Medicine

There Have Been Zero New Types Of Antibiotics Since The '80s

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When penicillin was introduced in the 1940s, it changed the world. Before, hospitals were full of people with blood poisoning from minor injuries; after, patients with previously untreatable infections like pneumonia and gonorrhea were being cured right and left. But in the decades since, bacteria have evolved to resist our miracle drugs. Now, the CDC estimates at least 23,000 Americans die every year from an antibiotic-resistant infection. The only way to fight back is to develop new antibiotics, and all but a few drug companies have stopped trying. New efforts, however, could change that.

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A Bright Future Turned Dark

With penicillin proving to be such a lifesaver, drug companies quickly began creating a whole range of bacteria-fighting drugs. From Alexander Fleming's 1928 discovery to the 1970s, 270 new drugs were developed, and by 1990, 18 major pharmaceutical companies were in the business of antibacterial research and development.

Fast forward to today, and only five of the top 50 pharmaceutical companies are creating new antibiotics. And what they're creating is slim: a 2002 analysis published in Clinical Infectious Diseases found that out of 506 drugs in development, only five were antibiotics, and out of 89 drugs hitting the market, there wasn't a single antibiotic among them. Of the drugs that are being developed, all are just variations on antibiotics that already exist. According to the Pew Charitable Trusts, we haven't seen a new type, or class, of antibiotic since 1984. That's a big problem, because when bacteria is resistant to one antibiotic, it's usually resistant to other ones in the same class.

Why aren't drug companies stepping up? There's no money in it. A new antibiotic starts with basic research designed to identify organisms that create antibiotic compounds, a process that can include the screening of thousands of different samples. Once researchers find a candidate, they test it against a range of bacteria, and if the results are positive, then they have to grow it on a large scale. Even after all that, scientists can discover that they haven't actually found a new antibiotic. That means going back to the drawing board. If it is new, there's still clinical testing, FDA approval, and finally it can go to market — where it will eventually lead to bacterial resistance. As a result, it can take more than 20 years before a company sees a profit from an antibiotic, and even that profit is usually meager and short-lived.

What You Can Do

This is a serious global problem. Even our "drugs of last resort" — the ones doctors turn to when no other antibiotic is working — are beginning to fail. But there's still hope: numerous organizations are stepping up. In 2016, the Pew Charitable Trusts released A Scientific Roadmap for Antibiotic Discovery laying out the priorities companies and governments need to go after to fix the problem. The UK's Review on Antimicrobial Resistance proposed how to tackle the issue internationally, including funding recommendations: up to $37 billion over a decade.

But in the meantime, what can you do? The CDC recommends that patients take an active role in their own health care. Ask if your doctor will do tests to make sure they're prescribing the right antibiotic, and don't ask for antibiotics if you doctor hasn't recommended them. When you do take antibiotics, follow all instructions and finish the entire prescription, even if you're feeling better. Antibiotic resistance is scary, but you can do your part to help fight it.

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