Tag Archives: new antibiotics

“Selling your soul to the devil”

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During the American Society of Microbiology (ASM) conference in Boston, I attended an industry sponsored evening symposium. This was held by a pharmaceutical company promoting a new antibiotic.

A lavish meal was provided in plush surroundings for approximately 300 attendees. It must have cost the company a small fortune… To ASM’s credit, at least it was clear on the program that it was an industry sponsored event.

Three “expert” speakers had been recruited to talk at the seminar, and I am sure they were all handsomely rewarded for their efforts. I am also sure that all their talks were carefully vetted beforehand. The title of the seminar was not “Please use antibiotic X as much as possible“, but rather the more subtly titled “Best practice management for Infection Y in Population Cohort Z“.

You get the picture…

Each speaker declared multiple conflicts of interest, having received consulting fees from several different companies. They were all “distinguished” in the fields of microbiology and Infectious Diseases. A means of extra income I guess, but not the life for me. I prefer to set my own agenda as opposed to having it set for me…

Anyway, I made it through about half of the seminar before my conscience (and jetlag) got the better of me.

I guess the pharmaceutical companies would not hold these costly events if they did not think they were worthwhile.  Maybe we all like to think we are immune to persuasion. However the reality is that most of us, to varying degrees, are not.

And in a sense the pharmaceutical company has achieved their aim. I am now aware of the new antibiotic, and when it becomes available in NZ, I would consider using it if the clinical circumstances justify it.

And I also got my “free” dinner…

Michael

“Use it or Lose it? Listen to yourself.”

Take for example a couple of the latest antibiotics on the block, tigecycline and ceftaroline.

As new, broad spectrum anti-microbials they should be given the utmost protection in order to prevent selection of antibiotic resistance, only being used in cases where there are few or no other reasonable options available. 

The pharmaceutical companies will not tell you this however. They would like you to use the drug as much as possible, for obvious reasons.

…and sometimes general physicians will have heard of these new antibiotics and because they are new, assume they are the best, and seek to use them.

… and sometimes Clinical Microbiologists and ID physicians like to use new antibiotics like these because it makes them look clever, or in order to stay ahead of “the game”.

….and sometimes pharmacists feel the compulsion to stock a few vials of all the exotic antibiotics, just in case…

….and sometimes the CEO will want these antibiotics used in his/her hospital, because other neighbouring hospitals are using them.

….and sometimes the patient will have heard of the latest new antibiotic on the news or internet, and demand its use.

Protection of antibiotics like these starts in the laboratory, with focused testing and reporting. It always has done, always will do. If you test or report any such antibiotics on a routine basis, you need to take a long hard look at your laboratory policy.

 I have hardly ever reported or advised the use of these antibiotics, because in the area of the world I work in, there is very little need for them. I suspect this will be the case for the vast majority of us.

When we make decisions on which antibiotics to test, which to report, which to advise etc, there may be several opinions given to you, or subtle pressure applied from various sources.

Listen to the advice, be aware of the agendas, and always, always make up your own mind. 

Michael