innovative Medicines Initiative has launched new programmes to develop antibiotics and accelerate early drug discovery.  In 2014, UK government formed The Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection.

Communication can contribute to the solution

A consistent problem in the fight against in antibiotic resistance has been a lack of education.  According to Nesta and the Longitude survey, nearly half of GPs prescribe antibiotics ‘several times a week’ even if they’re not sure they’re medically necessary and 90% of GPs say that they feel pressure from patients to prescribe antibiotics. Patients are also unaware of the consequences of not finishing a prescription – many of whom only take antibiotics until they feel better.  As a consequence, many patients do not understand that antibiotics may no longer work for them, and that their actions are contributing to the evolution of resistance and hence the wider problem of global antibiotic resistance.

Government taskforces and awareness campaigners have played a huge part in drumming up public awareness through the media, with specialists commenting on the findings of special reports on the subject, allowing a forum for those who work with patients to share their knowledge and those pharma and biotech companies leading the charge to showcase their research, whether it is a new class of antibiotic or an alternative, such as bacteriophage therapy.

Ultimately, better diagnostics will also play a role – when we have an infection it’s critical to know what it is (bacteria, virus, parasite etc), and, if it is a bacteria then, which species (streptococcus, clostridium difficile etc); and ideally, the antibiotic resistance profile of the bacteria in question. The diagnostics industry is working on new tests to more rapidly and specifically address these three questions. The £10m Longitude Prize 2014 invited the public to vote for the most important challenge facing mankind: ahead of issues like dementia and water supply, the winner was antibiotics – proving that there is rising awareness of the issue. The prize itself will be awarded for the development of an effective test for use in the management of bloodsteam infections and prevention of sepsis. Sepsis kills over 37,000 people in the UK each year – more than diseases such as lung cancer.

What can you do?

Only use antibiotics when they are prescribed by a certified health professional; and don’t push for antibiotics for viral or other infections. Ensure that you complete the full treatment course, even if you feel better; never sharing antibiotics with others or using left over prescriptions.

Be aware, be educated, be responsible and support actions to ensure that future generations can enjoy modern medical advances made possible through keeping bacterial infections at bay through the effective use of antibiotics.

Image: courtesy of NovaBiotics