The lost war or is it? – Infections vs Antibiotics

Antibiotics, once hailed as magic bullets for battling infection are now facing serious challenge from their adversaries, the bacteria, which are hitting back with renewed vengeance. A recent case of a patient in New Zealand dying of bacterial infection (Klebsiella pneumonia) which was resistant to all known antibiotics points to an ‘apocalypse’ scenario in the future if corrective measures are not taken. 

So where is the problem? First, the tendency to overprescribe antibiotics for even slightest of infection is a big worry. Alexander Fleming, the father of antibiotics had warned of dangers of antibiotic resistance. In fact, Penicillin-resistant bacteria arrived while the drug was still being given to only a few patients. Another breeding ground for antibiotic resistant bacteria is in their rampant use in farm animals. Unfortunately, for the pharma companies research interest into antibiotics have slowly waned as there are far more profitable drugs to throw money at, since antibiotics are usually single-serve drugs for humans, not long-term treatments. Drugs for chronic conditions tend to be more profitable. And with drug resistance quickly evolving, rendering older antibiotics ineffective, pharma companies have even less incentive to invest in these drugs. However, recent trends suggest that big pharma companies might be reviewing their strategy as Roche has re-entered the arena through a $550 million tie-up with privately held Polyphor, a Swiss company, to develop and commercialize an experimental antibiotic against hospital superbugs. 

The key is to collaborate with Universities and small drug discovery companies that focus on infections as Roche did. Smaller companies are looking at next-generation drugs or in some cases alternative therapies. Some companies for example are looking at bacteriophage therapy. But despite technical successes, these companies face an uphill battle in developing a consistent, approvable product and haven't yet found much commercial validation or attracted much investment. This is where the experience and backing of big pharma companies would help. Another alternate and a newer area of interest is the human microbiome, which can lead to potential commercial therapeutics. Microbiome companies like Seres Health, Vedanta Biosciences and Second Genome are a good bet as far as making the next cut for coming out with a new approach to treating infections are concerned!