David Cameron has announced a review into why so few antimicrobials have been introduced over recent years. This seems to be too little too late. The impending car crash in healthcare of death from minor surgeries and incidental infections looms over us all. I have seen patients in critical care die of infections because we literally had no drugs left to treat them with. The continued evolution of bugs – MRSA and others– against our best drugs has been a huge problem for some time, one that rightly makes headlines problems. But it is hard for a society to take a such a grave threat seriously until it reaches epidemic proportions – and by then, it is not an exaggeration to say, we could all be at risk.
I have heard unsubstantiated rumours that there is not a single new antibiotic in development. The problem is simple, antibiotics are not profitable. We have discovered all the ‘easy’ ones and further drugs will take a lot of research. It is expensive for drug companies to bring a drug to market, and during much of the 20 year patent a new antibiotic will be reserved as a last line of defence and will not create a lot of revenue. Eventually as it begins to be used a lot, it stops working as selection pressure becomes applied to the already drug resistant bacteria it is designed to eliminate. In short, drug companies seek profit not public health and new antibiotics don’t promise great profits.
Medicine has accommodated as much as it can in recent years with what’s called ‘antibiotic stewardship’ — that is, guidance on who gets which antibiotics and why from experts becoming commonplace, falling GP prescriptions and public health education on when antibiotics are not required. But it isn’t nearly enough. The government needs to take this problem more seriously — and tackle it with ever more urgency.
Steven Vates is currently a final year medical student at Warwick Medical School, and hopes to train in psychiatry after graduating in 2015. Prior to this he practised as a registered nurse in critical care.