World run­ning out of an­tibi­otics

UKZN med­i­cal team says de­liv­ery of drugs is is­sue,not re­sis­tance

The Sunday Independent - - HEALTH -

IT’S BE­COME a global health cri­sis that ex­perts be­lieve could eclipse the HIV epi­demic if novel ap­proaches to treat­ment aren’t created – and fast. An­tibi­otic re­sis­tance – dubbed as a “se­ri­ous threat to mankind” by the World Health Or­gan­i­sa­tion – has sci­en­tists scratch­ing their heads try­ing to find so­lu­tions that can mod­ify and main­tain in­fec­tion fight­ing prop­er­ties of the drugs.

But, as a Univer­sity of KwaZu­luNatal team has as­serted, the is­sue may not be in the drugs them­selves but in forms of de­liv­ery that could be fu­elling re­sis­tance.

As a so­lu­tion, the univer­sity’s Novel Drug De­liv­ery Unit is de­sign­ing and man­u­fac­tur­ing sev­eral in­no­va­tive medicines that will tar­get the very site of the in­fec­tion which could spell the end of tak­ing an­tibi­otics for sev­eral days and im­prove the ef­fi­cacy of drugs that are cur­rently on the shelves.

The team, un­der the lead­er­ship of Pro­fes­sor Thiru­mala Goven­der and post-doc­toral fel­low Dr Rahul Kal­ha­pure, said: “In­fec­tious dis­eases, es­pe­cially in Africa, are the main causes of death. And while an­tibi­otics have rev­o­lu­tionised the treat­ment of in­fec­tions, nu­mer­ous lim­i­ta­tions ex­ist with their cur­rent dosage forms avail­able for pa­tient ad­min­is­tra­tion.”Al­most all drugs given to pa­tients have to be for­mu­lated into a dosage form such as tablets, cap­sules or in­jecta­bles.

How­ever, ac­cord­ing to Goven­der, more of­ten than not, once ad­min­is­tered, only a frac­tion of the drug reaches the in­fec­tion site, mean­ing the pa­tient has to take the an­tibi­otic nu­mer­ous times a day over a course of days.

“This is a ma­jor rea­son for higher doses than re­quired be­ing ad­min­is­tered and for pa­tients suf­fer­ing from se­vere side-ef­fects… Poor sol­u­bil­ity and sta­bil­ity of these drugs in these dosage forms is also a prob­lem. These fac­tors con­trib­ute to treat­ment fail­ure, poor pa­tient com­pli­ance, drug re­sis­tance and deaths.”

It is re­ported that around 700 000 peo­ple die ev­ery year as a re­sult of drug-re­sis­tant in­fec­tions, in­clud­ing drug-re­sis­tant tu­ber­cu­lo­sis, HIV and malaria.

And so Goven­der and her team are fo­cus­ing on the devel­op­ment of in­no­va­tive phar­ma­ceu­ti­cal for­mu­la­tion ma­te­ri­als and nano drug de­liv­ery sys­tems as so­lu­tions to over­come chal­lenges with the cur­rent dosage forms. “We are us­ing nan­otech­nol­ogy, which is the science deal­ing with the de­sign, pro­duc­tion and ap­pli­ca­tion of ma­te­ri­als in the nano scale range. The de­liv­ery of an­tibi­otics via nano-sized drug de­liv­ery sys­tems such as nano par­ti­cles, nano mi­celles, nano plexes, solid lipid nano par­ti­cles, etc, in­stead of con­ven­tional dosage forms is be­ing widely in­ves­ti­gated as an ap­proach to im­prov­ing an­tibi­otic de­liv­ery and erad­i­cat­ing mi­cro­bial re­sis­tance,” Goven­der said. In one par­tic­u­lar case, the re­searchers have just com­pleted a proof-of-con­cept study where they de­signed and syn­the­sised a novel type of lipid, which not only tar­gets the in­fec­tion site but also re­leases en­cap­su­lated an­tibi­otic drugs and bind to bac­te­ria.

The team’s study has been ac­cepted for pub­li­ca­tion in Nano medicine: Nano tech­nol­ogy, Bi­ol­ogy and Medicine, a lead­ing in­ter­na­tional jour­nal in drug de­liv­ery.

“This medicine shows po­ten­tial to tar­get and re­lease an an­tibi­otic specif­i­cally at an in­fec­tion site, main­tain ef­fec­tive con­cen­tra­tions for ex­tended time, and de­creases ex­po­sure to other healthy sites and ben­e­fi­cial bac­te­ria in the body.”

But, it will still be some time be­fore this kind of medicine is avail­able to hu­mans.

Re­searchers need to con­duct fur­ther re­search to op­ti­mise this medicine be­fore it be­came avail­able to the pub­lic. It would also be tested on an­i­mals be­fore be­ing in­tro­duced to hu­mans.

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