Allow antibiotics that cause nasty side-effects to help stop rise of untreatable infections, expert says
Regulations on side-effects should be relaxed to allow the creation of new ‘antibiotics of last resort’ which make people sick but kill infections that have become resistant to other drugs, according to a leading microbiologist.
Dr Paul Hoskisson, a member of the Microbiology Society Council, warned that the world could be as little as 10 years away from the “terrifying” point at which many infections start to become untreatable.
That would mean a small scratch could prove fatal while transplants and other major operations would become too risky to perform.
He spoke out as David Cameron, who is currently at the G7 Summit in Japan, announced new targets to limit the “inappropriate use” of antibiotics and kickstart the stalled effort to create new drugs.
American researchers have also revealed that they had found someone with a strain of E. coli bacteria that is resistant to the current antibiotic of last resort, colistin, for the first time in the US.
That prompted Tom Frieden, director of the Centres for Disease Control and Prevention, to warn that “the end of the road isn’t very far away for antibiotics”. Colistin resistance has already been found in China and parts of Africa and Europe, including the UK.
Dr Hoskisson, of Strathclyde University, said researchers had already discovered most of easy targets to make antibiotic drugs and the search for new ones was now much harder.
Asked if the world was at risk of returning to the days when a scratch while gardening could result in death, he said: “I don’t think we are too far away from that at the moment.
“I think even more stark than that is people forget how antibiotics are used routinely in hospital. If you go in for abdominal surgery you are prescribed antibiotics as a prophylactic against infection.
“It would be the end of transplants, major surgeries, because you just couldn’t take the risk anymore.
“If we return to a pre-antibiotic era, the advances made in modern medicine in terms of the treatment of diseases and surgeries … we’ll go back to square one.
“It’s terrifying, isn’t it?”
Part of the problem, he said, was the drug companies have little financial incentive to spend large amount of money on research into new antibiotics, given the whole point is they are only sparingly used for the worst kind of infections.
“The resistance to antibiotics is inevitable, we always have to have drugs in the pipeline,” Dr Hoskisson said. “Unfortunately the pipeline is no longer like a running tap, it’s a very slow drip.”
He said the tight controls on antibiotics meant they were “very safe” – particularly compared to cancer drugs that make people vomit and lose their hair.
“For an antibiotic, the rules are very much more strict in terms of the side-effects that are permitted,” he said.
“But we may find in 10 or 15 years, once these drugs stop working and that really is a worry, many people may develop infections in the future and we will have no drugs.
“The regulatory process is a very good thing, but we need to maybe rethink our strategy of how we do drug discovery and also bring drugs to market.
“I think we need some kind of change for last-line-of-resort antibiotics, to potentially allow more side-effects.
“It could be things like sickness … some people have diarrhoea.”
Last week, a report on the results of a Government-commissioned review of the use of antibiotics by Jim O’Neill, an economist and former chairman of Goldman Sachs Asset Management, concluded that urgent action was needed to avoid paying a “terrible human and economic cost” as they stop working.
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Reacting to the discovery of colistin-resistance in the US, Lord O’Neill, who is Commercial Secretary to the Treasury, said: “This worrying news just underlines how important it is for the world to agree to implement the proposals that we outlined last week, and the urgency of a G20, and separately, a United Nations’ high-level agreement, this September.
“It is highly encouraging that our Government is taking such a lead, as evidenced by the bold announcements the Prime Minister made today in Toyko.”
The Government is still to formally respond to Lord O’Neill’s report but Mr Cameron’s announcement was broadly in line with its recommendations.
The Prime Minister said the Government would work to cut the number of hospital-acquired blood infections by 50 per cent to reduce the demand for antibiotics, set a target to reduce antibiotic use by agriculture and work with the international community to set up a global system to reward drug companies that produce new antibiotics.
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