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 therapy Cidal vs. static What 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 Boucher H W et al. Clin Infect Dis. 2013;cid.cit152 © The Author Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please

GAIN legislation

The first new beta lactamase inhibitor in 30 years

Beta Lacatmase Inhibitors MK-7665 Relebactam NDA Approval 2015? Sulbactam CP-45899

Bacteriophages

Ebola virus and vaccine See 2014 ICAAC Video for presentations about the current Ebola outbreaks in Africa

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