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| The need to incentivise antibiotic research | The need to incentivise antibiotic research |
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| David Cox reports on the “war on bugs” and development of “superantibiotics” (23 October). A blunderbuss is effective against the enemy, but what of the collateral damage? We humans contain more bacteria than human cells – our microbiome – which are key for many aspects of health. A more modern approach is to identify precisely the bacteria responsible for a disease, and use a narrow-spectrum antibiotic to target it. A neat example of the pitfalls of killing too wide a range of bacteria is provided by vancomycin, mentioned in the article, which is used to treat Clostridium difficile-associated diarrhoea. Unfortunately, it also kills the normal bacteria in the bowel, leaving a vacuum into which C difficile can recur, and studies have now shown vancomycin to be less effective than more targeted antibiotics in preventing recurrence. | David Cox reports on the “war on bugs” and development of “superantibiotics” (23 October). A blunderbuss is effective against the enemy, but what of the collateral damage? We humans contain more bacteria than human cells – our microbiome – which are key for many aspects of health. A more modern approach is to identify precisely the bacteria responsible for a disease, and use a narrow-spectrum antibiotic to target it. A neat example of the pitfalls of killing too wide a range of bacteria is provided by vancomycin, mentioned in the article, which is used to treat Clostridium difficile-associated diarrhoea. Unfortunately, it also kills the normal bacteria in the bowel, leaving a vacuum into which C difficile can recur, and studies have now shown vancomycin to be less effective than more targeted antibiotics in preventing recurrence. |
| The current commercial landscape does not favour development of new antibiotics. Efforts, such as those discussed at the G20 in Hamburg, are being made to change this with “push and pull mechanisms” to create incentives for innovation. History shows that thoughtful governmental action can make development of new drugs for small patient populations viable: the Orphan Drug Act, signed into law in the US in 1984 and replicated in the EU, was followed by a rush of new drug approvals for rare diseases. This can incentivise the pharmaceutical industry in efforts to discover new antibiotics that can be deployed with precision and offer superior benefits over current medicines.Prof David RoblinPresident of R&D, Summit Therapeutics | The current commercial landscape does not favour development of new antibiotics. Efforts, such as those discussed at the G20 in Hamburg, are being made to change this with “push and pull mechanisms” to create incentives for innovation. History shows that thoughtful governmental action can make development of new drugs for small patient populations viable: the Orphan Drug Act, signed into law in the US in 1984 and replicated in the EU, was followed by a rush of new drug approvals for rare diseases. This can incentivise the pharmaceutical industry in efforts to discover new antibiotics that can be deployed with precision and offer superior benefits over current medicines.Prof David RoblinPresident of R&D, Summit Therapeutics |
| • Your article (Farming sector aims to cut antibiotics use to help tackle human resistance, theguardian.com, 27 October) states that post-weaning diarrhoea is “a frequent complaint when piglets are taken from their mothers too soon”. | • Your article (Farming sector aims to cut antibiotics use to help tackle human resistance, theguardian.com, 27 October) states that post-weaning diarrhoea is “a frequent complaint when piglets are taken from their mothers too soon”. |
| In reality, weaning is a stressful time for piglets regardless of what age they are. The stress of the change from the sow’s milk to solid food, mixing with piglets from other litters and transportation to new accommodation makes piglets susceptible to E coli and other organisms which cause diarrhoea. Since later weaning is not commercially viable and can be detrimental to the welfare of the sow, farmers employ numerous other measures to support piglets through this challenging stage of production, enabling weaning at 28 days of age, as permitted by legislation. | In reality, weaning is a stressful time for piglets regardless of what age they are. The stress of the change from the sow’s milk to solid food, mixing with piglets from other litters and transportation to new accommodation makes piglets susceptible to E coli and other organisms which cause diarrhoea. Since later weaning is not commercially viable and can be detrimental to the welfare of the sow, farmers employ numerous other measures to support piglets through this challenging stage of production, enabling weaning at 28 days of age, as permitted by legislation. |
| It is disappointing that, rather than praising the impressive reduction in antibiotic use in pig farming (a 34% drop between 2015 and 2016), the article suggests that one of the reasons for the reduction is the increase in use of zinc oxide. While the use of zinc oxide in piglet diets in the post-weaning period is supporting reductions in antibiotic use on pig farms, ensuring piglet suffering is avoided, data from one of the major suppliers of piglet starter feed in the UK suggest that total zinc use is actually slightly declining. Since zinc oxide is a prescription-only medicine, veterinary oversight ensures it is used appropriately.Dr Georgina CrayfordSenior policy adviser, National Pig Association | It is disappointing that, rather than praising the impressive reduction in antibiotic use in pig farming (a 34% drop between 2015 and 2016), the article suggests that one of the reasons for the reduction is the increase in use of zinc oxide. While the use of zinc oxide in piglet diets in the post-weaning period is supporting reductions in antibiotic use on pig farms, ensuring piglet suffering is avoided, data from one of the major suppliers of piglet starter feed in the UK suggest that total zinc use is actually slightly declining. Since zinc oxide is a prescription-only medicine, veterinary oversight ensures it is used appropriately.Dr Georgina CrayfordSenior policy adviser, National Pig Association |