Is antibiotic resistance one of the greatest threats to human health?
Researchers are raising the alarm because the number of antibiotic resistances is increasing steadily in Europe. An estimated 25,000 people die in Europe each year from infections with resistant pathogens, with intestinal germs such as Klebsiell and Escherichia coli or tuberculosis bacteria playing a central role here. According to the Academy of Sciences in Hamburg and the National Academy of Sciences Leopoldina, this development is a serious problem: Because fewer and fewer new antibiotics have been developed since the 1970s, so that experts are increasingly concerned that the need for some of them vital medicines may no longer be sufficient in the future: "An increasing number of infections caused by antibiotic-resistant bacteria are faced with fewer and fewer new antibiotics," the scientists warned. Therefore, there is an urgent need for action here, the experts continue, because, as they write in a current statement, "the worldwide occurrence of antibiotic resistance is one of the greatest threats to human health in the opinion of the WHO."
Antibiotics kill bacteria or prevent them from multiplying. According to Ansgar Lohse from the University Medical Center Hamburg-Eppendorf, this happens because the medication destroys the cell walls of the germs and interferes with the metabolism or the genome. Scientists argue that the microorganisms defend themselves against this as a "natural phenomenon in evolutionary competition", because resistance can be passed on to others by bacteria or can also arise from mutations. Another problem here is the exchange of pathogens between humans and animals.
Danger of medical regression
However, according to the scientists, there is now a risk of returning to a situation that existed before the introduction of penicillin in the 1940s: “So far, resistance has been discovered three, four or five years after the introduction of an antibiotic and one has become aware of one another could be sure that the industry would supply a new antibiotic, ”says Werner Solbach from the University Medical Center Schleswig-Holstein - but this is no longer the case today.
In order to change the situation, according to Solbach, physicians would need new classes of substances that harm the bacteria in a different way than before - the principle of "More of the same" would not help, however. However, contrary to the expert's recommendation, only four of the substances approved in the US and Europe between 2000 and October 2012 would be based on new classes of antibiotics - and these would only work against the "gram-positive" pathogens.
Antibiotics for the pharmaceutical industry unattractive
The scientists see the reason for the inadequate new development of antibiotics, among other things, in the lack of incentives for the pharmaceutical industry - for them it is not attractive enough to bring new medicines onto the market, because in most cases treatment with antibiotics would be few Last for days - however, in most cases, taking blood pressure medication is necessary for years. If a new antibiotic is then introduced, the prescription would initially be held back and treated as a “reserve”.
Academies make recommendations in the fight against resistant pathogens
But what are the alternatives in the fight against resistant pathogens? In order to reduce the spread of resistance and to develop new antibiotics, the opinion of the two institutions requires, on the one hand, greater research efforts and, on the other hand, and framework conditions "are required that enable effective implementation of scientific knowledge in practice."
The scientists provide starting points for this in their statement in the form of eight recommendations, which include strengthening basic research and improving the structural prerequisites for innovation. According to the experts, it was also important to "facilitate and strengthen cooperation between industry and academic research in order to link basic research resources more efficiently with the diverse requirements of pharmaceutical product development."
The eight recommendations of the authors also include facilitating clinical research and further developing or simplifying the regulatory requirements for the development and approval of new antibiotics. A restriction of the use of antibiotics in veterinary medicine and in plant protection is also required, as well as the need for information: "Employees in agriculture and in the food industry should be given further training measures to explain how antibiotic resistance develops and which measures trigger it reduce, ”was the recommendation of the scientists.
In the fight against the increasing resistance to antibiotics, continuous monitoring and recording of "important pathogens at all levels: local to worldwide and cross-departmental in clinic, outpatient clinic and animal breeding" and "the socio-economic, legal and ethical framework conditions for development must also take place more research into new antibiotics, obstacles identified and possible solutions identified, ”the authors continued. (sb)
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