Vol.65 No.4 July 2017
A proposal for the future for the Japanese Society of Chemotherapy Part 2. World trend of the development of antimicrobial agents
Professor Emeritus, Teikyo University
Abstract
Although antimicrobial development has become saturated worldwide, increasing bacterial drug resistance is threatening the treatment of infectious diseases. In 2001, the CDC in the United States launched a national action plan, “Combat Antimicrobial Resistance.” The Infectious Diseases Society of America (IDSA) is taking the matter further than an academic exercise, trying to call the FDA and US Congress to action with the slogan, “Bad Bugs, No Drugs.” In 2012, the FDA enacted the “GAIN Act”; however, many approved antimicrobial agents are prohibitively expensive commercially and have limited uses because of toxicity and their administration and dosage.
On the other hand, when I listened to a lecture titled “Cooperation of industry, government and academia to promote drug discovery” in Japan, the representative of the Ministry of Health, Labour & Welfare (MHLW) was so focused on introducing new policy to compensate for the discrepancies in the current medical system that the speech did not include any information about drug discovery. The representative of the Ministry of Economy, Trade & Industry (METI),mentioned that more emphasis will be put on the development of biotechnology-based drugs and the export of low molecular chemosynthetic pharmaceutical products to overseas countries because of the present excessive imports. The representative of the Science & Technology council of the Ministry of Education, Culture, Sports, Science & Technology (MEXT) pointed out that the “construction of infectious diseases research systems and training of human resources in the field” are urgent tasks. “Countermeasures against the threat of infectious diseases and drug resistance” cannot be achieved without the collaboration of MHLW and METI.
How should the Japanese Society of Chemotherapy respond in a situation like this? For sure, great results with nosocomial control have been achieved in collaboration with other academic societies involved in infectious diseases in response to the widespread MRSA infections throughout hospitals in Japan; however, there is a gap in the incidence rates between medical facilities with more than 200 beds and those with fewer than 200 beds. I wonder if the gap could be reduced by publishing guidelines and repeating the lectures. Empiric therapy involves the problem of inappropriately indicated usage of antimicrobial agents. In this chapter, I describe the ideal future guidelines, including the example of the guidelines on MRSA infections.
Key word
methicillin-resistant Staphylococcus aureus，penicillin-resistant Streptococcus pneumoniae，β-lactamase negative resistant Haemophilus influenzae，macrolide-resistant Mycoplasma pneumoniae，vaccination
Received
December 16, 2016
Accepted
January 26, 2017
Jpn. J. Chemother. 65 (4): 531-551, 2017
