AMR and the importance of finding new ways to prevent and treat infections

Jim O’Neill, chair of the UK Government’s Review on Antimicrobial Resistance, has today called for vaccines and alternative approaches to be used more widely in healthcare and agriculture as an alternative to antibiotics in the fight against drug-resistant “superbugs”.

There has been much in the media recently about our currently available antibiotics becoming less effective, the fact that we must all be more responsible with their use, and the urgent need to develop new ones. However, even with increased investment, there is no guarantee that we will be able to discover new antibiotics to solve this crisis we find ourselves in. Hence the need to develop alternative ways to prevent and treat infections.

But first why vaccines? Unlike most other treatments, the majority of vaccines act to prevent or reduce the effects of an infection, rather than treat it. Vaccines have been responsible for the eradication of smallpox as well as reducing the incidence of polio, measles, flu, chickenpox and typhoid. More recently, vaccines have been used to prevent infections that increase the risk of cervical cancer.

Furthermore, new types of vaccines are currently being developed to treat, rather than prevent, disease. For example, research is underway to develop vaccines to treat people already infected with HIV. As with vaccines used to prevent infection, the goal of vaccines to treat illness is to stimulate the body’s immune system to destroy the cause of the disease.

Unfortunately, however, it is not easy to prepare a vaccine against every virus and bacterium. Indeed there are serious challenges to producing vaccines to treat many types of infection, particularly those caused by rapidly evolving microorganisms such as HIV or infections, that cannot be readily treated with by stimulating only one part of the immune response.

So, in addition to research into new vaccines, it is essential other (non-antimicrobial) approaches to treating microbial infections are also investigated.

Possible alternative treatments to antimicrobials that are less likely to cause drug-resistant infections include the use of bacteriophages which are viruses that infect and kill bacteria but not human cells, the use of anti-viral drugs and immune-based therapies including monoclonal antibodies or white cells.

New approaches that genetically modify bacteria are also under consideration, such as treatments that “silence” the genes in bacteria that cause an illness or else “switch off” the resistance genes in bacteria that stop antibiotics working. The development of these gene-specific so-called “antisense” antibiotics that directly affect the genetic make-up of bacteria offer potential in the future battle against drug-resistant bacterial infections.

It is essential that all possible ways to treat microbial infections are fully explored to ensure that we have a constant supply of effective and new antimicrobial products available.