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Q&A: Bradley University Chemist At Front Lines Of Fight Against Antibiotic Resistance

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(AP Photo/Rich Pedroncelli)
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In this Friday, July 8, 2016 photo, a pharmacist holds a bottle of the antibiotic doxycycline hyclate in Sacramento, Calif.

A Bradley University biochemist is a national leader in the fight against the growing threat of antibiotic resistance.

Dr. Brad Andersh researches and tests new antibiotics. He's also one of this year's scientific ambassadors tasked with lobbying federal health officials and Congress for more funding for this research - before the problem becomes a crisis.

Tim Shelley: You are one of the people selected by Pew Charitable Trusts for the "Stand Up to Superbugs" initiative. Tell me a little bit about how you got involved in that. And what that is.

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Credit Bradley University
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Brad Andersh

Brad Andersh: Well, the Pew efforts are really aligned towards trying to make the community more aware of the the challenges we're facing, with respect to the treatment of bacterial infections. And they reached out to me about a year and a half ago, and asked if I was willing to participate in one of their events. And for the last several years, they've had an annual fly-nin, where they bring people who are working in the area as doing research, or they're doing treatments in hospitals, or they also bring in people who are, have lost a loved one due to an infection or are working in the agricultural industry.

It's an interesting collection in the sense that we have people ranging from farmers who are trying to develop more sustainable products for putting on the market in terms of protein source, to people who are working in the hospitals, so directly with patients. And so it's it's a wide range of people.

TS: One of the main focuses here is antibiotic resistance. And we know Peoria is kind of known for its spot in history with antibiotics. But tell me a little bit about that problem. Just to describe it for our audience here.

BA: Well, what's happened is due to the exposure of bacteria, organisms to the different drugs that we use for treating them is that those bacteria have developed the ability to live in the presence of those drugs, and so they've become resistant to it.

We see the same thing in agricultural fields. You'll find that some of the plants have become resistant to Roundup. You see the same thing as people talk about viruses, that they can become resistant to some of the drugs that we use for treating them. You saw that a lot in the HIV fight that continues to this day. And that many of those treatments, people have been the organisms that become resistant to it.

And that's the biggest fear right now, even as we're looking at the current pandemic, is that the virus will eventually have a mutation that will make our current lines of defense inactive against them. So with the bacterial and resistance issue, again, it's the evolution of these particular organisms, where after they've been exposed to something, they eventually develop mechanisms to either destroy the drug, or to just actually pump the drug out, or, you know, some other mechanism that makes the drug ineffective at killing them. So this is the normal evolutionary process.

TS: So how do we respond to that? I mean, because obviously, if somebody gets a bacterial infection, and this infection is resistant to the drug we traditionally might give for it, then they might have a problem. So what would we do in response to that?

What we've been doing for the last six decades, really, since the penicillin product. The process for producing penicillin, on a large scale, which was developed here in Peoria, is to constantly modify the drugs that we're using, or find new drugs that could be used, that the organisms have not developed the resistance to. And the problem is, is that we're no longer doing that as much as we used to.

If we think about the issue of drug development, it's incredibly expensive for a company to take on that initiative. There are estimates that it costs. In the end, these are estimates $1.5 billion to develop a new drug as you go through all of the development, all the testing, all the federal regulations and doing all of the clinical trials, and then putting that drug onto the market.

And antibiotics are just a different category of medications than we typically think of using because we use them for very short periods of time. We may take a antibiotic for five days, those Z-Pak type antibiotics or we might take it for 10 days, and that's typically the length of time you're taking it. That's not a lot of the compound that the patient is taking.

And so the pharmaceutical company doesn't make a lot of money, versus if you were taking medications for diabetes, taking medications for high cholesterol, hypertension, whatever it might be, you're probably gonna be taking those to the rest of your life. And that's a lot of money that can be made still. Antibiotics are...it's very difficult to recover, the investment has to be made. The large pharmaceutical companies have pulled out of the business because it's not profitable. I mean, they are businesses, they have to make a profit, and they can't make a profit.

Smaller drug companies got involved with the hope that then if they did the initial discoveries that maybe the larger pharmaceutical companies would then buy the product and finish the process of getting the approval. But they've been going bankrupt and out of business left and right as time has passed, and there's just less and less being done in the area of antibiotic development.

And so what we've been traditionally doing of, okay, the organism found resistance, let's just use a different drug. We don't have those drugs in the pipeline. And that's where things stand today.

In the United States, 35,000 people per year die of infections due to organisms that we don't have treatment for. 2.4 million people annually in the United States are infected with organisms that have shown resistance to some of the drugs we're using.

Thankfully, in most of those cases, they were eventually able to find a drug to treat that infection and clear it. But the fear is that we won't be able to do that much longer. There are some that estimates that by 2050, we could be looking at millions of deaths per year worldwide, due to antibiotic resistant infections if we can't find ways to develop new drugs.

TS: And this is kind of where some of your research comes in. Right? You're actively doing some research right now on antibiotics. If you could talk a little bit about that.

That's correct. So what we're trying to do is kind of a twofold approach. One is trying to find how we can modify compounds, to make them more effective at either inhibiting the growth or killing the organism. And along those lines, then as we're trying to develop new compounds, we're also trying to figure out what mode of action they have. And if we can, possibly find an alternative strategy for killing the organisms.

So if we think about penicillin, again, penicillin has its connections in Peoria. Penicillin is a material that causes the cell wall of the bacteria to rupture, and therefore causes cell death. But the organisms eventually develop a process to stop that. And what it does is it causes the penicillin to be destroyed before it ever has an opportunity to interact with the cell wall of the organism.

But that's just one mechanism. If we can find a different mechanism that the organisms haven't been exposed to previously, we could potentially then have another opportunity to buy us a few years. And that's really all we're doing, is we're trying to keep ahead and just buy time, so that eventually, we can have time to make the next development.

Where a lot of the research really needs to be happening is understanding how the organisms are developing this resistance. And that's where it kind of comes into understanding the role of basic research, and the funding mechanisms that support basic research. Many times, you know, we all have concerns about how federal money is being spent. But as we're looking at supporting basic research, it's a necessity for a society of our time that we continue to do this, because without it, we won't be able to make those fundamental discoveries that allow us to understand how this all happens, so that maybe we can eventually find a solution.

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Credit (AP Photo)
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Sir Alexander Fleming, right, who won a Nobel Prize for his discovery of Penicillin, examined Dr. Selman Waksman’s latest experimental cultures in the Waksman laboratories of Rutgers University in 1951. Fleming had been working on staphylococci cultures when he noticed an area of contamination and mold around the dead colonies of cells. Thus was born the miracle of Penicillin.

Developing new drugs is a temporary solution. It buys you time. It doesn't solve the real problem. It will always have resistance developing. Fleming, who discovered penicillin, within years after he had discovered (it), penicillin was already being resistant. During his Nobel Prize address, he warned the scientific community about the problems of antibiotic resistance, and how we had to make sure that we're using antibiotics wisely.

And I think as a society, we got a little complacent with our use of antibiotics and started to use them for purposes they weren't intended. You know, they do nothing to help us fight a viral infection. But we're using them for that. The agricultural industry had discovered that low dose antibiotic led to faster weight gain in many livestock, and so they were being used in that capacity. But now that practice been almost completely halted, but not entirely, because antibiotics now have to be administered under the direction of a veterinarian. But there's just a lot of missteps that we as a society have made, as we're using antibiotics.

TS: Just to summarize, we're kind of in a spot right now where we're just kind of using stopgaps that get us a few more years, a few more years, a few more years. But what you're saying is, we need funding for kind of more fundamental research to to get to the root cause of this, rather than just kind of treating the symptoms. Is that an accurate way to put it?

BA: It is. We need funding on both fronts, we have to be able to buy the time. And the only way we can buy time is by developing new antibiotics. But we also need the support for the fundamental research to understand how this all happens. So that possibly, real solutions can be done.

TS: And that's where you come in with Pew, basically coming to Congress and saying this is needed.

BA: That's correct. And so our role really is to help educate people on Capitol Hill about the problem. And then to advocate for support for the funding agencies that typically are designed to support academic and basic research. But then also to advocate for an alternative way of looking for supporting the development of antibiotics.

You know, as you're looking at the antibiotics, the economics are just not in a favorable situation with this particular class of compounds. And so one of the things that we were advocating for this time, with support of a some legislation that was introduced in the previous Congress that hasn't been reintroduced from this current Congress after the elections, but called the Pasteur Act.

And what the Pasteur Act is really designed to do is to provide a market for the antibiotics so that a pharmaceutical company could see that, okay, there is the opportunity to recover the money that they've invested by having a market once the drug is developed. And you may say, well, there's always going to be a market, we've got the antibiotic resistance. But if we're using antibiotics correctly, and we develop new antibiotics that are more effective in these resistant organisms, then we need to kind of hold those in reserve, we only use those in situations where it's absolutely warranted. The standard infection that somebody may have, you wouldn't use that drug.

And so there's not going to be a huge market for that, therefore, not a lot of opportunity to make money. But if there was what's called a pole incentive, where you're providing the company with a market, and somebody is going to be buying that product, and guaranteeing us some income. That is, they're guaranteeing you a way to recover your investment, then the pharmaceutical companies can get back involved. But without that it's very difficult to do it.

TS: Brad, was there anything else that you would want people to know about this?

BA: Well, I think the the other thing that I would like to mention to everyone is that all of us can have an impact in trying to solve these problems as we think about our own daily life and our own usage of antibiotics, a couple things we can do.

One is, when we're prescribed an antibiotic, we take the entire course of that particular antibiotic that's been prescribed. So if we're told to take it for 10 days, we take it for 10 days, we don't take it for five days and say, 'Well, I'm feeling better, I'll save those for another time.'

The reason being is that you may have killed the majority of the bacteria that are causing the infection, but there may still be some that have a mutation that allows them to still survive in the presence of this compound, this drug, and you're just leading to the development of more resistance, those proliferate, some ability to fight or not, not to succumb to the the treatment, and you're just proliferating it.

Second thing is, as we go in, and we're not feeling well, we should never demand to take antibiotics when the physician says that we're dealing with a viral infection. Antibiotics will not do anything to fight viral infections. So, you know, asking for something to treat this when there may not be something to treat. The common cold, for example, it's a viral infection, antibiotics won't do anything.

And then finally, as we're thinking about our own consumerism, maybe one of the things that we should all be thinking about is, in the agricultural industry, there's been a larger push towards developing products, that are protein sources, that are antibiotic free. And what that means is that the livestock have not been treated with antibiotics during while they're being produced. But that typically comes at a cost. That product is usually more expensive. But if we start to shift more to to consuming proteins that are from antibiotic free sources, we can build up that market and start to supplant some of this mass production of protein that's really on the backs of antibiotics.

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