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Shannon continued , “ The other societal construct is drug development . This is a pretty tricky space for pharmaceutical companies , as there is no real financial incentive for them to put in the time , the money , and the effort to research and produce antimicrobials . Since 1990 , we ’ ve seen a considerable number of pharmaceutical companies reduce or eliminate antibiotic research . We have also gone 38 years with no new antibiotic classes to treat Gram-negative infections . Thankfully , we ’ ve started to see some new combo drugs that are helping in that space , but they are quite expensive . Then , the process to get through the Food and Drug Administration ( FDA ) trials of antimicrobial agents is quite time-intensive , quite rigorous , and only about 20 percent of antimicrobial agents that reach human trials are approved by the FDA . While we don ’ t want ineffective or harmful antimicrobials on the market , it is such a difficult pipeline to get through that we need to make sure that we ’ re trying to incentivize our pharmaceutical companies to re-start antimicrobial research .”
Shannon reviewed the basics of antibiotics , noting the two types that impact bacteria : bacteriostatics and bactericidals . “ Bacteriostatic antibiotics such as Erythromicin and Tetracyclines wrangle the bacteria
We know antibiotics are important , and we realize they don ’ t come out of the pharmaceutical pipeline as quickly as we need them to . We also know how fast resistance develops . Essentially , antibiotic resistance can spread from person to person , with or without symptoms , which is part of the problem .”
and keep them at bay , preventing them from proliferating , which also helps our immune system to fight off the infection . They weaken the bacteria . Bactericidal antibiotics such as Vancomycin and Beta-lactams actively kill the bacteria .”
Shannon pointed to spectrum-of-activity charts that help classify organisms against various antibiotics that are either considered to be broad-spectrum antimicrobial or narrow-spectrum .
“ For example , Vancomycin is a narrow-spectrum antibiotic , and it ’ s typically used during the de-escalation of antimicrobials by infectious disease physicians and pharmacists who might say , ‘ We started this patient on a broad-spectrum antibiotic , but we now have some additional information from our susceptibility testing . Let ’ s de-escalate our prescribing and get them to an appropriately targeted antibiotic .’ They are shrinking the target range of bacteria in the microbiome as much as possible and then getting the patient on a narrow-spectrum antibiotic as quickly as possible , which is part of responsible prescribing and antibiotic stewardship .”
Shannon addressed the spread of antibiotic resistance . “ We know antibiotics are important , and we realize they don ’ t come out of the pharmaceutical pipeline as quickly as we need them to . We also know how fast resistance develops . Essentially , antibiotic resistance can spread from person to person , with or without symptoms , which is part of the problem . When you don ’ t have symptoms and you can transmit an infection , whether it ’ s an active infection or colonization , it can go from person to person , from facility to facility , and then even spread between bacteria .”
He continued , “ There are numerous risk factors , including any kind of recent healthcare exposure , regardless of the care setting , as well as any recent medical procedures or invasive device use ( such