Inpharma 1653 - 30 Aug 2008

Drug wars: the bacteria strike backThe battle between antibiotics and bacteria is

ongoing, and the bacteria are putting up a good fight,reports Science’s Gary Taubes.

Taubes writes that, over the last decade, there hasbeen a phenomenal increase in antibiotic-resistantbacteria, simply because "resistance happens". This,however, fails to make the issue any less difficult to dealwith.

Compounding the problem is the fact that there is adearth of new antibiotics in the pipeline. There arecurrently a few new antibiotics that have been approvedor are in development to treat methicillin-resistantStaphylococcus aureus (MRSA) and other Gram-positivebacteria. However, this is not the case for Gram-negative bacteria, where new antibiotics are limited todevelopment programmes in a few small companies;only one drug has succeeded in making it throughphase I trials. One reason for the lack of potential drugsis that Gram-negative bacteria are harder to kill.

Exacerbating the problem is the gradual migration ofpharmaceutical companies away from antibioticdevelopment, due mostly to an "iffy" market and slimchances of success. While the antibiotic market hoversaround $US25 billion per year, other drugs such asantidepressants or antihypertensives give a better "bangfor the buck" as they are often taken for years rather thansimply a 7- to 14-day course. In addition, the better theantibiotic, the less experts wish to see it used to avoidresistance development.

Taubes concludes that the only real route to curbingantibiotic resistance is to hold back the use ofantibiotics. One benefit to this is that it may rejuvenatethose antibiotics that have lost their effectiveness.Taubes G. The bacteria fight back. Science 321: 356-361, No. 5887, 18 Jul2008 801020508

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Inpharma 30 Aug 2008 No. 16531173-8324/10/1653-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved