Bugs Behaving Badly
Antibiotics are aging, and bacteria are learning to fight them off
Empty shelves. The solution to larger issues of antibiotic resistance is more and better drugs. If that doesn't happen, warns "Bad Bugs, No Drugs," a report issued in 2004 by a task force of the Infectious Diseases Society of America, whose 8,000 members are mostly physicians and scientists, the country--and the world--face a brewing crisis in which millions of people could die. "The shelf is very sparse," says John Bartlett, a physician who chaired the task force and is founding director of the Center for Civilian Biodefense Strategies at the Johns Hopkins School of Public Health. "When we go on rounds every day, we are continually reminded that we're running out of drugs."
Why few new antibiotics are emerging, says George Talbot, a task force member and consultant to drug manufacturers, is simple: "Big companies decided that there are more fertile fields. They needed to have blockbuster drugs." Antibiotics are expensive to develop--putting a new one on the market would cost at least $800 million and take as long as 10 years--and offer a lower return than that offered by medications for chronic illnesses, such as heart disease, Alzheimer's, and depression. Potent new antibiotics, notes Talbot, "are put on the shelf to be used in reserve. It may make sense clinically, but it's not exactly an incentive to companies to develop new drugs."
The task force concluded that Congress has to give large pharmaceutical manufacturers a good reason, in the form of tax breaks and other financial carrots, to get back into antibiotic R&D. Several bills that would do so, however, languish in committee. And so a perfect storm well may be in the making, as microbes gain in strength while current antibiotics, unbolstered by reinforcements, are defeated one by one.
MUSCLING UP
Two types and one whole class of bacteria are getting tougher to defeat, as shown by the rise in strains found in hospital intensive care units that are resistant to the usual antibiotics.
STRAINS WITH RESISTANCE
Staphylococcus aureus
Enterococci
Pseudomonas aeruginosa
[labels]
0
10
20
30
40
50
60 pct.
1980
2002
1990
Source: Centers for Disease Control and Prevention
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