- The Washington Times - Tuesday, March 19, 2013

Health officials are warning of the rise of the “superbugs” — bacteria and other pathogens that cannot be killed by modern medicine.

But many pharmaceutical companies are resisting the call to develop effective antibiotics and instead are shifting their resources to other products.

Exhibit A is AstraZeneca, one of the major companies still working on developing antibiotics.

Its new chief executive, Pascal Soriot, said Monday the drug giant was restructuring its workforce and will focus on three therapy areas: cancer, cardiovascular and metabolism disorders, and respiratory and inflammatory diseases. This means “reduced spending on anti-infectives,” according to Reuters.

Pfizer, Roche, Bristol-Myers Squibb and Eli Lilly have all reduced or eliminated their antibiotic research efforts, while Merck & Co. and GlaxoSmithKline are still actively pursuing such medicines, Reuters added.

The reason businesses resist making new antibiotics is rational: The drugs are expensive to develop but are used briefly by most patients and are aimed at pathogens that eventually learn how to build up a resistance to them.

As a result, there have always been relatively few antibiotic products in development, and now — gauging by what is in the pipeline — “none of them really is going to be active against these bacteria in the near term,” said Dr. Gary A. Roselle, national director of the Infectious Diseases Service for the Department of Veterans Affairs health care system.

“Incentivization” for drug development that may not have major monetary success is a big topic of discussion, added Dr. Roselle, who works at the Veterans Affairs Medical Center in Cincinnati. But in the meantime, “The current goal has to be prevention, wherever possible,” he said.

Public warnings have been issued about multidrug-resistant tuberculosis and gonorrhea, and a hospital-associated infection known as methicillin-resistant Staphylococcus aureus.

A new bug, described as a “nightmare bacteria,” was highlighted in early March by Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Carbapenem-resistant Enterobacteriaceae (CRE) refers to a family of mostly harmless bacteria that live in the gut, and includes E. coli, shigella, salmonella and klebsiella. These bacteria can cause illnesses, including pneumonia, diarrhea and urinary tract infections, if they are swallowed or enter the bloodstream through an open wound.

Carbapenem-resistant refers to some bacteria that become immune to even the “last-resort” class of drugs.

CRE “pose a triple threat” because few, if any, antibiotics can kill them; they are associated with a high mortality rate; and “they can spread their resistance to other bacteria,” Dr. Frieden said.

That last point is of great concern, Dr. Frieden said, because if CRE pathogens transfer their drug-resistance genes to another bacteria such as E. coli, it could make a common illness, such as a urinary tract infection, extremely difficult to treat.

Reports of the rise of the rare but potentially deadly CRE superbugs caught the attention of lawmakers on Capitol Hill.

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