The rise and fall of penicillin

Penicillin

Every now and then a new drug comes along that redefines the pharmaceutical industry. But, as the industry itself is currently demonstrating - with patent expiries due on some of the market's biggest drugs - the lifeline of drugs aren't forever set in stone.

For many, especially laymen, penicillin is one of those drugs that you just know about. In other words, ask anyone outside of the pharmaceutical industry to name an antibiotic, and chances are penicillin is going to feature pretty high on their list.

However, while antibiotics such as penicillin have been key to the decline of infectious diseases over the last 60 years, becoming staples of the pharmaceutical industry, new research suggests that penicillin is now becoming obsolete as bacteria are becoming increasingly resistant to existing drugs.

The study makes for a shocking read, with the authors suggesting that antibiotic resistance could lead to a "major health crisis" unless governments act to promote research into new drugs.

What's more, perceptions that the pace of new-drug development has slowed in recent years and that the pharmaceutical industry is highly profitable have sparked concerns that significant problems loom for future drug development.

According to reports, which comes from the London School of Economics and Political Science (LSE), governments need to spur investment in the discovery of new antibiotics that can tackle the increase in the number of people dying from infections.

The report, entitled Policies and Incentives for Promoting Innovation in Antibiotic Research, warns that the problems with penicillin stem partly from over-prescription: citing a real problem in nations such as France, Spain and Romania.

In the report's findings, many doctors misdiagnose viral infections as bacterial infections because taking tests takes too long and because of a mounting tendency for litigation by patients.

CNN reports that Elias Mossialos, professor of health policy at LSE and the man who led the research, believes the emergence of "superbugs" such as methicillin-resistant staphylococcus aureus (MRSA) is causing the growing problem of hospital-acquired infections.

He added: "Antibiotic resistance is a much more important situation than swine flu, for instance, and it will only get worse."



The concern for Mossialos is that as doctors are commonly misdiagnosing viral infections as bacterial infections - and then prescribing antibiotics to treat them - over-prescription is encouraging the emergence of resistant bacteria.

The problems get worse. According to Dr Kathleen Holloway of the World Health Organization (WHO), antibiotic resistance is a global problem, with diseases including childhood pneumonia, dysentery and tuberculosis (TB) no longer responding to first-line antibiotics in some parts of the world.
She told CNN that "research and development (R&D) of new antibiotics isn't keeping up with development of resistance." She backed up Mossialos' findings, warning that if we [governments] don't do something soon, it is likely that the pharmaceutical industry will be facing a situation where all old drugs have resistance and there are no new drugs.

So, what's the problem? Well, much of the recent public interest in pharmaceutical R&D concerns the relationship between drug prices, drug firms' costs, and the pace and direction of innovation.

What's more, R&D developments are currently trying to keep their heads above water amidst much healthcare debate - not least in the US, where President Barack Obama's current proposal for healthcare reform is causing considerable difficulties.

Mossialos recommends that governments need to introduce incentives that encourage pharmaceutical companies to develop new antibiotics, and he suggests an international fund that would invest in the early stages of antibiotic R&D, and guarantee sizable orders for new antibiotics.

The warnings are clear and concise. As Holloway reports: "If we run out of antibiotics it's not just poor people with infections who will suffer, it's people across the globe who will find they won't be able to have anti-cancer therapies or routine operations that today rely on antibiotics."

Antibiotics, like penicillin, are more than just a staple of the pharma industry - they are critical to the treatment of patients across the globe; and, without action, the pharma industry may soon be facing its biggest crisis in years.

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