抗生素的过去、现在与将来（英文ppt）课件

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1、Medicine.Past,PresentandFuture.ANTIBIOTICSProfessorAnthonyCoatesMedicalMicrobiologyDepartmentofCellularandMolecularMedicine,StGeorge’s,UniversityofLondon.MicrobeskilleachotherwithantibioticsTheyhavedevelopedself-defencemechanisms:1.Non-multiplyingstate2.Biofilm3.Geneti

2、cresistanceThesearchforantibioticsbeginsBacterialgeneticresistancetoantibioticsbeginstoneutralisethebeneficialeffects.1945,inaninterviewwithTheNewYorkTimes,FlemingwarnedthatthemisuseofpenicillincouldleadtoselectionofresistantformsofbacteriaThesolution:Makenewantibioticst

3、oreplacetheoldonestowhichresistancehasemerged.Antibioticdevelopment1929-72TheAntibioticParadox,StuartLevy,NewYork,PlenumPress,1992,4THEPRESENTAntibioticresistanceisrising807060504030201001990199520002003PercentofResistantStrainMRSAQRPSEMRSPN/VREPRSPNMRSA=methicillinresis

4、tantStaphylococcusaureusVRE=vancomycinresistantenterococciMRSPN=macrolideresistantStreptococcuspneumoniaePRSPN=penicillinresistantStreptococcuspneumoniaeQRPSE=quinoloneresistantPseudomonasaeruginosaThenumberofnewantibioticswhichreachthemarketisfallingLife-or-deathCrisis:

5、TheBacteriaarewinningEmergenceofresistanceisoutpacingtheintroductionofnewantibiotics(2003Daptomycin;2004none;2005Tygacil)Nonewagentsinclinicaldevelopmentagainstmulti-drugresistantgram-negativesegPseudomonasaeruginosa,AcinetobactersppWhyhasthepharmaceuticalindustryreduce

6、ditsproductionofnewantibiotics?ResistanceemergestooquicklyandreducestheeffectivelifeofanantibioticToolittleprofitBigBiologyhasfailedtoproducenewantibioticsIncreasedcostsduetomoreregulationegECLitigationfearsGovernmentrestrictionsonuse(Keepinreserve)Antibioticuseintoday’s

7、worldAmoxilandAugmentin25%ofallpresciptionsMorethan$1billionsalesperyearforAugmentin,Klacid,ZithromaxandLevaquin.(IMSHealth,IMSMidas,www.imshealth.com/globalinsights)THEFUTUREInternationalresponsetotheglobalspreadofantimicrobialresistanceImprovestandardsofantimicrobialpr

8、escribingandsoprolongthelifeofexistingantimicrobialsVaccinesPreventionbyimprovedinfectioncontrolLimited