Honey a secret weapon in battle against antibiotic resistance

honeydressing

Source: Kerrie Armstrong, SBS
It may sound too sweet to be true, but research is underway to see whether honey could replace some antibiotic treatments.

If you had told Professor Liz Harry she would one day be researching honey as an antibiotic alternative she would have laughed.

But in the battle against increasing antibiotic resistance in Australia and around the world, honey could be the new secret weapon.

The medicinal use of honey has gone from a quirky alternative medicine to a serious research project – and Professor Harry is at its forefront.

She is the acting director of the ithree institute (infection, immunology and innovation) at the University of Technology, Sydney and is working as part of the Australian Honey Project, which is connected to the Rural Industry Research Development Corporation.
She is looking into the practical use of honey as an alternative to topical antibiotics.

“It doesn’t matter what antibiotics are used, bugs will always become resistant to it,” Professor Harry told SBS News.

“Honey has multiple antibiotic components in it.

“It doesn’t allow bacteria to rescue themselves or have a chance of surviving.”

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Medical experts have come up with 61 recommendations to protect patients from unnecessary and possibly harmful tests, treatments and procedures.
Professor Harry said the use of honey as a medicine was not new.

“I didn’t realise honey was used since the dawn of time and was used up until the discovery of antibiotics,” she said.

Evidence has been found that even ancient cultures like the ancient Egyptians were convinced on honey’s healing powers.

She said her research aims to prove whether honey is effective at targeting a range of bacteria and whether is able to remain effective over long term use.

It is then used as a topical treatment – that is, treating wounds and infections on the skin – either as a dressing or in the form of a cream or a gel.

She said there had been considerable success in the use of honey this way, as well as using topical honey treatments in conjunction with oral antibiotics.

The honey is also able to remove dead cells from a wound, which is known as debriding the wound.
Professor Harry said she hoped patients and medical professionals would one day consider honey to be an alternative wound or post-operative treatment to the antibiotic creams and gels that were currently used by general practitioners and in hospitals.

“It would help to reduce the resistance to antibiotics,” she said.

“One of reasons was have this problem is we use a lot of antibiotics.”

Certain honey gels and creams have been available for a number of years, Professor Harry said but more research is still needed into why honey works the way it does.

The honey project is expected to be completed in October, 2019.

Research begins on animal-human antibiotic resistance link

AMR-study

Source: Laboratory News
A team of Bristolian scientists have started a large-scale study to investigate how antimicrobial resistant organisms can be transferred from farm animals to humans.
A main part of the project — ‘antimicrobial resistance (AMR) in the real world’ — will investigate if bacteria from cattle can cause drug resistant infections in humans. Half a million people, from Bristol and the surrounding areas, will be studied to see how many urine infections are caused by AMR bacteria found in dairy cows.
Dr Matthew Avison, from Bristol University’s School of Cellular & Molecular Medicine, said: “There is little doubt that over-using antibiotics in farm animals and pets increases the number of AMR bacteria in those animals, just as it does in humans. There is also strong evidence that AMR bacteria present in farm animals can spread to humans having close physical contact with them, for example, farm workers.
“However, there is considerable debate about the extent that AMR bacteria can spread more widely – for example when people eat food contaminated with bacteria from animals or interact with environments contaminated with animal wastes. Our research project will add much needed data to the debate.”
The researchers will also look at ways to reduce AMR bacteria levels in animals as part of the project. The scientists and government bodies will work with farmers, vets and retailers to encourage responsible use of antibiotics. The study will also investigate AMR bacteria in puppies by testing their faeces before they start going outside and after several months of walking along public footpaths. The last part of this multi-faceted study will also look at determining the effect of antibiotic use in humans on AMR bacteria levels and how a reduction in antibiotics affects this.
Professor Alistair, from the University’s School of Social and Community Medicine said: “We will look to see if these reductions in antibiotic prescribing are translating into reduced rates of antibiotic resistant urine infections. If we find that a reduction in antibiotic prescribing has led to a reduction in the number of antibiotic resistant urine infections, it will be positive news for patients, GPs and nurses in primary care.”
The research is funded by a £1.75m grant from the Natural Environment Research Council, the Biotechnology and Biological Sciences Research Council and the Medical Research Council.

Plant kingdom provides two new candidates for the war on antibiotic resistance

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Source:
Trinity Science Daily

Scientists have isolated peptides (strings of amino acids) with antibiotic effects on bacteria that spoil food and cause food poisoning, after turning to the plant kingdom for help in boosting our arsenal in the ongoing war against antibiotic resistance.

The scientists found two small peptides from widely cultivated crop species (one from broad beans and one from cowpea) that were especially effective.

Further work then confirmed that when these peptides were used together, and with a human peptide that is also an antimicrobial, their protective effects were beefed-up in a one-two antimicrobial punch.

Associate Professor and Head of Microbiology at Trinity College Dublin, Ursula Bond, led the team that has just published its research in the journal Applied and Environmental Microbiology.

She said: “There are two major advantages to these small peptides in that no resistance mechanisms have emerged yet, and in that they can be inexpensively synthesised in the lab. Initially, our aim was to identify peptides that provide protection against food-spoiling bacteria, but these peptides may also be useful as antibiotics against bacteria that cause serious human diseases.”

The research team behind the discovery had previously isolated a human peptide that is a potent antimicrobial agent against many of the bacteria that spoil beer during industrial fermentation. Instead of screening for other human peptides with similar desired effects, the scientists scanned plant peptides databases and focused on the peptides whose structural blueprints were similar to the human one with the desired characteristics.

Many of the most effective antibiotics are derived from proteins produced by plants, but there is a growing need to discover new therapeutic candidates as resistance is increasing in bacterial species that have major health and economic implications for society.

Professor Bond added: “We reasoned that natural peptides found in many plants and plant seeds might be useful new antibiotics, because plants have evolved these systems to protect themselves against the billions of bacteria and fungi they interact with in the soil every day.”

Story Source:

The above post is reprinted from materials provided by Trinity College Dublin. Note: Materials may be edited for content and length.

Theravance on Vibativ and fighting antimicrobial resistance

theravance

Source: drugtargtreview
At ASM Microbe 2016, Theravance Biopharma announced new positive data from several studies of Vibativ (telavancin) showing potent in vitro activity against isolates from a range of difficult-to-treat infections, including methicillin-resistant Staphylococcus aureus (MRSA).

Vibativ

We caught up with Frank Pasqualone, Senior Vice President and Global Head, Acute Care Business at Theravance Biopharma, to find out more about the therapy and the results of the studies. Mr. Pasqualone began by explaining more about the mode of action of the treatment: “Vibativ has a dual mechanism of action that works by both inhibiting bacterial cell wall synthesis and disrupting bacterial cell membrane function. This dual mechanism of action acts at two separate targets on the bacterium, differentiating Vibativ from several MRSA antibiotics, including vancomycin, the most commonly prescribed treatment for MRSA and related bacterial infections.”

Greater in vitro potency

The findings presented at ASM Microbe demonstrated that Vibativ possesses greater in vitro potency against MRSA and other difficult-to-treat clinical pathogens compared to widely prescribed antibiotics such as vancomycin, daptomycin and linezolid. We asked Mr. Pasqualone how the therapy differs from other antibiotics like vancomycin: “One of the most important points of comparison is the data presented at ASM Microbe which demonstrated greater in vitro potency for Vibativ against a range of difficult-to-treat Gram-positive pathogens as compared to other well-known antibiotics such as vancomycin, daptomycin and linezolid. These findings further supplement the extensive and well-documented evidence of greater in vitro potency for Vibativ against these types of infections as compared to alternative antibiotic treatments.

“Additionally, Vibativ is differentiated from vancomycin in a number of ways, including its dual mechanism of action, demonstrated penetration into infection sites, convenient, once-daily dosing with no need for therapeutic drug-level monitoring, ability to reduce MRSA concentrations within eight hours and the fact that no resistance to treatment was seen during its Phase II and III clinical programmes (reports of resistance during post-approval clinical use are extremely rare).”

Data at ASM Microbe 2016

The data presented at ASM Microbe showed that Vibativ possessed the greatest in vitro activity of all antibiotics evaluated against a broad, global collection of contemporary S. aureus clinical isolates causing bacteremia, including endocarditis. Overall, the minimum inhibitory concentrations (MICs) for Vibativ were eight times lower than for daptomycin and 16- to 32-times lower than for vancomycin and linezolid against the S. aureus isolates that were evaluated, including MRSA, MSSA and multi-drug resistant subsets.

Data from a second study demonstrated potent in vitro activity for Vibativ against multiple daptomycin-resistant MRSA strains causing infective endocarditis in a rigorous animal model. Vibativ significantly reduced the levels of MRSA found in all three target tissues (heart, kidney and spleen) that were evaluated as compared to the untreated control and daptomycin-treated groups. Additionally, Vibativ produced a high percentage of target tissues that were classified as culture-negative for MRSA, while daptomycin did not sterilize any of the target tissues. Finally, there was no mortality observed in animals treated with Vibativ, as opposed to a 29 percent mortality rate for those animals in the standard daptomycin treatment group.

Findings from a third study demonstrated potent in vitro activity for Vibativ against a broad, global collection of contemporary Gram-positive pathogens, including S. aureus clinical isolates such as MRSA, causing bone and joint infections. This potency was demonstrated against all S. aureus isolates evaluated, regardless of phenotype. Additionally, all clinical isolates that were shown to be daptomycin-resistant or teicoplanin-resistant remained susceptible to Vibativ.

Potency regardless of isolate phenotype and resistance profile

Mr. Pasqualone commented on the ASM Microbe data: “These findings demonstrated greater in vitro activity for Vibativ against a range of difficult-to-treat Gram-positive pathogens.

“Importantly, the in vitro activity of Vibativ was demonstrated against isolates from difficult-to-treat infection types with significant unmet medical need including Staphylococcus aureus bacteremia, infective endocarditis caused by daptomycin-resistant MRSA, and bone and joint infections. In some cases, these pathogens against which Vibativ demonstrated in vitro potency were non-susceptible or resistant to treatment with other evaluated antibiotics.

“As we continue to evaluate Vibativ against a range of these infection-causing clinical isolates, we are impressed to consistently see that the drug has potent in vitro activity, regardless of the isolates’ phenotype and resistance profile. Importantly, in many cases this potency is demonstrated to be several fold greater than other antibiotics routinely used for the treatment of Gram-positive infections.”

Antimicrobial resistance

The threat of antibiotic resistance is great. Over the last thirty years the number of new antibiotic approvals has dropped and the number of effective antibiotics has decreased. Jim O’ Neill’s Review on Antimicrobial Resistance (AMR) highlights that drug resistance has serious implications and will be felt the world over: routine surgeries and minor infections will become life-threatening once again, and hospital stays/expenses will increase significantly. The review notes that infections are on the rise and by 2050 the number of deaths from drug resistant infections is predicted to surpass the number of deaths from cancer.

We asked Mr. Pasqualone more about the threat of antimicrobial resistance and how Vibativ can help combat it: “With the crisis of antibiotic resistance continuing to grow more acute, there is an urgent need for differentiated antibiotic products that are able to address difficult-to-treat bacteria that have limited or no susceptibility to currently available antibiotics. We believe that Vibativ demonstrates a number of critical attributes that may offer key advantages in the fight against antibiotic resistance. These include demonstrated in vitro potency, dual mechanism of action, clinical evidence of efficacy in a range of difficult-to-treat infections in HABP/VABP and cSSSI, proven ability to penetrate important lung and tissue sites, and dosing that ensures effective levels of the antibiotic are maintained.”

Nutreco CEO calls for industry collaboration over antimicrobial resistance threat

nutreco

Source: https://www.undercurrentnews.com

STAVANGER, Norway — Antimicrobial resistance (AMR) is a global megatrend, and the attention on the use of antibiotics in raising animals will only increase in the coming years, warned Nutreco CEO Knut Nesse.

The World Health Organization confirmed last year that one cause of AMR — the process by which a microbe evolves to become more or fully resistant to antimicrobials which previously treated it — was the inappropriate use of antibiotics in animal husbandry.

On top of the inherent risk posed by this irresponsible antibiotic use, as AMR continues to become a megatrend, it will attract increasing attention from media and consumer pressure, he believes.

“The aquaculture industry needs to respond to this challenge in a proactive way through innovation,” Nesse told the audience of aquaculture executives at the recent Aquavision 2016 conference.

He called for cross-collaboration across the entire aquaculture value chain, and said that part of the answer will come from preventative health, and innovative nutritional, solutions.

Nesse presented a diagram which predicts AMR could be the leading cause of deaths globally by 2050, contributing 10 million deaths per year.

He also noted headlines from a range of food sectors showing the global trend for retailers to reject animals raised with antibiotics.

Costco Wholesale is to phase out drugs important in human medicine from its supply chain; Tyson and Chick-fil-A (the largest US buyer of chicken) are to distance themselves from drug use in chickens; and Walmart has pressed its meat suppliers on antibiotic use.

“The public perception in some areas already is that aquaculture is becoming more unsustainable,” he said. “Antibiotic use is part of that picture. As an industry we must react pro-actively.”

Nesse predicts that in the future the industry will operate under global targets to reduce antibiotic use in food production to an agreed level per kilogram of livestock and fish. He also expects there to be special restrictions on the use of those drugs important in human medicine.

There will, he added, also be full transparency over antibiotic use in animal husbandry. The sector has probably seen the first step in this process just this month, as the Chilean government, under legal pressure from environmental groups, published the amount of antibiotic use per company for the first time ever.

Costco’s switch the eye-opener

In 2015 US club store Costco made the decision to switch its majority salmon supply from Chile to Norway.

Chile had provided Costco with 90% of its farmed Atlantic salmon, and Norway just 10%; but starting in June 2015, Norwegian, antibiotic-free salmon was to fulfill about 60% of its needs.

The store purchased 600,000 pounds of salmon filets a week — close to 10% of all US Atlantic salmon imports from Chile.

Walmart weighed in, updating its policy to state that antibiotics should “only be used for medical purposes” and that suppliers should “eliminate the growth promotion uses of antibiotics”.

SalmonChile’s chairman, Felipe Sandoval, stated in response that exported Chilean salmon products did not have traces of antibiotics. “The final products from Chile don’t have traces of antibiotics, otherwise they could not enter other markets.”

According to Sandoval, there were no “concrete facts” of the existence of residues of antibiotics in Chilean salmon. “Maybe other competitors want to take advantage of things that are not so certain,” he said.

Some producers, including Australis Seafoods, Cermaq and Nova Austral, have set salmon farms in the Magallanes region at the tip of Chile, where they have no need to use antibiotic treatment. The region is more than 1,000 miles south of Puerto Montt, the traditional hub of Chile’s salmon farming industry.

But the growing trend to market salmon free of antibiotic treatment could damage Chile’s reputation, which in April 2016 was still struggling to shake off a negative image stemming from the outbreak of infectious salmon anemia a decade ago, according to Cermaq CEO Jon Hindar.

Chile’s salmon industry as a whole had in 2015 tabled the idea of promoting its “from Patagonia to the table” brand, in response to concerns over extensive use of antibiotics.

Pesquera Camanchaca, meanwhile, reduced its use of antibiotics in 2015, after implementing its health management program. Despite a 10% higher salmon harvest at 43,000 metric tons, the company decreased its use of antibiotics by 30%.

Speaking at Aquavision, Norwegian fish health firm Pharmaq revealed it has its live salmon rickettsial septicaemia vaccine testing across 20 million young Chilean fish, after the innovative product was approved in February.

“The product was commercially launched in Chile with an approval in February 2016,” Martinsen told Undercurrent. “The product is therefore in commercial use, but we are lacking the field efficacy performance as the product has been approved based on laboratory data (as all new vaccines in Chile are).”

“We expect to collect more data throughout the rest of this year and continue to get more data from commercial operations also next year.”

To fight antibiotic resistance, we need to fight bad prescribing habits

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shutterstock. Antibiotics image via www.shutterstock.com.
SOURCE-http://theconversation.com/

May’s announcement that a strain of bacteria with genes conferring resistance to colistin, our antibiotic of last resort, was identified in the United States, is just the latest report highlighting the growing threat of antibiotic resistance.

Antibiotic resistance is driven by many factors, the most significant of which is inappropriate prescribing. This is when patients get a prescription for an antibiotic that they don’t really need, or get a prescription for the wrong antibiotic, the wrong dose or the wrong duration. And doctors know that inappropriate prescribing feeds the problem. So why do they keep doing it?

As a clinical pharmacist who has studied antimicrobial resistance and developed intervention programs to reverse the trend, I know firsthand how challenging this problem is to solve.

I believe there are two reasons inappropriate prescribing is so hard to curb. First, there is a philosophical disconnect between the data about antibiotic resistance and what drives prescriber behavior. The second is that physicians may bend to patient demand for antibiotics, even if the physician knows it won’t help or isn’t really needed.

Physicians: Does your hospital have a resistance problem?

Typically, antibiotic resistance data is captured at the population level. Reports about resistance look at what is going on in countries, states or regions. But antibiotics are prescribed by individual physicians to individual patients. So looking at population-level data makes it easy to deny that it’s a problem in your clinic or hospital, and that your behavior is contributing to it.

That means one of the solutions to curbing antibiotic resistance is to personalize the problem for doctors to get them to change their prescribing habits. And, at least in hospitals, this approach has been shown to work.

In the 1990s, I led a group at the University of Florida College of Pharmacy that established the Antimicrobial Resistance Management (ARM) Program. ARM worked with over 400 hospitals nationwide and in Puerto Rico. We sent customized reports to hospitals that included their antibiotic use over at least the past three years, which was compared to resistance levels for several types of bacteria that commonly cause infections. That meant we could determine if there was any statistically significant relationship between antibiotic prescribing habits and resistance at the hospital level.

Because the data was institution-specific, providers couldn’t deny that their hospital had a resistance program, and that they may be contributing to it.

What does that mean in practice? ARM examined the relationship between imipenem, a broad spectrum antibiotic, and Pseudomonas, a bacteria that often causes healthcare-acquired infections, at a particular medical center. The program found that if the medical center did not change their prescriber behavior for this antibiotic, resistance would rise one percent for every 30 average daily doses in adults.

This tells prescribers much more about the chance that a key antibiotic will become less effective against a common infection than general population-level data would. Knowing this, hospital staff and individual providers might think carefully about when to prescribe antibiotics, and to prescribe the right dose, the right frequency of dose and the right duration if and when they do.

Those behavior changes have a big effect. For example, at the same medical center, these reports helped to change prescribing habits for ciprofloxacin, a widely used antibiotic that you may know as Cipro, to the point that it became 26-76 percent more effective at treating infections caused by certain organisms, especially those associated with hospital-acquired infections.

Patients get prescriptions for illness that don’t require them. Prescription pad image via www.shutterstock.com.
Patients play a role

So there’s a way to get physicians in hospitals to think about how they prescribe antibiotics. But most antibiotics are prescribed in outpatient clinics.

In fact, a recent sample of outpatient visits in the United States revealed that there were about 506 antibiotic prescriptions per 1,000 people in the U.S. Of these, about 69.7 were deemed appropriate. The rest weren’t, and were often prescribed for diseases include bronchitis, sinusitis, ear infections and sore throats, which will often go away on their own. And many of these diseases are often caused by viruses, which won’t respond to antibiotics.

So to really combat inappropriate prescribing, we also need to reach physicians in outpatient clinics. Targeted data could help here. But the problem is that the systems that monitor antibiotic resistance and prescribing rates do not collect quality data on outpatient clinics. Even if they did, there is no standardized mechanism to deliver that information back to the community-based provider.

Beyond that, we also need to reach their patients. Part of the reason physicians prescribe antibiotics is that they bend to the expectations of their patients.

If a patient with a chest cold decides to see his provider, the patient most likely took off work, spent time in a waiting room, then more time waiting in the exam room until the provider finally came in to spend a few minutes of face-to-face time with him. The last thing the patient wants to hear is that he should get some rest, drink plenty of fluids and take Tylenol. He feels as if he made an investment, and for his investment, he wants a return. Hence a prescription, often for an antibiotic. Providers know this and realize that patients will leave sooner and happier if the provider gives patients what they want.

The challenge for patients is complicated by the fact that numerous pharmacies will now provide them free antibiotics with a proper prescription. This not only increases the demand from patients for an antibiotic from their provider but it also increases the demand for select antibiotics since not all antibiotics are offered free of charge.

The increased demand for a select group of antibiotics speeds up the development of resistance against those drugs and cuts down on the time before they become useless.

While physicians should avoid prescribing antibiotics to patients unless they are truly necessary, patients must also accept the fact that not all infections require an antibiotic.

Patients have to take responsibility for the retention of antibiotic efficacy for future generations. They should share with their provider that they want to partner with him or her toward a more responsible level of infectious disease care.

There are solutions, but to realize them, we need to stop discussing antibiotic resistance as an abstract, population-level problem and drive the solutions down to where the problem started, the patient-provider relationship.