Volunteer for NIAID-funded clinical studies related to antimicrobial (drug) resistance on ClinicalTrials.gov.
Scientific discovery begins with basic research in the laboratory at "the bench." To improve human health, however, these discoveries must be translated into practical applications that reach the patient's "bedside." NIAID-supported research in antimicrobial (drug) resistance helps facilitate this translation of basic research discoveries from "bench to bedside."
Tests that determine exactly which microbe is making a person sick can take a long time—sometimes several days—to get results. This is because many of today's tests are based on technology that requires laboratory staff to wait for the microbe to grow over a period of time before they can identify the cause of infection. As healthcare providers often cannot wait several days for that information before treating their patients, they may reach for a broad-acting drug they hope will kill whatever is infecting a patient. Unfortunately, the practice of using broad-spectrum drugs before the specific microbe is identified can accelerate the emergence of drug-resistant strains.
Healthcare providers need faster ways to diagnose infections and evaluate whether a certain strain of microbe is susceptible to antimicrobial drugs.
To meet this need for better, faster diagnostics, NIAID supports
Along with accurate diagnosis, healthcare providers need to prescribe the proper dose of a drug—one that is effective but limits the microbe's odds of developing resistance following prolonged or excessive exposure to the drug. The appropriate dosage requires a clear understanding of how the antimicrobial is broken down in the human body (the drug's pharmacokinetics) and how the drug affects the body (the drug's pharmacodynamics). To improve dosage recommendations, NIAID is supporting research proposals that incorporate drug dynamics and kinetics into studies on preventing antimicrobial resistance.
NIAID also supports efforts to collect data on the dynamics and kinetics of older antibiotics for which the most appropriate dosage information is not available. As situations arise where commonly used antibiotics are no longer effective, healthcare providers are resorting to some of the older antibiotics, such as Colistin. Though resistance to Colistin is still low, healthcare providers stopped using the drug because it was known to be toxic.
Recently, the number of new antimicrobial drugs has not kept pace with the rise of antimicrobial-resistant microbes. NIAID has a substantial research program to spur development of new therapeutics against disease-causing viruses, bacteria, parasites, and fungi.
NIAID supports university-based scientists and researchers at biotechnology companies, who are exploring new ways to treat infections with substances that make it difficult for microbes to develop resistance. For example, NIAID supported key foundational and preclinical studies of a novel monoclonal antibody for the treatment of Staphylococcus aureus. This therapeutic is now being tested for effectiveness in humans.
Other NIAID-supported efforts to develop new or improved drugs include
To assist the research community, the NIAID Division of Microbiology and Infectious Diseases (DMID) has built a comprehensive set of product development services and research tools and technologies to facilitate efforts to develop the next generation of vaccines, diagnostics, and therapeutics. These services make needed expertise as well as standardized, high-quality research materials and state-of-the-art technologies available to eligible investigators worldwide at no charge. Information regarding these resources may be found at Microbiology and Infectious Diseases Resources.
The more an antibiotic is used, the more likely resistance to that drug becomes. In the presence of an antimicrobial, microbes are either killed or, if they carry resistance genes, survive. Through this process of selective pressure, drug-resistant survivors will replicate and their progeny will quickly become the dominant type throughout the microbial population. The selection of antimicrobial-resistant microbes can be reduced if the unnecessary use of these drugs is minimized. Well-designed clinical trials provide the data that healthcare providers need to make treatment decisions. This research will lead to better healthcare practices and more refined therapeutic approaches, such as shorter treatment duration or alternative therapies that do not require antimicrobials to minimize the emergence of antimicrobial resistance.
Examples of NIAID-supported clinical trials to examine ways to reduce the risk of antimicrobial resistance include
The need for new drugs would be reduced if bacterial or other infections could be prevented with vaccines. NIAID supported preclinical studies of a vaccine that is protective against both drug-resistant and susceptible S. aureus, the most common hospital-associated bacterial infection.
An NIAID-supported researcher who was testing an experimental vaccine in mice against the fungal infection caused by Candida albicans discovered that the vaccine also appeared to protect the animals against S. aureus. The discovery raises the possibility of developing a single vaccine against multiple microbes.
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Last Updated July 23, 2013