Use antibiotics sparingly as we are running out of new effective drugs, say experts


Dr David Livermore said patients with coughs and colds should not be prescribed antibiotics

Common bugs such as E.coli are becoming increasingly resistant to antibiotics, infection experts have warned.

They have called on pharmaceutical companies to switch attention from the superbug MRSA - which is gradually coming under control - to developing agents to fight a different set of bacteria.

The Health Protection Agency (HPA) is worried about increasing resistance among a group of 'gram-negative' bugs which includes E.coli.

The proportion of antibiotic-resistant cases of E.coli infection has trebled since the turn of the century.

There are about 20,000 E.coli bloodstream infections each year in England, Wales and Northern Ireland, of which about 12 per cent (2,400) are resistant to antibiotics.

In 2000, about 4 per cent of E.coli bloodstream infections were resistant but this rose to 12 per cent in 2006.

E.coli consists of harmless strains as well as those causing illness when contracted from contaminated water, food and infected people.

It is the commonest cause of urinary tract infections, but the antibiotic-resistant form is particularly dangerous to very sick patients in intensive care who may have had several courses of antibiotics.

Dr David Livermore, laboratory director at the HPA Centre for Infections, said E.coli was a 'big beast' and resistance was ruling out first-line antibiotics.

He said 'It is becoming more resistant. Hospitals are having to use what were second-line antibiotics first.

'We are not actually running out of antibiotics however we are having to use last defence antibiotics first in hospital infections.'

He said it was harder to get antibiotics to work against gram-negative bacteria and the situation was 'worsening'.

Worryingly, there were just two antibiotics in the pipeline against this group of infections, neither of which was problem-free.

This compared with up to eight new medications for gram-positive infections like MRSA, he said.

He said 'Over the last 10 years the pharmaceutical industry has significantly invested in antibiotic treatments for bacteria including MRSA.

'There is however a big public health threat posed today by mutl-resistant gram-negative bacteria and an urgent need for the pharmaceutical industry to work towards developing new treatment options.'

Some drug firms have pulled out of the field in recent years as they were not seen as particularly profitable.

'What I think is that antibiotic development whether public or private has to be made financially attractive and financially viable' he added.

He said clinical trials of new drugs should be reviewed to make it easier for them to be carried out, reducing the need for 'irrelevant' checks that pushed up the cost.

Figures suggest that it costs between £0.5 billion to £1 billion to bring new drugs to market.

He said other steps could be taken to help tackle the problems including making sure antibiotics are prescribed appropriately and not given for common coughs and colds.

Doctors should also make sure that hospital patients get the right drugs at the right dose for the right length of time.

Good infection control at hospitals would also help slow down the spread of germs, he said.

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