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A New Category of Antibiotics May Present a Fresh Threat to Public Health

June 13, 2003

Bacteria have developed resistance to all antibiotics in use today, and this is causing a major health problem. However, a remarkable range of new antibiotics, called cationic antimicrobial peptides (AMPs), is attracting increasing interest as a key weapon in the fight against bacterial infection. They are based on toxic proteins that are part of the natural immune system of all animals, including humans. It is claimed that bacteria will be unable to evolve resistance to these defence proteins. Yet, "both experimental evidence and theoretical arguments suggest that this claim is doubtful", says Professor Graham Bell, from McGill University in Canada, who has reviewed the current research in this area for the June 2003 issue of Microbiology, a Society for General Microbiology journal.

Some scientists claim that if these substances are used generally, then the bacteria may evolve resistance to these antimicrobial peptides that are part of the natural immune defences of the human body. This might threaten the normal operation of parts of the immune system in everyone, not only in the individuals treated. "This does not mean that they should not be developed", states Professor Bell, "but rather that their development should proceed with caution until we understand how the bacterial populations they will be used against would respond."

The review is the first detailed explanation of why resistance is expected to evolve, and what the consequences would be for humans. It draws attention to the possible consequences of releasing a new category of antibiotics, before they have been properly tested. Professor Bell argues that "the evolutionary consequences of new clinical treatments involving the health of whole populations, present and future, should be considered in the regulatory process".

Future experiments are needed to investigate the claim that bacteria will not evolve resistance to these new antibiotics. If these show that the claim is justified, then the path is clear for their development, and they can become a valuable resource in the struggle against infectious disease. If resistance does evolve, then further experiments will be needed to define safer pathways of development, in order to avoid longer-term dangers for the population as a whole.

Society for General Microbiology

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