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Home Publications e-pharmalink e-pharmalink December 2008
e-pharmalink December 2008

Ecumenical Pharmaceutical Network (EPN) is an independent, non-profit Christian organization whose mission is to increase access to medicines and health services through facilitating the development of compassionate, just, and sustainable quality pharmaceutical care through the church health care system.

e-pharmalink newsletter aims at equipping pharmacists and other health professionals with information about international trends relevant to their work and opportunities that could support them in their efforts to provide effective and efficient services. It is a summary of news reported by a wide range of publications or organizations and includes web links to the original sources. Anyone can receive this e-mail.

This edition focuses on antimicrobial resistance (AMR) and infectious diseases

For thought …..

“We currently have effective medicines to cure almost every major infectious disease. But we risk losing these valuable drugs and our opportunity to eventually control many infectious diseases because of increasing antimicrobial resistance....If the world fails to mount a more serious effort to fight infectious diseases, antimicrobial resistance will increasingly threaten to send the world back to a pre-antibiotic age,”-Gro Harlem Brundtland  

News

Resistance to antiretrovirals among children in the Central African Republic
Investigators from the Central African Republic and France designed a study involving 52 children receiving HIV treatment whose median age was eight years. The researchers determined the HIV subtype with which these children were infected. Adherence to treatment was assessed using a questionnaire, and changes in CD4 cell percentage and count as well as viral load were measured six months after the initiation of antiretroviral therapy. Data were also gathered on the presence of drug resistance.

A total of 26 children had resistance tests. Only 23% had HIV that was fully sensitive to anti-HIV drugs, the remaining 77% having HIV that was resistant to at least one anti-HIV drug. Overall, five (19%) had resistance to one drug in their treatment, 4 (54%) to two drugs and one (4%) to all three drugs.
http://www.aidsmap.com/en/news/C8F78456-49CD-4E68-A837-7C2379CB665D.asp

South African resistance survey confirms that HIV clade C is more likely to develop multi-drug resistance mutation
A survey of resistance among recipients of HIV therapy in South Africa has found that HIV clade C – the predominant subtype in southern Africa – is much more likely to develop the dangerous K65R resistance mutation, which confers resistance to most of the nucleoside (NRTI) drugs except AZT. Furthermore, whereas K65R is normally seen in patients failing tenofovir, abacavir or ddI treatment, among clade C patients it was common in patients failing therapies including d4T (stavudine).
http://www.aidsmap.com/en/news/2E39FB01-5534-444D-B693-72BDDD17BABC.asp

Wales losing fight against infections
The Welsh Assembly Government has launched a new leaflet stressing to the general public that antibiotics are either not required or not effective for many ailments, and taking antibiotics when they are not needed may reduce their effectiveness when a patient is most in need of them.
http://www.newswales.co.uk/?section=Health&F=1&id=15620

Treating food animals with antibiotics could lead to serious health consequences for human beings.
The potential for danger from antibiotic use in farm animals comes in two forms, experts say: The antibiotics could remain in meat when people eat it. They could also contribute to the development of resistant bacteria.

If people are getting a dose of antibiotics every time they have a hamburger or a piece of chicken -- or a turkey drumstick -- this exposure could possibly be harmful. We all have benevolent bacteria in our bodies, and the antibiotics we eat could kill those good bacteria. Also, some people are sensitive to antibiotics, with reactions ranging from diarrhea to itching to seizures, and they could have these reactions to the food they eat.
http://www.latimes.com/features/health/la-hew-turkeybiotics24-2008nov24,0,1183307.story

Six bad bugs increasingly escaping effects of antibiotics
Infectious disease experts warn that new drugs are urgently needed to treat six drug-resistant bacteria that cause most hospital infections and increasingly escape the effects of antibiotics.

Enterococcus faecium, Staphylococcus aureus, Klebsiella species, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species - are among the biggest threats infectious diseases physicians face today," said Helen Boucher, MD, of Tufts Medical Center in Boston, lead author of the new report, published in the January 1 issue of Clinical Infectious Diseases and now available online. "We desperately need new drugs to fight them. But we also need cooperation among industry, academia, and government to create a sustainable R&D infrastructure that will fill the pipeline to meet today's needs and keep it filled with drugs that tackle tomorrow's infectious diseases threats."
http://www.news-medical.net/?id=43634

MRSA's threat continues
According to a recent report from the CDC, more people in the U.S. now die from methicillin-resistant Staphylococcus aureus (MRSA) than from the long-feared HI Virus.

The report also revealed MRSA was responsible for an estimated 94,000 life-threatening infections and 18,650 deaths in 2005. That same year, roughly 16,000 people in U.S. died from AIDS, cite CDC figures. The national estimate is more than double the invasive MRSA prevalence reported by CDC researchers 5 years earlier.

MRSA - first reported in the early 1960s - is now regarded as a major hospital-acquired pathogen worldwide. Nearly 35 percent of U.S. hospital strains of are resistant to methicillin or other penicillin antibiotics, and in recent years the emergence of vancomycin-resistant S. aureus (VRSA) has caused additional concern.
http://lpn.advanceweb.com/editorial/content/editorial.aspx?cc=189379

Drug Development

Two-phase resistance to emergence of microbial resistance: the example of insects
In less than an hour, the immune system of the beetle Tenebrio molitor neutralizes most of the bacteria infecting its hemolymph (the equivalent to blood in vertebrates); this is rendered possible by a cascade of ready-to-use cells and enzymes. Bacteria that resist these "front-line" defenses are then dealt with by antimicrobial peptides – a sort of natural antibiotic – which halt their proliferation.

A clearer understanding of these actors in insect immunity may make it possible to design treatments that prevent the development of drug resistance. This has been shown in the results of a study carried out by the Equipe Ecologie Evolutive in the Laboratoire Biogéosciences (CNRS/Université de Bourgogne in Dijon), in collaboration with a British research group.
http://www.physorg.com/news146925795.html

New antibiotic against serious infections
The Committee for Medicinal Products for Human Use (CHMP) has recommended approval for the antibiotic, ZEVTERA(TM) (ceftobiprole medocaril) for the treatment of complicated skin and soft tissue infections. The CHMP's positive opinion is now referred for final action to the European Commission.

Ceftobiprole is the first, broad-spectrum, anti-MRSA cephalosporin antibiotic with activity against a range of difficult-to-treat Gram-positive and Gram-negative hospital- and community-acquired infections including methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa.

In clinical trials, ceftobiprole has demonstrated high cure rates in patients with complicated skin infections, including those with deep wound and diabetic foot infections, and in infections caused by the potentially deadly MRSA.
http://www.finanznachrichten.de/nachrichten-2008-11/12443738-new-antibiotic-against-serious-infections-007.htm

Novel antibiotic class also active against malaria parasite
A new class of antimicrobial agent with broad-spectrum activity has been found to kill Plasmodium falciparum, the parasite that causes the most lethal form of human malaria. University of Pennsylvania pharmacologist Doron Greenbaum, Ph.D., presented these results, from in vitro experiments, at the 48th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), held in Washington, D.C. from October 25-28.

Dr. Greenbaum reported that Bacterial Amphiphilic Antibiotic Compounds (BAACs), discovered at U. Penn and developed by Radnor, Penn.-based biopharmaceutical company PolyMedix, irreversibly kill P.falciparum while sparing human red blood cells. Plasmodium species are responsible for the nearly 500 million cases of malaria worldwide and as many as two million deaths, most of them in children. As with anti-microbial agents, first-line malaria agents are losing effectiveness due to development of resistance to drugs by the target organisms.
http://www.medicalnewstoday.com/articles/128173.php

Position Papers

SHEA and IDSA joint committee on the prevention of antimicrobial resistance in hospitals.
The position paper offers guidelines for the prevention of antimicrobial resistance in hospitals
http://www.shea-online.org/assets/files/position_papers/AntimicroResist97.PDF

Antimicrobial use in long term-care facilities.
The paper outlines  the concerns  regarding  adverse  consequences  of inappropriate  antimicrobial use  in long term  care facilities  and recommends best  approaches  to promote  rational use.
http://www.shea-online.org/assets/files/position_papers/Abx-LTCF96.PDF