STOA study recommends containing antibiotic resistance over search for new drugs
Resources allocated to the serious problem of increasing antibiotic resistance would be better spent on action to combat further resistance than research into new antibiotic drugs, according to a report commissioned by the European Parliament's Scientific Technology Options Assessment (STOA) committee. Antibiotics have been used to treat previously fatal illnesses such as pneumonia and tuberculosis since the discovery of penicillin in 1928 by Alexander Fleming. Antibiotics have also facilitated advances in surgery, as the treatment of infection has improved. However, the increasing use of antibiotics has been their downfall. Bacteria are becoming increasingly resistant to the drugs that doctors are prescribing to defeat them, creating a situation in which conditions involving multi-drug resistant bacteria cannot be treated. The inappropriate use of antibiotics has been a key contributor to bacterial resistance. Inappropriate use includes use for viral infections where antibiotics have no effect, the sale of antibiotics without prescription, and the practice of self-medication. An interdisciplinary working group involving researchers from Denmark, Spain and the UK, examined antibiotic resistance on behalf of STOA, coming up with an action plan that outlines six policy options. The policy options come under four headings: coordination; standardisation; stimulation and research. Recommendations include increasing the role and scope of the European Centre for Disease prevention and Control (ECDC) in coordination European strategy with respect to antibiotic resistance, encouraging the implementation of 'prescription only' policies, encouraging the use of rapid diagnostics, and using EU funds to match national educational campaigns. On research, the report proposes increased funding to enhance the containment of resistance. Research should address, among other issues: understanding the cultural, contextual and behavioural aspects of antimicrobial usage; the costs and benefits of containment strategies; analysis of initiatives to reduce antibiotic consumption and to limit the spread of infection; and the rapid dissemination of research results. Previous reports on antibiotic resistance have frequently advocated increased research into the development of new antibiotic drugs, but this approach is rejected in this latest report. 'There is no question that without containing the further development of antibiotic resistance, these drugs will be direly needed. However, refilling today's think pipeline with new discoveries and then developing these into new drugs will take time,' states the expert group. The report gives three reasons why pursuing new drugs is not the best option: resistance is currently outrunning antibacterial research, leading to a high risk situation that needs addressing urgently; the ability of new antibacterials to treat infections will be reduced if resistance is not contained by the time that they reach the market; and there is no guarantee that new drugs will be discovered or developed in time. 'It is therefore the conviction of the working group that if additional resources are to be spent on addressing the antibiotic resistance problem, immediate and concerted action to combat further antibiotic resistance will be of much greater benefit to society than increased public investment in antibiotic R&D [research and development],' concludes the report.