1、Antibiotic resistance a new pandemia,Economic and social impact of antibiotic 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. Pr
2、oductivity losses are estimated to around EUR 150 Mio., Overall social costs of antibiotic-resistant infections are estimated to EUR 1.5 billion each year.,Recent initiatives,European Antibiotic Awareness Day EU/US transatlantic task force on antibiotic resistance A conference on incentives for effe
3、ctive antibiotics hosted by the Swedish EU presidency,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,Methicillin-resistant S
4、. aureus (MRSA) - most common multidrug resistant bacterium in EU,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 childr
5、en died during a few weeks in neonatal care in a Swedish hospital due to a ESBL infection,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 nove
6、l 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,What can be done immediately?,Legislation Restricted use of antibiotic
7、s, e. g. clear rules how antibiotics should be used in whole EU to minimize the spread of antibiotic resistanceSurveillance/Epidemiology Develop a monitoring systems including a large database to monitor the epidemiology of antibiotic resistance and make this information rapidly available which also
8、 should include details about the infecting organism as such,meta-genomics,Create a task force on EU level and national level against antibiotic resistance to take immediate actions,Improve hygiene Combination therapy of known antibiotics to improve effect of treatment and possible resistance develo
9、pmentNew and improved methods for rapid diagnosis of the infectious agents and resistance patterns based on large scale genome sequencing, reduce the need of antibiotics through disease prevention,What can be done immediately?,Characteristics of the ideal novel antibiotic,Narrow spectrum Coupled to
10、rapid diagnosis Not leading to resistance,What can be done in a sustainable perspective?, find new anti-bacterial agents or therapies with novel mechanisms of action that will limit resistance development,Anti virulence strategies to disarm infectious bacteria Functional genomics - targeted drug des
11、ign Continue high throughput screening of natural products Novel vaccines based on meta-genomics Therapeutic antibodies Antibacterial peptides,Areas of research that will have the highest probability to solve the antibiotic resistance problem:,EU: international leading research on molecular mechanis
12、ms of microbial pathogenesis,When do we expect results?,Maximise the effectiveness of research efforts through coordination of funding and resourcesBoost research advances and innovationsIncrease competitiveness of the EU on a global scale,Joint Programming- the way forward,European Centre for Disea
13、se Control (ECDC) European Medicines Agency (EMEA) report:, 25 000 patients in the EU die each year from infections caused by multidrug-resistant bacteriaantibacterial drug resistance - one of the major health threats in Europe,Support for small and medium sized biotech companies needed Coordinated
14、funding in EU networks of excellence,Development of new antimicrobials in biotech companies:,EU: translational research,Epidemiology and surveillanceInformatics based on genomicsRapid diagnosisPrevention and treatment of infectionRapid diagnosisImproved hygienNovel anti-microbial drugs,Swedish MRSA cases 2000-2009,Swedish ESBL cases 2005-2009,
