EU addresses deadly threat of rising resistance to antibiotics
By James Kanter International Herald Tribune
FRIDAY, MARCH 17, 2006
PARIS In a major challenge to doctors and drug manufacturers, European Union officials will tackle a looming public health crisis on Friday as options for treating for common ailments like pneumonia and bronchitis disappear after decades of overprescribing of antibiotic drugs.
"We know that there is growing concern among the public about rising rates of antibiotic resistance," said Janez Potocnik, the EU science and research commissioner, who will present the plan.
The initiative represents a challenge to doctors and pharmacists, who often dispense antibiotics to people with viral illnesses rather than bacterial infections, giving bacteria plentiful opportunities to build up defenses.
The initiative also could represent a challenge to the makers of generic antibiotics, which have come to dominate the market and could have their sales eroded if the EU campaign takes hold.
EU officials will use €11.5 million, or $13.9 million, to jump-start a network, dubbed Grace. It will link medical and science faculties in nine countries, which will focus on training for health care workers, monitoring resistance and developing tests to establish patients' suitability for drugs to treat pneumonia and bronchitis.
A key element of the project, EU officials said, will be to encourage a new crop of companies to develop fast and affordable kits for doctors so they can identify patients who would benefit from drugs, and withhold drugs from those who are unsuited to treatment.
If successful, the EU aims to promote testing and perform trials on drugs for a wider range of emerging infectious diseases, which could include diseases like avian influenza, or bird flu.
Leaders of the Grace project said an outbreak of pandemic bird flu would be likely to trigger even heavier consumption of antibiotics.
Those antibiotics would probably do little to help patients with the virus but would create even more resistant strains of bacteria, in turn making it more difficult to cure patients who have developed bacterial complications as a result of bird flu.
"A pandemic would be terrible," said Sophia Tickell, a researcher for React, a network of academics and researchers based in Sweden. "Think how much worse it would be if effective new antibiotics were not available for hospitalized patients."
But there are few signs that new medicines are coming. Adding to the urgency of the EU campaign is the near- empty pipeline of new, resistance-free antibiotic medicines.
Since the 1970s, drug companies seeking to improve their bottom lines have redirected research and development away from antibiotics, which are used for short-term illnesses like bronchitis and pneumonia, and into far more lucrative drugs to treat chronic disorders like depression and diabetes.
Other factors also reduce the incentives for new antibiotic breakthroughs: Even if there were new drugs, analysts say, doctors would still prescribe generic copies of older antibiotics first, because they are cheap and plentiful.
The economics of antibiotics are "making it difficult for new antibiotics to warrant the premium price they need to generate a return on investment," Stewart Adkins of Lehman Brothers in London said.
So rather than depending on industry to develop new, resistance-free medicines to keep Europeans healthy, the EU authorities now are seeking to reduce overall use of antibiotics to stop the current elevated levels of resistance from rising .
"We need diagnostics, we need rapid molecular tests that give us results in one or two hours," said Herman Goossens, the leader of the EU project and a professor at the University of Antwerp in Belgium.
Goossens said it would be important for governments in Europe to reimburse for tests to ensure that diagnostics companies find a market for their products.
Drug companies spend billions on trials and promotions of new drugs but spend relatively little on developing such tests, knowing that they could reduce overall drug consumption.
Goossens also favors public campaigns to raise awareness of the problem. In Belgium, prescriptions of some antibiotics have fallen up to 8 percent since 2000, when the Belgian authorities started a televised awareness campaign, according to Goossens.
React said that in some European countries 50 percent of the tests carried out on bacteria from patients indicated that the antibiotic methicillin had no effect on Staphylococci, the most common infection in hospitals, showing how even people suffering from nonbacterial illnesses can be in grave danger when antibiotic resistance takes hold.
Clinicians have blamed the spread of hospital "superbugs" for the deaths of as many as 3,000 people each year in Belgium and as many as 15,000 people each year in Britain.
