The dearth of new antibiotic development: why we should be worried and what we can do about it
The dearth of new antibiotic development: why we should be worried and what we can do about it
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DOI：
10.5694/j.1326-5377.2004.tb06444.x
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发表时间：
2004-11-15
影响因子：
11.4
通讯作者：
Grayson, ML
中科院分区：
文献类型：
--
作者：
Charles, PGP;Grayson, ML
在过去20年中，耐多药病原体的出现和传播大幅增加。在同一时期，新抗生素的开发惊人地减少，许多制药公司退出抗生素研究，转而开发“生活方式”药物。退出抗生素开发的原因包括抗生素的“净现值”状况不佳，法规的变化需要更大规模的药物试验和长期的上市后监测，临床偏好窄谱而不是广谱药物，以及高昂的新药购买成本。澳大利亚需要在感染控制方面取得重大进展，以防止耐药克隆的进一步传播，争取时间开发急需的新抗生素制剂。延续“抨击制药”的文化只会导致更多的制药公司退出市场。需要改变卫生和研究文化，以改善公共、学术和私营部门之间的合作。
The emergence and spread of multidrug-resistant pathogens has increased substantially over the past 20 years.Over the same period, the development of new antibiotics has decreased alarmingly, with many pharmaceutical companies pulling out of antibiotic research in favour of developing "lifestyle" drugs.Reasons given for withdrawing from antibiotic development include poor "net present value" status of antibiotics, changes in regulations requiring larger drug trials and prolonged post-marketing surveillance, clinical preference for narrow-spectrum rather than broad-spectrum agents, and high new-drug purchase costs.Major improvements in infection control in Australia are needed to prevent further spread of resistant clones, buying some time to develop urgently needed new antibiotic agents.Perpetuating a culture of "pharma bashing" will simply lead to more pharmaceutical companies withdrawing from the market. A change in the health and research culture is needed to improve cooperation between public, academic and private sectors.