Burst of innovation in India could lead to breakthroughs in antibiotic development. Scientific startups in Bengaluru, Hyderabad, and New Delhi are working to develop solutions to the encroaching problem of antibiotic resistance, in some cases with support from the Indian government. Even initiatives such as CARB-X in the US are funding some of the Indian companies dedicated to innovative research. The abundance of highly skilled scientists and the lower costs of doing business in India are among the reasons for the recent surge in antibiotic research projects, according to CDDEP Director Ramanan Laxminarayan.  New technologies, plus the urgent need in India for new approaches to fighting antibiotic-resistant infections, have been other motivating forces. [Bloomberg]

Profiling the human cost of antimicrobial resistance in India. In a six-part series, two Canadian journalists tell the personal stories of survivors of antibiotic resistance, as well as explaining the urgency of the global problem. One article, Edging Closer to a World Without Antibiotics, features the parents and doctors of premature infants who beat the odds in India. Families whose newborns lose the battle against antibiotic resistant infections may now number 120,000 each year, according to CDDEP’s recent research. [Canada Press/Manitoba Post]

Clinical trial finds improved blood glucose persists in Type 1 diabetics who received BCG. A clinical study at Massachusetts General Hospital has found that two doses of bacillus Calmette-Guérin (BCG)—long used to prevent tuberculosis in some countries where TB is endemic—resulted in a statistically significant reduction of blood glucose levels in a small group of Type 1 Diabetes patients. The researchers hypothesize that BCG effectively brings about better blood sugar regulation by causing a switch in cellular metabolism. Three years after they received the vaccine, the study participants’ HbA1c had lowered by approximately 10 percent. In the fourth year the overall reduction was 18 percent, and this persisted for yet another four years of monitoring. [WBUR, npj Vaccines, MedPageToday]

Automatic stop order gets clinicians to reconsider each NICU prescription individually. In a study examining how a 48-hour automatic stop order—a tactic used in hospital antibiotic stewardship—affected antibiotic prescribing in a Neonatal Intensive Care Unit, researchers found that the total number of doses per patient decreased by 35 percent and the number of doses per day decreased by 25 percent. Prescriptions were continued in infants whose doctors suspected a bloodstream infection and for those who had confirmed infection in blood or spinal fluid. [Infectious Disease Advisor, JPIDS]

China invests in preventive health policies: A new display of soft power. As the US cuts support of international health projects, China has begun to increase its global health investments. Compared to investments in biosecurity and outbreak management typical of the US, Chinese investments favor preventive medicine and large general health projects. A recent analysis suggests such expenditures stand to expand China’s legitimacy while effectively supporting the increase in basic healthcare standards in developing countries. Recently, China has increased participation in collaborative research as part of collaborative efforts with countries in the Belt Road Initiative, a massive development project introduced in 2013. China’s global health investments are expected to expand into global health research in the near future. [Brown Political Review]

Cheap antibiotics flow on animal farms. According to agricultural business data, each year animal antibiotics earn approximately $5 billion for pharmaceutical companies. While those sold for human use are a much larger share of the $45 billion antibiotics market, the total tonnage sold is much higher in agriculture, amounting to 70 percent of antibiotics sold in the US, and 52 percent in China, according to the Guardian newspaper. Animal antibiotics are cheaper because they don’t need special packaging and they are less costly to develop. In order to reduce the threat of dangerous antibiotic resistance, international public health organizations agree that governments, medical professionals, agricultural industries, and drug companies should do all they can to reduce the use of antibiotics.  Pharmaceutical producers therefore face a conflict of interest, as reducing use could cut into their profits. [The Guardian]

HIV testing: Missed opportunities at the doctor’s office. Early and consistent antiretroviral treatment has given newly infected HIV patients an opportunity to live an almost normal life, but a recent study shows that many high-risk individuals are not being tested regularly for the virus, even if they had visited a clinician in the past year. Researchers found that of 67 HIV positive men who have sex with men (MSM), 13 had visited a clinician in the past year and were not offered an HIV test, and of 141 HIV positive people who inject drugs, 23 had visited a clinician in the past year and were not offered an HIV test. [JAMAHealio]

Campaign backed by pharmaceutical company distracts attention from serious risks. The animal antibiotics producer behind a social media campaign stands accused of attempting to confuse consumers and reduce pressure to regulate the industry.  In the “Enough” advertisements, targeted at women, messaging focuses on residues from antibiotics, which is a much less significant threat than the overuse of antibiotics on farms, which contributes to antibiotic resistance. [The Guardian]

With loophole in US law, farmers easily continue feeding antibiotics to livestock. Rules against using antibiotics to promote animal growth, passed in 2017 by the US Food and Drug Administration, now require that a veterinarian prescribe antibiotics before they can be given to livestock. Some critics dislike the loophole that allows farmers to continue using antibiotic in animals that appear healthy under the guise of “disease prevention,” and others worry that veterinarians give the prescriptions too freely. Either way, there is growing evidence that damage to the human intestinal biome occurs if antibiotics in food animals or antibiotic-resistant bacteria from farms make their way into the human gut. An article in the New York Times examines these issues from the vantage point of an eccentric upstate cattle rancher. [New York Times]

Anthony Fauci talks strategy on the battle against superbugs. Acknowledging the dead ends that scientists have encountered while pursuing new antibiotic development through traditional drug discovery methods, Dr. Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases (NIAID) recently outlined new approaches underlying US actions to combat “superbugs.” Using collaborations, funding, legislation, and incentives, the current NIAID approach encourages (and funds) public-private collaborations, information sharing, technological innovation, partnerships across disciplines, infrastructure, and transparency, all features of successful scientific discovery, according to Fauci. The US government’s competitive Antimicrobial Resistance Diagnostic Challenge has already produced ten finalists whose results show promise; development of vaccines and therapeutics are two other areas supported by NIAID, through funding, technical support, sharing of data, and recruitment of clinical trial participants and healthcare providers. [Pew Trusts]

 

Photo Credit: The Canadian Press/Aleksandra Sagan, with permission.