NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Tuesday, June 25, 2013

Antibiotic-resistant bacteria, like the proverbial time bomb, are poised to wreak infectious havoc on a worldwide scale. Brad Spellberg, associate professor of medicine at the Los Angeles Biomedical Research Institute and the Harbor-UCLA Medical Center, is committed to defusing the bomb with the development of new antibiotics and creative platforms. He believes investigators must look at alternative ways to deal with bad bugs, perhaps by neutralizing their toxic effects rather than killing them. In this interview with The Life Sciences Report, Spellberg explores this critical issue and names four companies with novel technologies that address this looming global crisis.

The Life Sciences Report: The first thing I want to ask is if you believe it’s a hopeful sign that young physicians are less likely to prescribe antibiotics, especially at the patient’s request? Isn’t that a sign that residents and fellows are being trained with increasing awareness of bacterial resistance, an issue that is so important to you?

Brad J. Spellberg: I have not seen data to suggest that there is a generational effect. I think we are doing a better of job of talking about it than 20 or 30 years ago, when a large segment of the medical community thought that the problem was solved and we could just move on. There is still a huge amount of room for improvement. I see young physicians, old physicians, all physicians—and, frankly, even I have done it out of fear—prescribing antibiotics for infections that are highly unlikely to be bacterial all the time. Prescribing antibiotics for viral infections is certainly inappropriate. The other thing physicians do all the time—and there is absolutely no generational effect in my experience—is treat patients very broadly when narrow spectrum therapy is needed. They also treat for far longer than is needed. Both of these practices are inappropriate.

TLSR: Brad, your book, Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them, was published in September 2009. We know there is a threat of pandemic, but what do you mean by dwindling arsenal? Are you talking about a lack of will or desire to tackle this problem? Why is the arsenal dwindling?

BJS: The dwindling arsenal specifically refers to the collapse of the antibiotic research and development (R&D) pipeline. We have what has been accurately termed on Capitol Hill a market failure of antibiotics. The traditional capitalistic market has not supported antibiotic trials. It has collapsed. There are a couple of companies left, but most pharmas have gotten out of the business. The root causes of the collapse include a lack of awareness. We need to take action in other areas, such as pulling antibiotics out of animal feed, but raising awareness about what’s going on is also necessary.