Leading article: Antibiotics, expensive and harmful

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The Independent Online

"Stop taking the tablets" is not a message often heard in medical circles.

Rather the reverse: keep on taking them is the instruction. Doctors justify their existence by handing out prescriptions for the magic pills, and pharmaceutical companies make a fat living from making and selling them.

When it comes to antibiotics, however, more is less. The world is swimming in a toxic soup of the drugs which have become so ubiquitous that they are losing their power and, more worryingly, stimulating the development of new bacteria that can trigger life-threatening infections. As our front-page report yesterday explained, infections resistant to almost all antibiotics are spreading across Europe at an alarming rate. In some countries – Greece is an example – up to 50 per cent of infections with one bug, K. pneumoniae, which causes urinary and respiratory conditions, are resistant to the most powerful class of antibiotics, called carbapenems. Greece also happens to be the country with the highest use of antibiotics.

While the threat from untreatable infections is growing, the supply of new antibiotics to combat them has dwindled. The difficulty of finding new agents, and the cost of bringing them to market, with all the paraphernalia of clinical trials needed to demonstrate safety and efficacy, have proved prohibitive.

The pharmaceutical industry cannot be blamed for this. New antibiotics are used only as a last-line treatment after other drugs have failed and are taken for only a short period, until the infection has cleared. Compared with a drug for diabetes, say, or high blood pressure, which must be taken for life, this is a poor business proposition. The commercial return is not sufficient to stimulate innovation.

We need a new business model, and the European Commission promised yesterday to provide it with a public-private collaboration to research new antibiotics and accelerated approval for drugs discovered. Where, however, the pharmaceutical industry bears blame is in fostering the "pill for every ill" culture that has brought the world to the brink of the abyss. It must now help us to curb that costly habit.