A radical plan to save antibiotics
Drug resistance is fast destroying the power of antibiotics. Tighter infection control and incentives for drug companies to invent more antibiotics are usually proposed as the answer. But the authors of a new paper say we have to think out of the box.What are we to do about the diminishing power of antibiotics - once the miracle drugs that looked set to end infectious diseases? We know the problem is becoming very serious - here is a piece I wrote about the alarming prospects for a future without antibiotics.But we don't hear much in the way of imaginative answers. So it's refreshing to read a paper out this morning from Aaron Kesselheim, from Brigham and Women's Hospital and Harvard Medical School in Boston, and Kevin Outterson, a professor at Boston University Law School.Their analysis, published in the journal Health Affairs, says the usual idea, to give pharmaceutical companies financial incentives to invent and manufacture more antibiotics, won't work. One of the reasons we are in this parlous state of affairs, they say, is that drug companies in the past have tried too hard to sell more tablets. Of course, the misuse of the drugs - physicians over-prescribing and patients not completing the course - is largely to blame, but companies have been disciplined for promoting wrong uses of antibiotics. They cite two cases involving Pfizer. In one of those, in 2005, the company, they say, was warned by the Food and Drug Administrationthat its 'misleading promotion' of linezolid (Zyvox) as a treatment for a wide range of methicillin-resistant Staphylococcus aureus (MRSA) infections 'poses serious public health and safety concerns because of its potential to result in inappropriate use'. The FDA concluded that the clinical trial data did not support linezolid's use for those conditions.Kesselheim and Outterson say that infection control, including handwashing, can work and so can guidelines on prescribing, but they have limitations. So do the various proposals on incentives to drug companies, from extending patents to handing out cash prizes, they say. Limiting the use of antibiotics depresses company sales, while incentives do not directly tackle the resistance problem - companies may still look to short-term profits by trying to encourage greater use of the drug.Their big idea is to reward both hospitals and drug companies for what they do to keep antibiotics effective. Take, for example, a new drug, or a conservation program for an existing drug, that treats or reduces vancomycin-resistant Enterococcus and leads to fewer intensive care unit admissions for patients with this infection. A value-based reimbursement plan would allow part of the savings to be shared with the manufacturer of the product and with the hospital that put the infection control program in place. Under such a proposal, the combined increase in antibiotic reimbursement should be substantial - amounting at least to several billion dollars a year. This approach would close some of the gap between the private cost and societal value of antibiotics.Radical? I think so. But it makes some sense. We would be paying for antibiotics to work and keep on working - not for more and more drugs that quickly become useless. I can imagine this being a nightmare to negotiate between the interested parties. But at least it's a new idea. Like new antibiotics, we are short of those.AntibioticsDrug resistancePharmaceuticals industryInfectious diseasesSarah Boseleyguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
Jupiter making closest approach in nearly 50 years
By MARCIA DUNN 2010-09-17T22:14:25ZCAPE CANAVERAL, Fla. (AP) -- Better catch Jupiter next week in the night sky. It won't be that big or bright again until 2022. Jupiter will pass 368 million miles from Earth late Monday, its closest approach since 1963. You can see it low in the east around dusk. Around midnight, it will be directly overhead. That's because Earth will be passing between Jupiter and the sun, into the wee hours of Tuesday.... hosted.ap.org |
The BP-Spill Baby-Turtle Brigade
How a vast and well-organized group of amateur enthusiasts helped save their beloved creatures. feeds.nytimes.com |
Denver Zoo hatches 4 Komodo dragons
By 2010-10-15T02:56:52ZDENVER (AP) -- The Denver Zoo says it's become the only zoo in the world to hatch endangered Komodo dragons for a third time.... hosted.ap.org |
The rise of rare earth elements
Demand for REEs can only increase as cars, computers, mobile phones and other electronic equipment become more advancedThe "rare earth elements" are a group of 17 naturally occurring metallic elements used in small amounts in everything from high-powered magnets to batteries and electronic circuits. The materials (including scandium, yttrium and a group of elements called the lanthanides) have specific chemical and physical properties that make them useful in improving the performance of computer hard drives and catalytic converters, mobile phones, hi-tech televisions, sunglasses and lasers.As technology advances, so the demand for the metals rises; in the past decade, their use has doubled. There are several kilograms of such elements in typical hybrid petrol-electric cars made by Toyota and Honda, a market that will expand in coming years.Despite their name, rare earth elements are not actually all that rare. In a report on the elements published this year, the British Geological Survey put their natural abundance on the same level as copper or lead.China has a near-monopoly on mining the elements. According to the geological survey China has 37% of the world's estimated reserves, about 36m tonnes, but controls more than 97% of production. The former Soviet bloc has around 19m tonnes and the US 13m, with other large deposits held by Australia, India, Brazil and Malaysia. The Royal Society of Chemistry is raising awareness of declining mineral resources, making conservation of rare earth and other elements a priority for 2011.The US House of Representatives is also worried about security of supply and is considering legislation to try to end America's dependence on Chinese imports. The Mountain Pass mine in California, shut down in 2002 because of environmental and cost issues, is now to be reopened, along with potential mines at Bear Lodge in Wyoming and Bokan Mountain in Alaska..Other sources, untapped as yet, include Greenland. Estimates suggest the land mass could meet 25% of global demand for REEs. South Africa also has potential for rich REE deposits, as do Malawi, Madagascar and Kenya.MiningAutomotive industryComputingChemistryGeologyAlok Jhaguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |