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As "Superbugs" Rise, Companies Abandon Antibiotic Research

This week's must-read is Jerome Groopman's article on super-resistant bacteria in the New Yorker.

If you get infected, the bacteria destroy your lungs and you end up drowning in your own blood. There's no cure: Antibiotics no longer work against them. These bugs are "literally resistant to every meaningful antibiotic that we had," according to one doc in the story. The strains, including MRSA and Klebsiella, have found themselves at home in hospital intensive-care units, where patients are often cathetered.

The problem is serious: Of 90,000 annual deaths in hospitals owing to infection, 70 percent were caused by bacteria resistant to at least one drug. The scariest part is the lack of research going on into the new antibiotics we will need to kill Klebsiella and MRSA. Groopman quotes a UCLA survey:

"FDA approval of new antibacterial agents decreased by 56 per cent over the past 20 years (1998-2002 vs. 1983-1987)" ... in the researchers' projection of future development only six of the five hundred and six drugs currently being developed were new antibacterial agents.
And major drug companies like Eli Lilly, Abbott Labs and the former Squibb have pulled out of antibiotic research, Groopman says.

We're in this crisis because of the over-prescription of antibiotics in the first place, often because docs cave when patients demand them for illnesses that can't be treated by antibiotics, like coughs and colds. The overprescription of these drugs has triggered bacteria to evolve to become resistant to them.

Which makes this report from the Telegraph in London all the more worrying. It says that British authorities have approved the antibiotic azithromycin for over-the-counter use against chlamydia.

To get azithromycin, patients must present a positive mail-order chlamydia test to a pharmacist. They no longer have to go to the doctor. At first glance, this would look like a trend that is absolutely going in the wrong direction. If over-prescription is the problem, then antibiotics should be used more sparingly, not made more available.

But, counterintuitively, making azithromycin available to patients OTC could reduce the total amount of inappropriate antibiotic prescriptions being written. After all, if it is the doctors who have caused this crisis by writing too many prescriptions, then taking them out of the loop and replacing them with a simple yes/no test could result in fewer total scrips handed out.