Coronavirus Outbreak Exposes Faults in Antibiotics Pipeline
(Bloomberg Law) -- The prospect of a coronavirus pandemic will strain the pipeline for antibiotics, a network that’s heavily reliant on components from China and already beset by bankruptcies.
A global outbreak of the disease, known as COVID-19, means more patients will rely on antibiotics to fight off pneumonia and other respiratory infections that can accompany the virus. Doctors may feel compelled to prescribe antibiotics even in instances where the cause of patients’ symptoms are unclear, running the risk that new infections develop resistance to the drugs.
The coronavirus threat may lead governments to consider stockpiling vital medications like antibiotics for these kinds of outbreaks and boosting development of new treatments, which have lagged because they are not profitable for drugmakers. Companies like Novartis AG have already stopped antibiotic research, and Achaogen and Aradigm Corp. have declared bankruptcy.
There are no known drug shortages right now, but the Food and Drug Administration is aware of the potential risks and is monitoring the situation closely, FDA Commissioner Stephen M. Hahn said Tuesday. The coronavirus threat in the U.S. still remains low, officials stressed.
The most immediate threat is that the outbreak in China will disrupt the supply of the components necessary to produce antibiotics. The pipeline is already tight even without a pandemic, James Johnson, a professor of medicine at the University of Minnesota and a staff physician at the Department of Veterans Affairs’ Minneapolis medical center, said.
“When the infrastructure starts crumbling, then the already challenged supply for all these things that we depend on for current high-tech medicine are not going to be reliably present,” he said. “So then suddenly we could see a big shortage of even boring, old fashioned antibiotics, let alone newfangled fancy ones.”
A Supply Chain in Trouble
An analysis of the pipeline for developing drugs to prevent infection is long overdue, Amesh Adalja, who specializes in infectious diseases and critical care at Johns Hopkins University Center for Health Security, wrote in an email. Supply chains for vital drugs like antibiotics need built-in redundancies to prevent one disruption from halting production.
“The CoV emergency in China has definitely exposed supply chain vulnerabilities for the pharmaceutical industry, which relies heavily on Chinese manufacturing,” Adaljia said. While this is true for the drug industry as a whole, anti-infective therapies are “of clear national security import.”
Pfizer sources most of its finished drugs and pharmaceutical ingredients from countries other than China, a spokeswoman said in a email.
While governments are ramping up their emergency preparedness response, more companies need to get involved to address the potential antibacterial shortage, Fatema Rafiqi, a research program manger for the Netherlands-based Access to Medicine Foundation, said in an interview. Companies like Johnson & Johnson and and Gilead Sciences Inc. are working on countermeasures, she acknowledged.
“You need a company making sure the right antibacterial at the right dose is given at the right time,” Rafiqi said. “Patients and providers understand how to use the antibacterial and also incentives to get industry out there and to stay within the game in order to provide the right direction with respect to R&D and getting new antibacterial out there that are remaining effective.”
The other threat posed by the outbreak is that new infections will develop resistance to existing antibiotics if they drugs are overprescribed or misused.
Patients already receive antibiotics for diseases that aren’t bacterial infections. With the outbreak, “there’ll just be a lot more opportunity to give unnecessary antibiotic treatment based on strictly a clinical algorithm: respiratory distress, a shadow on the chest X-ray, a fever. That patient’s going to get an antibiotic,” Johnson said.
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