Or GSK, which has partnered with a bunch of European universities to develop new antibiotics against gram negatives.
IIRC, general antibiotics have never lasted more than 18 months before we found a bacteria that became resistant to them. Pharma companies know this more than the rest of us.
They are betting/hedging on getting to market first with a multi-drug resistant (MDR) bug killer. Everyone on Earth will need a new antibiotic as the current MDR bugs become more widespread. And the more widespread the current MDR bugs are, the more valuable a fresh antibiotic would be (it would be an effective monopoly).
But this doesn't mean the drug won't be used. Drug resistance rates are often in the single percent of patients. You can have resistance out there, but still have a huge market.
Resistance is a continuum, not a binary state.
This does not seem to be correct. With the most recently introduced antibiotics—Levoflaxacin, Linezolid and Ceftaroline—resistance has developed very rapidly. But that didn't used to be the case; old antibiotics lasted much longer before resistance developed. [1]
I am not sure why this is---are these newer antibiotics more fragile (i.e., easier to resist), or are they being misused more broadly? If it is the latter reason, then perhaps we should stop developing new antibiotics until better usage practices are enforced. It is stupid to spend a lot of money developing antibiotics, only to throw it away by misusing them.
[1] http://www.nature.com/nature/journal/v509/n7498_supp/fig_tab...
In India, you can still buy antibiotics over the counter.
http://www.npr.org/sections/goatsandsoda/2015/09/17/44114639...
It's called the "ZeePack" or something of the sort (a play on the the azithromycin/zithromax 'Z-Pak') and is essentially vitamins and herbal supplements you can give to cold patients so they feel like they have been given something.
That kind of rates.
In the 1918 influenza pandemics for example, many people died of a bacterial pneumonia following the flu infection. So you see, the impact of "1-tier" infections is very real without antibiotics.
EDIT: by all means, downvoters, make your point explicit!
http://www.fda.gov/Drugs/DrugSafety/ucm341822.htm
Seems like one of the primary features of this antibiotic was to have a chemical that was new at the time, so patent protection could be enjoyed from that point forward.
Different features can have different priorities at different times, sometimes there's nothing "engineering" can do about it, it's a marketing thing.
Wherever cardiac health might fall on the priorities list, it's probably not way up there for this compound.
disclaimer: haven't worked for a drug producer since I was first out of college
- Differentiating "common cold" (viral infection) from a bacterial infection, which would be a correct indication for antibiotics, is often impossible. If you want the best chance for your particular patient, what will you do? Now, if you want the best chance for the whole patient population, what will you do? Not the same thing.
- If you don't give antibiotics, things turn wrong, and the patient's family comes back wielding pitchforks, what do you do? This is less of a problem nowadays, but in small communities and rural environments can still be a very real question.
This is also a bit of a cultural issue. Now, I agree completely that OTC antibiotics make no sense at all.
Of course this doesn't necessarily generalise, but there's plenty of older english people with the "I don't want to be a bother" mindset so it might do better than you think.
I am curious if this is true, ie: does medical science hold above as an accepted fact by general consensus?
I ask because my understanding is that the 1918 flu (aka Spanish flu) which was an H1N1 (upper respiratory infection in humans , intestinal tract in birds) predominantly killed young adults, ie: healthy non-immunocompromised people. Here's the wikipedia remark:
https://en.wikipedia.org/wiki/1918_flu_pandemic
"the 1918 pandemic predominantly killed previously healthy young adults."
"a rapid progressive respiratory failure and death through a cytokine storm (overreaction of the body's immune system). It was then postulated that the strong immune reactions of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults resulted in fewer deaths among those groups"
But there's some conflicting explanations: "special circumstances (malnourishment, overcrowded medical camps and hospitals, poor hygiene) promoted bacterial superinfection that killed most of the victims typically after a somewhat prolonged death bed "
You've got to remember, too, that it wasn't an especially virulent strain of influenza alone that caused the deaths from 1917-1919. It spread quickly among the war-weary, crowded, exposure-riddled young men who lived with chickens and hogs at the battlefronts. It was common practice at the time to logistically set up small-pen animals close to the long, mostly stable fronts as a source of local food rather than shipping in so much preserved food. Those young men then travelled far and wide across the continent and even overseas as their service rotations came and especially when hostilities ceased.
https://virus.stanford.edu/uda/ tells the story about as well and succinctly as any source. http://ww1centenary.oucs.ox.ac.uk/body-and-mind/the-spanish-... and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862337/ have lots of information.
As is common, the war's conditions and aftereffects killed far more people than died in combat. It was a nasty flu, but humans helped it out about the best we could.
1/5 chance it's Group A strep and worth throwing abx at. And... then what? We know the stats, we have a non-specific presentation, and the traditional reason to throw abx at this patient is because we want to minimize the chance of a subsequent heart or kidney disease (post-infectious immune hypersensitivity rxn). 4/5 chance they don't need abx; 1/5 chance that they'll benefit, but not a lot. But, hey,... how do you even attach a utility analysis to "and a small reduction in the likelihood of heart and/or kidney damage"? The magnitude of the risk is hard to comprehend, subjectively, in the face of the small reduction in incidence. And you will see those consequences play out; you're going to see so many sore throats that the small odds will manifest.
This isn't one of those, "stupid doctors, they don't know what they're doing!" things. It's something that doesn't readily yield to utility metrics.
...which is a big part of why it used to be common, and isn't now.
Why? Well the article practically spells out the why: pharma is not incentivised to bring new anti-biotics to market, but they can create lots of "new" ones that are similar to the old ones. Why not change the model, and create a system where pharma companies can churn out "new and innovative" anti-biotics, for a nice guaranteed government payout. "Win win" for pharma, politicians, and who knows - maybe farmers and people?
Cynical? Extremely. An element of truth in my view? Almost certainly.
The way I view it - we have too many different options available on the market. We should look to remove a decent % of them from circulation in as many countries as possible, to allow any resistant strains to lose their resistance. Yes, this would impact pharma companies, but their could be a rotational system with extensions to patents as required to keep them happy.
As a result, drug companies are looking at spending $100M to make a new drug, when they'd be lucky to make their money back on it.
I searched google.com for "increased antibiotic resistance over time" and found two sources that seem pretty legit. One is the World Health Organization, the other is the US National Library of Medicine. Both articles appear to address the question I believe you raised.
[0] http://www.who.int/mediacentre/factsheets/fs194/en/ [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/