The discovery of penicillin by Alexander Flemming in 1928, and the golden age of antibiotic development that followed, significantly decreased the global threat of bacterial infections. However, the evolution of countless pathogen strains to resist antibiotics coupled with the lack of funds for antibiotic development has resulted in an acceleration of deaths related to antimicrobial resistance.
Antimicrobial Resistance (AMR) is the result of bacteria, viruses, fungi, and other parasites (collectively called pathogens) becoming immune to antibiotic medications. Some commonly resistant bacteria are Staphylococcus aureus (staph infection), Group A streptococcus (strep throat), and E. Coli and Klebsiella pneumonia (which commonly cause urinary tract infections). Additionally, Methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and other tough bacterium are especially dangerous for people with compromised immune systems. For example, a person living with the rare genetic disease, Cystic Fibrosis, is constantly combating bacteria like MRSA and Pseudomonas with oral or IV antibiotics. Likewise, these tricky pathogens are evolving to fight off antibiotics and once again posing a serious threat around the world.
According to the World Health Organization, the COVID-19 pandemic caused antibiotic resistance to increase by 40%, which, in turn, heightened the risk posed by common blood, urinary tract, gut, and sexually transmitted infections. The current status of AMR-related deaths in the United States is around 35,000 per year. The Global Research on Antimicrobial Resistance (GRAM) has released a frightening prediction that about 39 million deaths between 2025 and 2050 will be caused by bacterial antimicrobial resistance.
The lives of thousands of Americans–immunocompromised or not–are at risk, and advocates have been pushing for a solution. The World Health Organization has been actively strategizing on how to increase research and drug development to combat the most threatening list of pathogens. In the United States, one of the potential solutions to the AMR problem is the proposed legislation, Pioneering Antimicrobial Subscriptions to End Up Surging Resistance (PASTEUR) Act, which would create a financial incentive for antibiotic companies to develop new drugs. Antibiotics used to be considered the “low hanging fruit” by drug manufacturers, but they are now a costly gamble. Since the late 1990s, the approval rating for new antibiotic medications has steadily dropped while medications for other illnesses, like cancer, have become drastically more profitable in comparison. Many antibiotic companies are losing money or have gone bankrupt due to the fact that doctors are pressured to treat patients with the cheapest and oldest antibiotics, and only when those drugs prove ineffective do doctors turn to the newer expensive antibiotics. Additionally, when utilizing new antibiotics, doctors use them in the lowest dosage possible so that they stay effective for longer. The PASTEUR Act proposes a solution to the AMR crisis by creating a subscription-like model for antibiotics companies which would allow for the robust development of new medications without the uncertainty of return on investment. The bill was first proposed to Congress in 2020 and has been re-introduced in subsequent years. It was, yet again, placed on the desk of Congress for reconsideration this February. The PASTEUR Act has yet to receive a floor vote, but its passage would be a significant step towards antibiotic research and development.