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There's a crisis afoot with gram-negative resistance


Patients infected with gram-negative organisms are in trouble. "Drugs that used to be very effective against gram-negative infections no longer work," Johnson & Johnson research fellow Karen Bush, Ph.D., warned the 46th Interscience Conference on Antimicrobial Agents & Chemotherapeutics, held recently in San Francisco.

Louis Rice, M.D., chief of medical services at Louis Stokes Veterans Affairs Medical Center, Cleveland, concurred. "Coming soon to an emergency room near you are resistant infections that do not respond to any available agent or combination of agents." Pseudomonas and other gram negatives are quickly gaining resistance to cephalosporins, fluoroquinolones, and other agents.

And the federal government is unlikely to respond, predicted legislative expert David Shlaes, M.D., president of Anti-Infectives Consulting in Stonington, Conn. Boosting basic research into gram-negative organisms would mean increased funding for the National Institutes of Health or other federal programs, he said, as would adding financial incentives to encourage pharmaceutical manufacturers to focus more attention on antimicrobials. "The government likes incentives," he said, "but this government is unwilling to put incentives into place that cost money."

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