Brussels, 22/09/2009 (Agence Europe) - Despite policies implemented to reduce consumption of antibiotics, resistance of certain bacteria continues to increase. Research and development into new medicines has slowed down considerably over recent years. Such is the is the observation made in a report by the European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA) published on 17 September as part of a conference organised in Stockholm. Without seeking to be too alarmist, the report underlines the urgency of the situation.
In their report the ECDC and the EMEA point out that every year, about 25,000 patients die in the EU from an infection with the selected multidrug-resistant bacteria. Infections due to these selected multidrug-resistant bacteria in the EU result in extra healthcare costs and productivity losses of at least €1.5 billion each year. Policies aiming the reduce consumption of antibiotics and use them more effectively are taking effect: overall resistance is falling overall in the European Union. It is necessary, however, to distinguish between Gram-positive (staphylococcus Aureus, Enterococcus Faecium) whose level of resistance is declining (this decline is particularly sharp an constant with regard to golden staphylococcus subject to greater surveillance over a number of years) and Gram-negative bacteria (Escherichia Coli, Klebsiella Pneumonia) whose resistance is increasing. Moreover, several molecules against Gram positive bacteria are current undergoing clinical trials, whereas there is practically no new antibiotic being developed against Gram-negative bacteria.
Professor Otto Cars (infectious diseases at Uppsala University in Sweden) said that they were very late. He did not hesitate in pointing out that they were in a “definitive hurry”. This expert deplored the fact that, “there is not very much in the pipeline”. Professor Cars heads the Swedish strategic fight against antibiotic resistance and calls for immediate EU and member state action. According to Cars, there is “market failure” and the “system needs to be changed”. The pharmaceutical industry has, over the course of the last few years, gone down the road of development of new molecules in relation to such as diabetic, rheumatic and degenerative illnesses, targeting an older population that is growing in number and presenting fewer risks. To this can be added scientific difficulties related to the morphology of Gram-negative bacteria, which, presenting an envelope of phospolipides (that is aqueous on the exterior) that is thicker than that of Gram-positive bacteria, are more difficult for anti-bacteria to penetrate. Today, there is a real need for public intervention, the professor says, stressing the need to improve research, particularly fundamental research in microbiology which has been especially neglected. Fresh incentives are also needed to support the development of the new medicines and compensate for the slight attraction of a market restricted by the policy of tackling over-consumption of antibiotics. For this, it is possible to use a form of public-private partnership, perhaps similar to undertakings by member states on vaccines, Cars said. At EU level, an expert group could be asked to monitor resistance and new medicine development. Member states' experts will meet in Brussels on 9 October to draft conclusions ahead of the Health Council of 1 December 2009. (O.J./transl.rh/rt)