Experts say the next pandemic will be caused by the antibiotic resistance. The term “superbacteria” was even coined to refer to those species capable of surviving all antibiotics known to date.
Recently, the World Health Organization (WHO) updated the list of the 15 most dangerous families of bacteria, all of them resistant to antibiotics. In the catalog there are, for example, Acinetobacter baumannii carbapenem-resistant (CRAB) – which kills 60% of those infected – and Mycobacterium tuberculosis resistant to rifampicin. Tuberculosis is the infectious disease that caused the most deaths throughout history and today continues to be the most lethal bacterial infection.
If we do not have medications to treat these types of infections, we are facing a war without weapons and we have everything to lose.
An arms race
It is well known that Alexander Fleming discovered the first antibiotic, penicillin, back in 1928. Since then, the discovery of new bactericidal drugs has renewed hope for fighting the bacteria that were winning the battle. However, they also learned new strategies to evade its effect. And back to square one.
The so-called drug resistances increase at the same time that we have fewer antibiotics available. Access to them is becoming increasingly difficult, and not only in developing countries.
The data is alarming: one person dies from antibiotic resistance every 6 secondsAccording to the WHO, this problem kills more than one million people a year and it is estimated that the number could increase to 10 million by 2050.
For example, a patient with an infection Staphylococcus aureus methicillin-resistant bacteria (MRSA) are 64% more likely to die than someone infected with the same antibiotic-sensitive bacteria.
New antibiotics with droppers
This is a problem that affects us all, but the development of new drugs is a long and expensive process. In the case of antibiotics, furthermore, many pharmaceutical companies are not interested due to their low retail price compared to other groups of medications.
In order to combat multi-resistant bacteria, the WHO created a non-profit organization: the Global Alliance for Antibiotic Research and Development. In addition, more than twenty pharmaceutical companies formed another international alliance, the ARM Action Fund, which has set itself the goal of launching between two and four new antibiotics in the next decade.
The powers of zosurabalpine
The discovery of a new antibiotic is a cause for great joy in the scientific community. And even more so if that new drug is effective against a superbacteria. This is the case with zosurabalpine, directed against Acinetobacter baumannii carbapenem-resistant bacterial (CRAB).
This bacterium was declared a critical priority by the WHO, and an urgent threat by the Centers for Disease Control and Prevention (CDC) of the United States. It causes outbreaks of hospital-acquired infections, affecting seriously ill patients with respirator-associated pneumonia and septicemia (bacteria in the blood).
Zosurabalpin prevents the CRAB bacteria from exposing a molecule called lipopolysaccharide on its outer layer, which acts as a toxin and allows it to form its outer membrane. By inhibiting the lipopolysaccharide transport system from the inside to the outside of the bacteria, the bacteria lose their ability to survive and become more sensitive to other antibiotics.
The new drug, developed by the pharmaceutical company Roche, is already being tested in phase I clinical trials on humans.
Lolamycin: respectful of the intestinal microbiota
The discovery of lolamycin, effective against a panel of more than 130 clinical isolates of different multidrug-resistant pathogens, was also recently published. It demonstrated efficacy in mouse models against acute pneumonia and sepsis infection.
In addition, lolamycin is able to selectively kill Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae, attacking a protein transport system present exclusively in this type of microorganisms. This makes it a drug that is respectful of the mouse’s intestinal microbiota, a great advantage over the rest of the known antibiotics.
It should be noted that bactericides are a double-edged sword, as they not only eradicate the pathogens causing the infection, but they also tend to kill the bacteria in our microbiota, which causes unwanted effects such as diarrhea or candidiasis. Lolamycin could even prevent diarrhea caused by colonization of Clostridium difficile after taking antibiotics.
Emblaveo: tests passed
And there should be great joy when a new antibiotic against multi-resistant bacteria passes the required clinical trials and can be marketed. This is the case of Emblaveo (aztreonam-avibactam), developed jointly by the pharmaceutical companies Pfizer and AbbVie, which has demonstrated its efficacy in treating various serious infections in patients with no or few therapeutic options.
Specifically, Emblaveo is indicated for the treatment of complicated intra-abdominal and urinary infections, hospital-acquired pneumonia, and infections caused by multidrug-resistant aerobic Gram-negative pathogens. The European Union gave the green light to put it into circulation on April 22.
All of these weapons give us some hope in the battle against superbugs. We develop new antibiotics and they create new resistance. Therefore, the only viable option to avoid drug resistance is to promote a Rational and appropriate use of new antibiotics. Let’s not let them turn into wet gunpowder, as has happened until now.
* Teaching and research staff at the Faculty of Health Sciences, Universidad San Jorge. The Conversation.
