Antimicrobials & Antibiotic Resistance

Bacteria can acquire antibiotic resistance genes from other bacteria in several ways. By undergoing a simple mating process called "conjugation," bacteria can transfer genetic material, including genes encoding resistance to antibiotics (found on plasmids and transposons) from one bacterium to another. Antibiotic resistance genes have been identified in diverse environments including soil, gull feces and, increasingly, in the human gut microbiota. Scientists have applied a range of approaches to detect antibiotic resistance genes in environmental or non-clinical microbiomes, all of which have their own inherent strengths/limitations.

Proteomic studies have improved our understanding of the microbial world. The most recent advances in this field have helped us to explore aspects beyond genomics. Proteomics has also advanced our knowledge of mechanisms of bacterial virulence and some important aspects of how bacteria interact with human cells and, thus, of the pathogenesis of infectious diseases. We have used proteomic technology to elucidate the complex cellular responses of Bacillus subtilis to antimicrobial compounds belonging to classical and emerging antibiotic classes.

Increasing drug resistance is caused primarily by inappropriate use of antimicrobials in humans as well as in animals, and spread of resistant strains between the two. Antibiotics develop selective pressure in bacterial strength, resulting accessible bacteria to die; this enhances the percentage of resistant bacteria which continue increasing. With resistance to antibiotics becoming more common there is greater need for alternative treatments. New antibiotic therapies have been needed, but new drug development is becoming scarce.

A World Health Organization (WHO) report released April 2014 stated, "This serious threat is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance—when bacteria change so antibiotics no longer work in people who need them to treat infections—is now a major threat to public health. Increasing public calls for global collective action to address the threat include proposals for international treaties on antimicrobial resistance.

The use of antimicrobials in animals closely parallels their discovery and usage in humans. Sulfonamide was the first antimicrobial to be introduced to food animal medicine in the 1940s. Antimicrobial resistance emerges from the use of antimicrobials in animals and the subsequent transfer of resistance genes and bacteria among animals and animal products and the environment. Antibiotics are also given to food animals for growth promotion and prophylactic medication. In 2011, a total of 13.6 million kilograms of antimicrobials were sold for use in food-producing animals in the United States, which represents 80% of all antibiotics sold or distributed in the United States. Of the antibiotics given to animals from 2009 through 2013, just above 60% distributed for food animal use are "medically-important" drugs, that are also used in humans. The rest are drug classes like ionophores which are not used in human medicine. here are also global concerns over the use of antibiotics for growth promotion or therapy purposes because of the potential for some drugs to enter the human food chain despite rigorous withdrawal measures and testing to prevent antibiotic residues in food, increasing antibiotic resistance in animals, a potential although largely unproven link to antibiotic-resistant infections in humans, and what some consider antibiotic misuse. When government regulation restricts use of antibiotics the negative economic impact is not often considered.

There is a renewed interest in the antibiotic sector, which is evident from the most recent patents and investments. Bacterial vaccines and new antibiotic classes are gaining a tremendous amount of attention with several product candidates in clinical development. These new products are expected to change the outlook of the antibiotic sector to a large extent over the next 5 years. Several reports focus on anti-infective markets in general. This report, however, focuses exclusively on antibacterials, with a particular emphasis on the emerging problem of antibiotic resistance. It also includes a detailed analysis of the emerging technology trends, which give a clear picture of the future of the sector. This helps to provide regulatory authorities and industry strategists a better perspective on which to base their decisions. BCC Research published a report on this topic in 2002. Since then, the market has witnessed dramatic changes in terms of technology, investment, and regulatory trends, which are captured in this report.

This topic reviews the global antibiotic markets, including discussions on the market development and growth potential over the next 5 years. It also analyses key factors that are driving the market growth. It describes the trends in detail with respect to various antibiotic classes, including the novel classes that are emerging and their technological basis. It includes in-depth discussions of the industry structure and the regulatory environment. It is valuable reading for investors, policymakers, and industry participants. Profiles of leading players in the industry are also included.

Such involved analyses have been conducted to help strategy developers and decision makers within pharmaceutical companies and government bodies. The detailed analyses of the regulatory factors that play major roles in deciding the industry trends are especially useful for legislators involved in government policy development programs. Technology trend and patent analyses give an overview of the new trends with respect to innovation within the sector.

In the time since penicillin was discovered nearly 80 years ago, antibiotics have become one of the most important lifesaving weapons in doctors' arsenal against bacterial infection. Now, the Lakeland, Fla.-based Publix grocery store chain is giving away seven of these drugs free of charge to those who have prescriptions for them. Five of these are amoxicillin, ampicillin, cephalexin, erythromycin and penicillin VK -- are commonly used by doctors to treat bacterial infections ranging from ear infections to gonorrhea. But two of the drugs on the list -- ciprofloxacin and sulfamethoxazole/trimethoprim -- are high-grade antibiotics that doctors usually reserve for particularly serious infections.

While some hail the program as a godsend, others fear that the move could lead to overuse of the drugs.

This is because the use of antibiotics comes attached with important considerations. According to the American Academy of Family Physicians, there are certain situations in which antibiotics are helpful -- and many in which they can cause more harm than good.

Penicillins, Cephalosporins, Aminoglycosides, Glycopeptides, Tetracyclines are antibiotics most commonly showing side effects.

The analysis of antibiotic susceptibility disks by high-pressure liquid chromatography (HPLC) methods are presented for the potency determination of mecillinam, ampicillin, carbenicillin, and cephalotjiin alone and in various combinations. Good agreement between HPLC and microbiological data is observed for potency determinations with recoveries of greater than 95%. Relative standard deviations of lower than 2% are recorded for each HPLC method. HPLC methods offer improved accuracy and greater precision when compared to the standard microbiological methods of analysis for susceptibility disks. The most popular analytical methods for the determination of beta-lactams are the chromatographic ones, including high performance liquid-chromatography (HPLC) and thin layer chromatography (TLC).

HPLC offers high sensitivity and separation efficiency, establishing itself as the first choice method for the analysis of beta-lactams; however it is expensive and requires sophisticated equipment. TLC is a less expensive and less complicated chromatographic procedure, which can be successfully used, in the preliminary screening of pharmaceutical substances. In modern analysis, TLC is usually used as a separation method, which establishes the presence or absence of beta-lactam antibiotics above a defined level of concentration.

Antibiotics have been applied for the treatment of autoimmune diseases for over five decades, based on the premise that infections play a role in the initiation and propagation of these entities. The antibiotics market was valued at USD 39.8 million in 2015 and is expected to witness a CAGR of 4.0% over the forecast period. Increasing efforts are being witnessed toward the development of advanced products. According to the data published by the Pew Charitable Trust, in March 2016, about 37 promising molecules were being investigated within the U.S. market. Majority of these, are in phase II clinical trials and are anticipated to hit the market between 2018 - 2020. Furthermore, supportive government legislations, such as the Generating Antibiotics Incentives Now (GAIN) Act are expected to expedite the approval process. GAIN Act has provisions which facilitate development of therapy against antibiotic resistant pathogens .

Antibiotics are a type of antimicrobials that are used in treatment and prevention of bacterial infections. They may kill or inhibit the growth of bacteria. Many antibiotics are also effective against protozoans and fungi; some are toxic to humans and animals also, even when given in therapeutic dosage. Antibiotics are not effective against viruses such as common cold or influenza, and may be harmful when taken inappropriately. Physicians must ensure the patient has a bacterial infection before prescribing antibiotics.

Certain bacterial infections now oppose all antibiotics. The resistance problem may be reversible, but only if society begins to acknowledge how the drugs affect "good" bacteria as well as "bad". Historically, most antibacterials were used in hospitals, where they were integrated into surgical clothes and soaps to limit the spread of infection. More recently, however, those substances (including triclosan, triclocarbon and such quaternary ammonium compounds as benzalkonium chloride) have been mixed into lotions, dish-washing detergents and soaps meant for general consumers. They have also been impregnated into such items as cutting boards, toys, high chairs and mattress pads.

Antibiotics must be used accordingly in humans and animals because both uses share to the emergence, persistence, and escalation of resistant bacteria. Resistant bacteria in food-producing animals are of particular concern. Food animals play as a source of resistant pathogens and resistance mechanisms that can directly or indirectly result in antibiotic resistant infections in humans. Resistant bacteria may be transmitted to humans through the foods we eat. Some bacteria have turned resistant to more than one sort of antibiotic, which makes it more difficult to treat the infections they cause. Sustaining the efficiency of antibiotic drugs is vital to insulating human and animal health.

Environmental microbes are a leading source of drug discovery, and several microbial products ( anti-tumour products, antibiotics, immunosuppressants and others) are used frequently for human therapies. Most of these products were accessed from cultivable (<1%) environmental microbes, means that the large number of microbes were not targeted for drug discovery. With the onset of new and emerging technologies, we are poised to harvest novel drugs from the so-called 'uncultivable' microbes. Multidisciplinary way of linking different technologies can assist and reform drug discovery from uncultivable microbes and inspect the current cramp of technologies and scenario to swamped such constraints that might further expand the promise of drugs from environmental microbes.

Prescribing doctors are, progressively, using clinical trial data as a major source of information for evidence-based medicine for the remedy of infectious diseases, as in other clinical disciplines. However, it may be difficult to excerpt from these data the material that is needed for the management of the individual patient. At the same time, clinical trial testimony have been used, probably satisfactorily, in the process of drug registration, and the pharmaceutical industry has spent progressively large amount of money to satisfy the needs of this process. In the face of all these problems, switch in the way antibiotic clinical trials are designed and performed are clearly necessary, although this must not disturb the balance so far as to restore them less useful for those who currently derive greatest benefit from them.

The discovery of a new antibiotic called teixobactin was announced by international team of researchers, in January this year. It is the most significant new antibiotic to be discovered in more than 30 years, and it may help combat the growing number of drug-resistant bacteria.

This new method uses the enzymes of bacteriophages to attack the bacteria. Bacteriophages are tiny viruses that infect bacteria. After they infect the bacteria, they replicate or make copies of themselves, and then leave the bacteria to go and infect other bacteria. To be able to leave the bacteria, the "phages" make an enzyme that dissolves the wall of the bacterial cell, thus killing it.