Antibiotic effectiveness: Balancing conservation against innovation

Abstract

Antibiotic effectiveness is a natural societal resource that is diminished by antibiotic use. As with other such assets, keeping it available requires both conservation and innovation. Conservation encompasses making the best use of current antibiotic effectiveness by reducing demand through vaccination, infection control, diagnostics, public education, incentives for clinicians to prescribe fewer antibiotics, and restrictions on access to newer, last-resort antibiotics. Innovation includes improving the efficacy of current drugs and replenishing effectiveness by developing new drugs. In this paper, I assess the relative benefits and costs of these two approaches to maintaining our ability to treat infections.

Peripheral modifications of [Ψ[CH 2 NH]Tpg 4 ]vancomycin with added synergistic mechanisms of action provide durable and potent antibiotics

“…These actions include providing new financial incentives to counter the declining economic interests in developing new antibiotics (4), revamping regulatory criteria for new drug approvals (5), improving the rate of diagnostic characterization of infecting organisms, enhancing nationwide resistance surveillance, encouraging work targeting mechanisms of resistance, and identifying new therapeutic targets for antibiotic discovery (6,7). The suggested actions also champion antibiotic stewardship (8). Although sounding attractive, the effort to restrict antibiotic use seems counter to their importance, introduces guilt into even their most legitimate of uses, challenges the prevailing practices of initial empirical best guess therapy and prophylaxis deployment, and produces additional disincentives to antibiotic development.…”

The race for antimicrobials in the multidrug resistance era

“…Examples include Pseudomonas aeruginosa or Acinetobacter baumannii strains that are responsible for multiple nosocomial diseases and are resistant to β‐lactams, such as carbapenems or third‐generation cephalosporins (Lister et al ., 2009; Vila and Pachon, 2011). Intensification of financial incentives, new regulatory criteria for drug approvals and the identification of new therapeutic targets for antibiotic discovery are actions to be taken to overcome this threat to public health (Laxminarayan, 2014). …”

Antibiotics Induced Seizures and Encephalopathy

“…Over one million children with untreated pneumonia die each year. 14,24 The pneumococcal conjugate vaccine has reduced pneumococcal disease. In the United States, resistant pneumococcal strains decreased by 59% between 1999 and 2004.…”