On the way home from an MRSA symposium in the US the other day, I was (perhaps fittingly) listening to a podcast about new antibiotic development. The podcast, by The Lancet Infectious Diseases, discussed the small number of new antibiotics that are in the pipeline (about 15), particularly in contrast to the number of new anti-cancer drugs (about 800). There are many reasons for this, and development of new anti-cancer drugs is certainly important. However, we have definitely not "won the war" against bacteria, and resistance continues to be a serious threat to human and animal health.
The small number of potential new drugs (since many drugs in development will not ever make it past drug trials) is a concern if resistance continues to increase. The disparity in development between antibiotics and anti-cancer drugs is also concerning when you consider that good antibiotics are very important for cancer therapy - people with cancer often get infections, and often their infections are caused by multidrug-resistant bugs. As we develop more and better anti-cancer drugs, there will be more people who are susceptible to these potentially severe infections, and ways to treat them are needed.
Why are there so few antibiotics in development compared to other drug types?
- $$$ - Money. The potential return on investment for pharmaceutical companies is much greater for many other drug types. Huge amounts of money must be invested to develop, test and license drugs. Logically, companies are going to focus on the higher yield drugs, leaving some important areas with less research and development than would be desired.
What do we do?
Well, unless you own a pharmaceutical company or have millions of dollars to spend, you're probably not going to have an impact on drug development. Since we can't control what will be available to us in the future, we need to make sure that we delay, as much as possible, the emergence and dissemination of highly resistant bacteria.
Common sense practices such as only using antibiotics when necessary, using them properly (e.g. proper dose and route, giving the entire treatment course), good preventive medicine to reduce the risk of bacterial infections and good infection control measures are critical and often underused. While not as fancy as high-tech drug develop, these are the ways that we can have a positive impact in both human and animal health, and reduce our need for new drugs.