History Repeating? Avoiding a Return to the Pre-Antibiotic Age

Abstract

Antibiotics are among the most important discoveries of medical science. Analysis of infectious disease mortality data from the U.S. government reveals that antibacterial agents may save over 200,000 American lives annually, and add 5-10 years to U.S. life expectancy at birth. The spread of antibiotic immunity among bacteria – an evolutionary phenomenon mediated by plasmids, transposons, and integrons (carrying DNA encoding attack enzymes, efflux pumps, and other protective devices) – threatens these public health achievements. The examples of increasingly resistant strains of Staphylococcus aureus, Acinetobacter baumannii, and Pseudomonas aeruginosa demonstrate the importance of continued development of new antimicrobials, especially ones to treat nosocomial, gram-negative infections. Unfortunately, studies indicate that antibiotics comprise less than 1.5% of compounds under investigation at the largest pharmaceutical and biotechnology companies. Data from papers on drug costs and revenues show that antibacterial agents are simply not as profitable as other types of pharmaceuticals. “Wild-card patent extension†– in conjunction with restrictions on the use of new antibiotics (to prevent the emergence of resistance) – provides one possible solution to the twin problems of “bad bugs, no drugs.â€