Beskrivelse

Letters to the editor

Emne

The problem with antibiotics

It is right to direct attention to the serious problem of antimicrobial resistance, but it is wrong to suggest that an unending supply of antimicrobial agents are simply waiting to be discovered if only the proper funding model can be devised (“Netflix and pills”, May 4th). The antibiotic pipeline may not have an infinite reserve of raw material on which to draw. For example, selective evolutionary pressure caused by the use of antibiotics could enable microbes to resemble their host environments in important ways that frustrate targeted approaches to treatment, raise development costs, or increase toxicity.

It is unclear whether a system dependent on endlessly churning out new and evermore expensive medicines will be either economically feasible or scientifically possible in the long term. Greater priority should be given to implementing more permanent solutions that are not limited to slowing resistance. No single approach is likely to be sufficient, so governments should begin by reviving the moribund vision of using the vaccines, treatments and other tools that are already at hand to eradicate disease and thereby stop—not slow—the development of resistance. Eradication may not currently be possible for every disease, but for those diseases where it is possible, the window of opportunity may fast be closing.

JONATHAN DARROW
Harvard Medical School
Boston

TIMO MINSSEN
Director
Centre for Advanced Studies in Biomedical Innovation Law
University of Copenhagen