NCPA - National Center for Policy Analysis


October 31, 2007

There's no question that poor hospital hygiene, overuse -- and sometimes misuse -- of antibiotics contribute to outbreaks of infectious bacteria.  But preventative efforts alone won't solve our bacterial challenges. What we need most are better diagnostic tests and new medicines, says Scott Gottlieb, a practicing physician and resident fellow at the American Enterprise Institute.

There are a number of steps that could help achieve this, says Gottlieb:

  • We need to recognize that developing drugs aimed at super bugs is not an ordinary pharmaceutical business, and requires unique incentives.
  • If public-health policies compel doctors to hold the best new antibiotics in reserve, we need to compensate with incentives for developing those niche drugs.
  • The Food and Drug Administration (FDA) also needs to create better opportunities for companies to target not only conditions -- such as pneumonia or skin infection -- but also specific bacteria, like multi-drug resistant staph.


  • The FDA should collaborate with the Infectious Disease Society of America (IDSA) to develop meaningful guidelines that provide clear pathways to new drug development.
  • We also need better tools for rapidly detecting resistant infections in blood, even screens for bacterial genes.
  • Today it can sometimes take days to discover that a patient is infected with a resistant bug; if there were better diagnostics -- similar to the "rapid" strep test -- bacterial infections could be distinguished early and doctors could treat patients with confidence.

Drug companies could also more easily develop drugs targeted to specific bugs, conducting clinical studies aimed at specific pathogens.  Also, they can make sure the right patients got the right drug early in the course of their illness, when drugs can make the most difference, says Gottlieb.

Source: Scott Gottlieb, "Attack of the Superbugs," Wall Street Journal, October 30, 2007.

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