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Sunday 17 March 2013 Letters
Antibiotics
How big a problem is resistant diseases?

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If Robin Walsh is a trainee doctor (ie, medical student), we have cause to worry. He clearly thinks that he knows it all and the chief medical officer, Sally Davies, who qualified as a doctor over 40 years ago, knows nothing.

Walsh’s simplistic solution to the shortfall in new antibiotics seems to be some sort of government subsidy (really?) to the drugs industry and making it easier to carry out trials. He blames Sally Davies for doing nothing to solve the shortfall. She knows enough to realise that this is way out of her area of expertise… and beyond the remit of the CMO.

Let us instead listen to an insider. Derek Lowe, a researcher in the field of drug discovery, wrote thus in the current issue of Chemistry World: ‘Money can’t buy new antibiotics’. He points out that it’s easy to find drugs that kill bacteria but they usually harm healthy human cells too. Even current antibiotics have many side effects (look them up in the British National Formulary).

Furthermore, bacteria that have been around for a while are very good at evolving. They have evolved resistance to all classes of antibiotics and quickly become resistant to any tweaked version. We need completely new classes that attack some aspect of bacterial cells not already targeted and which is not shared by human cells.

A moment’s thought should make even a trainee doctor realise that this might not be so easy.

Let’s try to make our current antibiotics last a bit longer. Let’s improve hospital hygiene so the bugs don’t get around so easily; let’s not prescribe them ‘just in case’; let’s not give them routinely to cattle to make them grow faster; let’s advise patients how to avoid certain infections.

So the CMO made no suggestions about increasing the supply of new antibiotics. It’s not her job! And, as Derek Lowe says, ‘no amount of cash will keep resistant bacteria from being the hard targets they are’.

Les Hearn, UK

 

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