Drug Topics - February 11, 2008 - (Page HSE1) www.drugtopics.com FEBRUARY 11, 2008 DRUG TOPICS HSE 1 HEALTH-SYSTEM EDITION MRSA’S MERCILESS MARCH Antibiotic-resistant germ is forcing hospitals, community to seek new ways to control infection Michael Barbella O mar Rivera first noticed the sore on his back after coming home from school one day last fall. Thinking he had nothing more than a routine infection, Rivera’s regular doctor gave him a painkiller and prescribed the boy amoxicillin to lower the high fever he had developed. When Rivera’s condition failed to improve the next day, his mother took him to Kings County Hospital Center in Brooklyn, N.Y., where doctors treated him for an allergic reaction to amoxicillin. The 12-year-old was given Benadryl and sent home to recover. But Rivera never recovered. He died two days later and the cause of his death remained a mystery until laboratory reports later confirmed the boy had contracted a methicillin-resistant Staphylococcus aureus (MRSA) infection. Rivera’s mother is now suing New York City and Kings County Hospital for $25 million. Rivera was one of a handful of students who died last year after contracting a MRSA infection. The high-profile deaths prompted schools throughout the nation to cancel events and sanitize classrooms. Further fueling the public’s paranoia was a government study that said MRSA infections run rampant in hospitals and nursing homes, and could be responsible for killing more people each year than HIV/AIDS, Parkinson’s disease, emphysema, and homicides. Said David Bearden, a clinical associate professor in the College of Pharmacy at Oregon State University, “We’ve had problems with MRSA in hospitals for decades, but it wasn’t until 2000 that some strains started to appear more frequently in public settings.” The government study found that 58% of MRSA infections in 2005 began in a public setting after the infected person had been in a healthcare facility. Hospitals not doing enough Since its escape from the confines of hospitals, the MRSA germ has spread like wildfire through prisons, schools, gyms and locker rooms, among gay men, and in poor urban neighborhoods. The bacteria that comprise the community-acquired MRSA germ can be carried by healthy people, living on their skin or in their noses. The bacteria do not respond to traditional antibiotics such as penicillin, partly because of overuse. MRSA can be treated with other drugs, but health officials worry that overuse of other medicines will lead to a more resistant strain of the germ. “Resistance to any antimicrobial is a possibility as long as the antimicrobial is in use,” said Michael J. Rybak, Pharm.D., MPH, associate dean for research at Eugene Applebaum College of Pharmacy in Michigan. “When we rely on only a few antimicrobials for many years, we run the risk of susceptibility.” He pointed to the use of vancomycin as an example. “We’ve had a good run with vancomycin for many years, but over time, we are losing susceptibility to this antimicrobial.” He believes there are several new agents, one of which is daptomycin (Cubicin, Cubist), that we should use so we don’t rely solely on vancomycin. “Although there have been some case reports of resistance to dapto- Boston Red Sox manager mycin, the frequency of these Terry Francona is speaking out against infections. has been low,” he said MRSA’s resistance to traditional drugs has prompted the nation’s pharmaceutical research companies to intensify their efforts to find new remedies for the germ. A report released in November by the Pharmaceutical Research and Manufacturers of America concluded that research firms are testing 11 new drugs and four vaccines to treat MRSA infections. One of these medicines is NVC-422, a drug under development by NovaBay Pharmaceuticals of Emeryville, Calif. Also known by its trade name AgaNase, the drug passed a Phase I clinical trial and is one of a group of compounds that work by mimicking the body’s natural immune defense mechanism and killing germs on contact. Since it does not kill germs by blocking the formation of cell walls, bacteria and viruses will most likely not develop a resistance to NVC-422, NovaBay officials claim. A Phase IIa study is expected to commence in early 2008. Importance of prevention An online poll conducted late last year by the Association http://www.drugtopics.com
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.