IDSA calls for
more antimicrobial research, development. IDSA officials identify a
target list of six microbes that are in desperate need of new
antibiotics.
by Colleen Zacharyczuk, IDN Managing Editor, March 2006
The IDSA “Hit List” of “superbugs,”
or highly dangerous, drug-resistant microbes, that are most in need of
research:
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Methicillin-Resistant Staphylococcus aureus (MRSA)
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Escherichia coli and Klebsiella spp.
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Acinetobacter baumannii
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Aspergillus spp.
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Vancomycin-Resistant Enterococcus faecium (VRE)
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Pseudomonas aeruginosa
Officials with the
Infectious Diseases Society of America (IDSA) are calling on
government officials to introduce and enact legislation that would
offer market exclusivity to pharmaceutical companies that research and
develop novel antimicrobials for “superbugs,” or highly dangerous,
drug-resistant microbes.
They also identified a
representative “hit list” of microbes that are most in need of
research - methicillin-resistant Staphylococcus aureus (MRSA),
Escherichia coli and Klebsiella species,
Acinetobacter baumannii, Aspergillus species, vancomycin-resistant
Enterococcus faecium and Pseudomonas aeruginosa.
In a press conference
announcing the list, Martin J. Blaser, MD, president of the IDSA, and
colleagues detailed complications associated with these microbes and
the challenges involved in treating them.
MRSA infections constitute
the single most important cause of health care-associated infections,
increasing lengths of hospital stay, severity of illness, deaths and
costs. Although these infections occurred primarily in hospitals, they
are becoming increasingly common in communities nationwide, especially
where groups of people are in close quarters, including military
facilities, sports teams and prisons. The number of infected children
jumped 28% between 2001 and 2004, according to Blaser. Although there
are treatment options available for MRSA, most medications need to be
administered by injection; oral drugs are desperately needed.
“[A. baumannii] is a prime
example of a mismatch between unmet medical need and the current
antimicrobial research and development pipeline,” wrote researchers in
an article in Clinical Infectious Diseases, which announced the IDSA’s
“hit list.” The bacterium is a growing cause of hospital-acquired
pneumonia, and the number and hardiness of drug-resistant strains are
growing, researchers said. Soldiers are also returning from Iraq and
Afghanistan with cases of highly resistant Acinetobacter wound
infections. In the case of A. baumannii, physicians have been forced
to resort to an old drug, colistin, which had previously been
abandoned as too toxic. IDSA officials said only one new drug is on
the horizon to treat Acinetobacter infections, and it is considered to
be too toxic for children.
Discussing the other
organisms, Blaser and colleagues said that although there are
treatment options for all of them, these bugs’ abilities to develop
resistance have made treatment difficult. IDSA officials said there
are relatively few new therapies in the pipeline for any of them.
A call to action
During the press
conference, IDSA officials said that Congress has not passed the
comprehensive legislation needed to stimulate the antimicrobial
research and development that the IDSA called for in its July 2004
report, “Bad Bugs, No Drugs: As Antibiotic Discovery Stagnates ... A
Public Health Crisis Brews.”
In the most recent report,
IDSA officials urged Congress to pass comprehensive legislation to
encourage the pharmaceutical industry to re-enter the antimicrobial
field. They state that members of Congress should establish a
commission to set antimicrobial discovery priorities. They add that
companies that develop novel antimicrobials should be rewarded with
10-year market exclusivity rights. Furthermore, IDSA officials said
that research, development and manufacturing should be encouraged
through tax credits. IDSA also is pressing for funding for
antimicrobial resistance efforts at the CDC, including MRSA extramural
research. Congress allocated funding to address potential agents of
bioterror under the Project Bioshield legislation that passed two
years ago; however, naturally occurring infections like MRSA were not
included in that legislation.
“We are very concerned
that Congress has not taken action to date or pass legislative
incentives that will spur antimicrobial development or funding for
resistance efforts. These bad bugs won’t wait, neither should we,”
said Robert Guidos, JD, director of public policy for the IDSA.
For more information:
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Talbot, GH, Bradley J, Edwards JE, et al. Bad bugs need drugs: an
update on the development pipeline from the Antimicrobial
Availability Task Force of the Infectious Diseases Society of
America. Clin Infect Dis. 2006;42:657-668.
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