抗生素的过去、现在与将来（英文PPT）课件.ppt

Medicine. Past, Present and Future.ANTIBIOTICS Professor Anthony Coates Medical Microbiology Department of Cellular and Molecular Medicine, St George’s, University of London. Microbes kill each other with antibiotics They have developed self-defence mechanisms: 1. Non-multiplying state 2. Biofilm 3. Genetic resistance The search for antibiotics begins Bacterial genetic resistance to antibiotics begins to neutralise the beneficial effects.  1945, in an interview with The New York Times, Fleming warned that the misuse of penicillin could lead to selection of resistant forms of bacteria The solution: Make new antibiotics to replace the old ones to which resistance has emerged. Antibiotic development 1929-72 The Antibiotic Paradox, Stuart Levy, New York, Plenum Press, 1992, 4 THE PRESENT Antibiotic resistance is rising 80 70 60 50 40 30 20 10 0 1990 1995 2000 2003 Percent of Resistant Strain MRSA QRPSE MRSPN/VRE PRSPN MRSA = methicillin resistant Staphylococcus aureus VRE = vancomycin resistant enterococci MRSPN = macrolide resistant Streptococcus pneumoniae PRSPN = penicillin resistant Streptococcus pneumoniae QRPSE = quinolone resistant Pseudomonas aeruginosa The number of new antibiotics which reach the market is falling Life-or-death Crisis: The Bacteria are winning Emergence of resistance is outpacing the introduction of new antibiotics (2003 Daptomycin; 2004 none; 2005 Tygacil ) No new agents in clinical development against multi-drug resistant gram-negatives eg Pseudomonas aeruginosa, Acinetobacter spp Why has the pharmaceutical industry reduced its production of new antibiotics?  Resistance emerges too quickly and reduces the effective life of an antibiotic Too little profit Big Biology has failed to produce new antibiotics Increased costs due to more regulation eg EC Litigation fears Government restrictions on use (Keep in reserve) Antibiotic