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04-11-07

Untreatable Infections, MDR

MDR (Multi-Drug Resistance) is a critical worldwide problem. Increasingly, common pathogens are evolving resistance to antibiotics. This is leaving many diseases effectively untreatable - diseases that just a few short years ago could be easily cured.

A key factor behind MDR is overuse of antibiotics. This overuse effectively turbo charges evolution by exposing more pathogens than necessary to selective pressures. As a result the microbes evolve even more quickly, soon overwhelming all possible treatments.

The MDR syndrome was first commonly noted with Tuberculosis, which now is reaching epidemic proportions in some regions of the world due to its resistance to treatment. MDR-TB is also a common killer in hospital settings, even in the developed world.

But the problem is now pervasive. Chloroquine - once the first-line treatment for malaria- is no longer effective in over 80 countries. Dysentery is now 90% immune to the two first-line drugs. Typhoid epidemics are increasingly immune to treatment.

The implications are most immediate for non-developed world. Here cost is a more important factor and so options are limited. But don't think the problem stops there. In 1999, 14,000 patients in the US died from drug-resistant bacteria.

What about developing new antibiotics? Unfortunately, due to a combination of complacency and economics, very few new drugs are coming to market. For years little research went into new drug discovery for antibiotics, since this was considered a solved problem. Further, there wasn't (and isn't) much money in such drugs. This provided little incentive to firms, who therefore tended to focus on the more profitably degenerative and geriatric diseases.

It's worth noting that MDR is of great interest for biological warfare. A great deal of work is going into outfitting weaponized pathogens with the genes for MDR. There is great value in having an anthrax weapon, for instance, that is invulnerable to all treatments and vaccines.

Link: WHO 1999 Infectious Disease Report
Link: Report on MDR Tuberculosis
Link: Another article on Tuberculosis and Antibiotic Resistance
Link: Report on old and emerging diseases, environment, MDR
Link: Status Report on MDR Malaria in SE Asia - And Probable Spread
Link: Outbreaks of MDR-Salmonella in the United States
Link: Some Statistics On MDR
Link: Drugs Failing Against Indian MDR-Typhoid
Link: MDR Fact Sheet
Link: Cipro losing its ability to fight germs (anthrax, fluoroquinolones)