Antibiotic resistance a new pandemia

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Antibiotic resistancea new pandemia
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Economic and social impact ofantibiotic
resistance

• ca. 25 000 patients per year die from antibiotic
  resistant infections
• ca. 2.5 Mio. extra hospital days to a cost of
  EUR 900 Mio.
• Out-patient care costs increase ca. EUR 10 Mio.
• Loss of work costs EUR 150 Mio.
• Productivity losses are estimated to around EUR
  150 Mio.

? Overall social costs of antibiotic-resistant
infections are estimated to EUR 1.5 billion each
year.
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Recent initiatives

• European Antibiotic Awareness Day
• EU/US transatlantic task force on antibiotic
  resistance
• A conference on incentives for effective
  antibiotics hosted by the Swedish EU presidency

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Methicillin-resistant S. aureus (MRSA) - most
common multidrug resistant bacterium in EU
MRSA in Europe 2006. S.aureus Proportion of
invasive isolates resistant to oxacillin (MRSA)
in 2006. These countries did not report any
data or reported less than 10 isolates, Source
http//www.earss.rivm.nl, March 2008
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An increasing problem is resistance among
Gram-negative bacteria
The biggest challenge is treatment of infections
caused by penicillin resistant bacteria so
called ESBL (extended spectrum beta-lactamase)
In Sweden, this year, 3 children died during a
few weeks in neonatal care in a Swedish hospital
due to a ESBL infection
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The industry has failed to launch new antibiotics

• Between 1996 and 2004 more than 125
  antibacterial screens on 60 different
  antibacterial targets were run by 34 companies
• None of these efforts resulted in novel mechanism
  compounds.
• Pharmaceutical companies left the antibacterial
  sector

?The industrial failure to meet the need of new
antibacterial drugs indicates that novel
approaches are needed to combat antibiotic
resistant infections
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What can be done immediately?
Create a task force on EU level and national
level against antibiotic resistance to take
immediate actions
Legislation Restricted use of antibiotics, e. g.
clear rules how antibiotics should be used in
whole EU to minimize the spread of antibiotic
resistance Surveillance/Epidemiology Develop a
monitoring systems including a large database to
monitor the epidemiology of antibiotic resistance
and make this information rapidly available which
also should include details about the infecting
organism as such,meta-genomics
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? reduce the need of antibiotics through disease
prevention
What can be done immediately?
Improve hygiene Combination therapy of known
antibiotics to improve effect of treatment and
possible resistance development New and improved
methods for rapid diagnosis of the infectious
agents and resistance patterns based on large
scale genome sequencing
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? find new anti-bacterial agents or therapies
with novel mechanisms of action that will limit
resistance development
What can be donein a sustainable perspective?
Characteristics of the ideal novel antibiotic

• Narrow spectrum
• Coupled to rapid diagnosis
• Not leading to resistance

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EU international leading research on molecular
mechanisms of microbial pathogenesis
Areas of research that will have the highest
probability to solve the antibiotic resistance
problem

• Anti virulence strategies to disarm infectious
  bacteria
• Functional genomics - targeted drug design
• Continue high throughput screening of natural
  products
• Novel vaccines based on meta-genomics
• Therapeutic antibodies
• Antibacterial peptides

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When do we expect results?
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Joint Programming- the way forward

• Maximise the effectiveness of research efforts
  through coordination of funding and resources
• Boost research advances and innovations
• Increase competitiveness of the EU on a global
  scale

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European Centre for Disease Control (ECDC)
European Medicines Agency (EMEA) report

• gt 25 000 patients in the EU die each year from
  infections caused by multidrug-resistant bacteria
• antibacterial drug resistance - one of the major
  health threats in Europe

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EU translational research
Development of new antimicrobials in biotech
companies

• Support for small and medium sized biotech
  companies needed
• Coordinated funding in EU networks of excellence

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• Epidemiology and surveillance
• Informatics based on genomics
• Rapid diagnosis
• Prevention and treatment of infection
• Rapid diagnosis
• Improved hygien
• Novel anti-microbial drugs

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Swedish MRSA cases 2000-2009
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Swedish ESBL cases 2005-2009