International Epidemics Lecture September 23, 2014

B.W. Cue, Jr. (UMB 1969)

• Outline– An overview of infectious microbes (excluding fungii)

• Bacterial vs. viruses• An overview of antimicrobial therapy• Cidal vs. static drugs• What is drug resistance?• Treatment approaches• New drugs and approaches

• Ebola virus and vaccine• A green chemistry example of an improved

antibiotic synthesis

An overview of infectious microbes (excluding fungii)

Bacteria or Virus?

Source: Wikipedia

Bacteria or Virus?

Source: Wikipedia

An overview of antimicrobial therapyCidal vs. staticWhat is drug resistance?Treatment approaches

Cidal vs. Static Drugs

• Bacteriocidal– This kind of drug kills all susceptible bacteria

• Bacteriostatic– This kind of drug inhibits/slows the growth of

bacteria until host’s immune system takes over

What causes drug resistance?

• Bacteria can become resistant to antibiotics by mutating (changing) their genes after being in contact with an antibiotic – These changes allow the bacteria to survive or

‘resist’ the antibiotic. • Bacteria can also develop resistance through

contact with other bacteria Resistant bacteria can pass their genes to other bacteria, forming a new antibiotic resistant ‘strain’ of bacteria. – Resistant strains can spread to and infect other

people

What causes antibiotic resistance?

• The more antibiotics are used, the more chances bacteria have to become resistant to them.

• Major causes of antibiotic resistance include using antibiotics when they are not needed

• not taking antibiotics at the doses and times that a doctor prescribes — this allows time for the bacteria in your system to become resistant.

• Antibiotics are also often overused in animals (in veterinary medicine and in agriculture).

You can help prevent antibiotic resistance

• understanding that most people don’t need antibiotics for colds and flu because they are caused by viruses

• telling your doctor you only want an antibiotic if it is really necessary

• taking the right dose of your antibiotic at the right time, as prescribed by your doctor

• taking your antibiotics for as long as your doctor tells you to taking simple steps to avoid infections and prevent them from spreading

• Properly disposing of unused/unwanted antibiotics

Source: CDC Report, Antibiotic Resistance Threats in the United States, 2013

New drugs and approaches

New systemic antibacterial agents approved by the US Food and Drug Administration per 5-year period, through 2012.

Boucher H W et al. Clin Infect Dis. 2013;cid.cit152

© The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

GAIN legislation

The first new beta lactamase inhibitor in 30 years

Beta Lacatmase Inhibitors

MK-7665 RelebactamNDA Approval 2015?

Sulbactam CP-45899

Bacteriophages

Ebola virus and vaccine

See 2014 ICAAC Video for presentations about the current Ebola outbreaks in Africa http://www.icaac.org/

Zmapp Vaccine• ZMapp is an experimental

biopharmaceutical drug comprising three humanized monoclonal antibodies under development as a treatment for Ebola virus disease.[1]

• The drug was first tested in humans during the 2014 West Africa Ebola virus outbreak and was credited as helping save lives, but it has not been subjected to a randomized clinical trial to prove its safety or its efficacy.

Source: Wikipedia

A green chemistry example of an improved antibiotic synthesis

Chemical Process for Semi Synthetic Penicillins

Bio Synthetic (Greener) Process for Semi Synthetic Penicillins