Have We Overcome Infectious Diseases Compared to 100 Years Ago?

2019/07/26

In 2007, a survey was conducted among readers of the "British Medical Journal," published by the British Medical Association, regarding the greatest achievements in the history of medical sciences. Public health was ranked 1st, antibiotics 2nd, anesthesia 3rd, vaccines 4th, and the discovery of DNA structure 5th. Alexander Fleming discovered penicillin in the 1920s, it was put into practical use in the 1940s, and numerous antibacterial drugs have been released since then. In addition, with improvements in public health and the spread of vaccines, infectious diseases that were previously leading causes of death became treatable, and it seemed as though the conquest of infectious diseases was imminent.

However, the bacteria that cause disease have also responded in various ways to protect themselves from antibacterial drugs, surviving as drug-resistant bacteria. Drug-resistant bacteria are more likely to emerge through the inappropriate use of antibacterial drugs. Meanwhile, the development of new antibacterial drugs has stagnated, and there are concerns that effective antibacterial drugs against resistant bacteria will cease to exist in the future. If no measures are taken against the inappropriate use of antibacterial drugs, the annual number of deaths worldwide due to drug-resistant bacteria is predicted to rise from the current 700,000 to 10 million by 2050.

Modern medicine is predicated on the effectiveness of antibacterial drugs. For example, if a patient's immunity is weakened by the use of anticancer drugs or immunosuppressants and they develop an infection, they will die from that infection without effective antibacterial drugs. Furthermore, antibacterial drugs are used during surgery to prevent post-operative infections, but if resistant bacteria increase, prevention will become impossible. If effective antibacterial drugs disappear in this way, both cancer treatment and surgery will become difficult.

Against this background, I am conducting research to overcome drug-resistant bacterial infections. Specifically, this includes: (1) the development of new antibacterial drugs with antimicrobial activity against resistant bacteria; (2) the development of enzyme inhibitors targeting enzymes that drug-resistant bacteria use to detoxify antibacterial drugs; (3) research on drug delivery where antibacterial drugs accumulate at high concentrations only at the site of infection; and (4) research on individualized optimization of dosing methods to increase the effectiveness of antibacterial drugs and prevent the emergence of resistant bacteria.

As we return to the era of Fleming (100 years ago) when infectious diseases were rampant, we must first strictly manage our health and prevention to avoid getting infected, reduce opportunities for antibacterial drug use, and extend the lifespan of existing antibacterial drugs. In the meantime, I hope to develop new drugs and establish dosing methods that prevent the emergence of resistant bacteria.