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Bad Bugs Need New Drugs


17 March 2006
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Staph, strep and more serious bacterial infections like meningitis, pneumonia and tuberculosis routinely killed millions of people before the discovery of antibiotics in the 1940s. But antibiotics have become less effective over the years, because some bacteria have evolved ways to survive the medicines meant to kill or weaken them and drug companies are not interested in developing new ones.

Baby Bryce with Santa in December, 2005
Baby Bryce with Santa in December, 2005
On Christmas Day 2005 Katie and Scott Smith's 14-month-old son Bryce got sick. "As first time parents we took him to the doctor the next day, and found out he had a viral infection that would last probably the next seven to ten days," says Katie Smith.

Baby Bryce sleeping in hospital with breathing tubes
Baby Bryce sleeping in hospital with breathing tubes
But Bryce didn't get better and was rushed to the hospital on New Year's Day. An aggressive staph infection called MRSA had eaten a hole in his lungs. Scott Smith says over the next two months the child had six blood transfusions. "His lungs were so bad they couldn't supply the oxygen his body needed." Surgeons had to insert five chest tubes in his body due to the hole that was in his lungs. "A respiratory therapist told us his lungs were so hard and infected that it was like trying to pump air into a brick," says Scott Smith.

Bryce finally went home in late February and is making slow, but steady progress in learning to walk and talk all over again. But his doctor John Bradley says even the slightest chest cold could set him back. "His lungs are ravaged by this infection," he says. "There are scars throughout both lungs, and we have some concern that the holes that were present earlier from the staph pneumonia may open up at any time."

Electron-micrograph depicting a group of MRSA bacteria
MRSA or methicillin-resistant staph aureus - once exclusively found in hospitals - is now increasingly common in community settings. A recent study says children under two years of age, like Bryce, are at greatest risk.

But they are not alone. Two million hospital patients a year get bacterial infections. 90,000 of them die. More than 70 percent of the bacteria that cause these infections are resistant to one or more antibiotics.

Martin Blaser is President of the Infectious Diseases Society of America, whose members include physicians and scientists. He says bacteria are becoming resistant faster than we can develop drugs to fight them. "The time to prepare is now because it takes years to develop new antibiotics."

But Blaser says the antibiotic drug pipeline is drying up. Market forces are partially to blame. Drug companies make a lot of money with medicines for long-term chronic diseases. They see little profit in drugs to fight the increasingly resistant germs doctors see in hospitals everyday.

Blaser says there are other financial roadblocks as well. "The development of resistant strains of bacteria limits the long-term market potential for an antibiotic," he says. "Also infectious disease experts may suggest restrictions on the use of new antibiotics in order to preserve the effectiveness of these drugs for those patients that need them most. Although sensible, such restrictions reduce the incentives for companies to develop new drugs."

The Infectious Diseases Society of America is calling on Congress to act. IDSA policy director Robert Guidos says incentives for the pharmaceutical industry can help pave the way. "We're calling for tax credits for research, for facilities that are used to manufacture and do [research and development] for these products. And, we are also calling for the establishment of an independent commission that will identify which of these infections are the most serious and therefore for which of these incentives should apply."

Guidos says that the problem can be addressed in part by re-authorizing the 2002 Public Health Security and Bio-terrorism Preparedness Act. IDSA hopes a new version of the law will include provisions that encourage drug companies to take a greater lead in the battle against ever more toxic germs.

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