Introduction to Antibiotic Resistance
The inexorable rise in multidrug-resistant Gram-negative bacteria has been widely reported. Multiple modes of resistance often present in a single strain of bacteria, and this may also be combined with an increase in virulence, both of which are leading t
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Contents 1 What Is Happening to Antibiotic Resistance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Epidemiology of Resistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Concerns and Activities Occurring to Reduce This Threat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 US Congress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 European Medicines Agency (EMA) Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 React . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Present State of Antibiotic Research Constraints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Proposals on Co-development of Antibiotics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Abstracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Abstract The inexorable rise in multidrug-resistant Gram-negative bacteria has been widely reported. Multiple modes of resistance often present in a single strain of bacteria, and this may also be combined with an increase in virulence, both of which are leading to a significant increase in morbidity and mortality in patients. Against this background, the absolute number of new antibiotics licensed has declined especially for Gram-negative multidrug-resistant pathogens. The reasons for this failure are presented here: market issues, big pharma changes, regulatory constraints, difficulties in finding drugable targets and, lastly, suitable compounds worthy of full development. Keywords Antibiotic resistance • Gram-positive bacteria • Gram-negative bacteria • Regulatory
R. Bax (*) • D. Griffin TranScrip Partners LLP, 400 Thames Valley, Park Drive, Reading RG6 1PT, UK e-mail: [email protected] A.R.M. Coates (ed.), Antibiotic Resistance, Handbook of Experimental Pharmacology 211, DOI 10.1007/978-3-642-28951-4_1, # Springer-Verlag Berlin Heidelberg 2012
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R. Bax and D. Griffin
Antibiotics have saved millions of lives and eased the suffering of patients of all ages for more than 60 years. These “wonder drugs” deserve much of the credit for the dramatic increase in l
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