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January 05, 2016

Germs Are Winning the Antibiotics Arms Race

When human scientists develop a new antibiotic to kill a germ... how long do you think it takes before germs develop a resistance to the antibiotic? 10 years? 20 years?

If only that was true... In reality, it's only a few years now (typically less than three years).

Check out this table made by the CDC that shows when an antibiotic was created by humans on one side and when germs develop a resistance on the other side.


Some interesting things to note from the table:

- Penicillin was discovered in 1928 by Alexander Fleming. Resistance developed in 1940 before it was even made available for human use in 1943.
- In the beginning, antibiotics lasted quite awhile before resistance developed. But since the 1990s, resistance to new antibiotics developed rapidly, sometimes within months of introduction.

The fact that antibiotics are now only good for a few years (if even that) has profound implications not only from a health perspective, but also from a financial aspect.

Think about it... It takes decades and almost a billion dollars for a company to create and bring any new drug to market including antibiotics. The overall return on investment for a company to create a new antibiotic is extremely low if not pathetic because:

1) The antibiotic is probably only going to be "good" for a few years before it provides limited benefit (so they won't be able to sell very many)
2) Antibiotics are not that expensive compared to more lucrative drugs like cancer treatments where people are willing to pay thousands of dollars to prolong life only a few months
3) Antibiotics are taken only for a short period of time (limits how many companies can sell)

So if a drug company had a choice of what type of drug to focus on which would make them the most money, it would be one that:

1) A patient would have to take everyday for years (like diabetes, hypertension, cholesterol, etc)
2) They can charge a lot for one pill (like chemotherapy drugs)
3) Drug has a long lifespan for what it is being used for (unlike antibiotics which now don't seem to last even one year)

All this depressing news only serves to illustrate that antibiotics should be used sparingly and carefully because it is inevitable that germs will eventually become resistant to all antibiotics known to man and also because companies are not developing any new ones as they basically lose money in this endeavor.

Sources:
New Antibiotic Development: Barriers and Opportunities in 2012. APUA Newsletter 30(1). 2012.

Antibiotic Resistance Threats. CDC 2013
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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