Interscience Conference On Antimicrobial Agents And Chemotherapy Research Articles

38th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) San Diego, USA, 24–27 September 1998

The renaissance in infections diseases, stimulated by well-documented and publicized microbial resistance, continues. The field is benefiting from the infusion of new technologies, aimed at accelerating the discovery process: genomics, combinatorial chemistry and high throughput screening. At this year's ICAAC, there were numerous reports on drug resistance and drug discovery though no surprises on either front. Microbial resistance to established agents is still edging upwards. Most agents (oxazolidinones, everninomycins, glycopeptides, ketolides, quinolones, β-lactams, azoles, echinocandins, sordarins) introduced in previous years are still in development. Combination antiretroviral chemotherapy (protease inhibitors, NRTIs and NNRTIs) is now the mainstream therapy for AIDS, at least in the developed world. A few antimicrobial agents (augmentin, ciprofloxacin, clarithromycin, fluconazole) are near or past the billion dollar mark, underscoring the healthy state of the market. In conclusion, convergence of medical needs and commercial opportunities has brought microbes and antimicrobials into center stage.

Studies Suggest a Darker Side of 'Benign' Microbes

NEW TECHNIQUES for diagnosing mycoplasma infections combined with rigorous culture and serologie methods are transforming long-standing perceptions of the tiny organisms as agents of mild and self-limiting illness to something more troubling. Evidence mounting in the past few years is prompting a reevaluation of mycoplasmata, the smallest free-living organisms, microbiologist Gail H. Cassell, PhD, told researchers and clinicians who met in Toronto, Ontario, for the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Studies are revealing that members of this family of microorganisms, long pigeonholed as relatively benign pathogens, apparently cause a variety of illnesses, including pneumonia—both mild and severe—far more often than previously thought. Low-Profile Microbes One reason that the potential of the mycoplasmata for causing more severe disease has been underappreciated is that these fastidious microbes are difficult to grow and work with in the laboratory. This has meant that efforts to determine whether a patient had

R&D news to beat the blues of influenza and the common cold

Several presentations at the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [Toronto, Canada; September 1997] focused on possible new ways to deal with respiratory viruses. These included promising first clinical experiences with a novel oral neuraminidase inhibitor, GS-4104, which reduced the severity and duration of influenza infection. And a new approach, which uses an intranasally administered soluble intracellular adhesion molecule as a ‘lure’ for rhinovirus, reduced the symptoms of an experimental common cold infection.

???Fortovase???: optimising the benefits of saquinavir

Saquinavir [‘Invirase’; Roche] was the first protease inhibitor to be launched for the treatment of HIV infection. Extensive clinical experience has shown it to be an effective and well tolerated component of combination anti-HIV therapy, delaying disease progression and prolonging survival in HIV-infected individuals. Recently, a new soft gelatin capsule formulation of saquinavir has been developed [saquinavir-SGC; ‘Fortovase’] which, at the recommended dosage, achieves plasma saquinavir concentrations approximately 8- to 10-fold higher than those attained with ‘Invirase’, the conventional hard gel formulation. Since the activity of saquinavir is directly related to plasma drug concentrations, it is anticipated that this new formulation will help optimise the antiviral and clinical benefits of saquinavir. The first data on saquinavir-SGC were presented at the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [ Toronto, Canada; September 1997 ] and at the 6th European Conference on Clinical Aspects and Treatment of HIV [ Hamburg, Germany; October 1997 ].

News from the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC)

News from the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC)

Antibacterial challenges for the next millennium

Approaching the next millennium, clinicians are faced with a double-edged dilemma with regard to antibacterial therapy: an increasing population of susceptible patients coupled with the spread of resistant bacterial pathogens. The role of the carbapenem antimicrobials, in particular meropenem, was discussed during an international symposium sponsored by Zeneca which was entitled ‘Carbapenems: taking β-lactams into the next millennium’. This symposium immediately preceded the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [ Toronto, Canada; September 1997 ].

Enteroviral disease & pertussis costs indicate need for changes to therapy

Cost-of-illness studies are being used to draw attention to the need for more effective treatments for certain diseases. Researchers from the University of Rochester, New York, US, have focused on 2 areas of concern. These are enteroviral disease and pertussis, both of which lead to considerable medical costs and absenteeism from school or work when they occur in children. The results of these cost-of-illness studies were presented at the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [New Orleans, US; September 1996].

Will G-CSF prove useful in non-neutropenic patients?

Both granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been approved for use in patients with neutropenia. However, G-CSF is more likely to expand its applications to patients with conditions other than neutropenia, due to its specificity of action and favourable tolerability profile. Early investigations with G-CSF in community-acquired pneumonia (CAP) and sepsis were discussed at an Amgen-sponsored satellite symposium during the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [New Orleans, US; September 1996].

Meeting Highlights Anti-infectives: 36th Interscience Conference on Antimicrobial Agents and Chemotherapy New Orleans, Louisiana, USA, September 15 – 18, 1996

The need for improved antibacterials, particularly in light of increasing antibacterial resistance, dominated the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) meeting in New Orleans, Louisiana. New and improved quinolones, led by levofloxacin (currently in review at the Food and Drug Administration; FDA), followed by grepafloxacin, trovafloxacin and sparfloxacin are all expected to facilitate major changes in therapy. New cephalosporins, macrolides and carbapenems will complement these new agents.

New treatments for bacterial infections at ICAAC

Favourable reports of trovafloxacin’s antibacterial activity were highlighted by several studies at the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [New Orleans, US; September 1996]. Of particular interest, promising results were seen with the agent in a study involving children with meningitis. Other developments to make the news were the use of berberine to treat diarrhoea in immunocompromised patients, and the discovery of a bacterial protein that could act as an immunogen to protect against infection of surgically implanted plastic devices.

Rising concern over multidrug-resistant fungi

In addition to the problems of dealing with multidrug-resistant bacteria, clinicians are now faced with multidrug-resistant fungi. Some 5-10 years ago, resistance of fungi to drugs was extremely rare, but now resistance to conventional antifungal agents has been reported, particularly in immunocompromised patients. This calls for immediate action. According to researchers at the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [New Orleans, US; September 1996], several measures are being taken. These include the short-term option of trying alternative treatment approaches, and the longer-term strategy of developing new antifungal agents that employ different mechanisms of action to those of currently available drugs.

Potential new treatments for sepsis, influenza

A number of presentations at the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [ New Orleans, US; September 1996 ] focused on new ways of dealing with sepsis and influenza. Developments in the field of sepsis included a new vaccine with a broad spectrum of activity against Gramnegative bacteria, and an antibody structure that may act as a ‘sponge’ for ‘mopping up’ endotoxin in cases of severe infection. Regarding influenza, researchers are investigating the efficacy of a live intranasal vaccine. In addition, a new orally active neuraminidase inhibitor is in development.

Maternal immunisation is a must

The success of maternal immunisation has been demonstrated by the use of tetanus vaccination programmes in developing countries. Many more diseases that can occur during the first few weeks of life could be prevented by this strategy. The science to support this idea is available, but there is some way to go before it is put into practice. Research is underway with a number of vaccines, including one that protects against group B streptococcus (GBS) infections. The current status of development of this vaccine was described at the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [New Orleans, US; September 1996].

Meeting Highlights: Anti-infectives: 35th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) San Francisco, California, 17 – 20 September 1995

Meeting Highlights: Anti-infectives: 35th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) San Francisco, California, 17 – 20 September 1995

Conjugate Vaccines Hold Hope for Countering Resistant Pneumococcus

THE INCREASING spread of drugresistant strains of bacteria such as pneumococci and enterococci is mirrored by increasing concern among infectious disease experts, who fear that the microbes are uncomfortably close to being able to take whatever human beings and the pharmaceutical industry can dish out. There has been an explosion in pneumococcal resistance throughout the world in the last 5 years, noted Keith Klugman, MD, at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) held in San Francisco, Calif. See also p 1333. In the United States, for example, where resistance to Streptococcus pneumoniae was less than 5% in 1990, about 25% of pneumococci are now resistant to antibiotics, said Klugman, head of medical microbiology at the South Africa Institute of Medical Research in Johannesburg. Other regions experiencing massive problems include Europe, the Middle East, South Africa, and at least some Asian countries, including South Korea and Japan.

Other AIDS Drug Regimens Beat AZT Alone, Reduce Clinical Progression and Mortality

TWO LONG-AWAITED trials of drugs to treat HIV disease and AIDS are yielding results that may prompt a shift away from using AZT (formally known as zidovudine) monotherapy as a first-line treatment for the viral infection. Speaking to a standing-room-only crowd at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) held in San Francisco, Calif, last month, researchers from Harvard Medical School, Boston Mass, and Stanford (Calif) University School of Medicine described surprising findings from AIDS Clinical Trial Group 175 (ACTG 175), a multicenter study of nearly 2500 participants. trial found that AZT, the oldest and most widely prescribed drug for the infection, is less effective in patients with intermediate disease than monotherapy with an alternative antiretroviral drug, didanosine (also called ddI), or than regimens that combine AZT with ddI or another nucleoside analog, zalcitobine (also called ddC). The finding that treatment in intermediate-stage HIV disease can

Meeting Highlights: 34th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) 4 - 7 October, 1994, Orlando, Florida

Meeting Highlights: 34th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) 4 - 7 October, 1994, Orlando, Florida

New problems demand new solutions for control of antibacterial resistance

Antibacterial resistance has become an extremely serious problem, to the extent that some strains of bacteria can no longer be treated. A particularly disturbing development is the emergence of vancomycin-resistant enterococci, as these organisms have the potential to transfer resistance to more pathogenic bacteria. Another issue faced by clinicians in the 1990s concerns the increasing incidence of tuberculosis, including multidrug-resistant cases. These problems, and possible solutions, were discussed at the 34th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) [ Orlando, US; October 1994 ].

News from the 33rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC)

News from the 33rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC)

The ???postantibiotic era??? - are vaccines the way to curb pneumococcal disease?

Pneumococcal infections cannot be ignored. While their incidence increases worldwide, treatment options are shrinking due to growing resistance to commonly-used drugs. With few new drugs on the horizon, and a lack of efficacy of the 23-valent vaccine in children under 2-years-old, scientists are having to look for alternative ways to combat these diseases. One of the most promising options is the development of new vaccines that can produce a response even in children. Progress with this work was presented at the 33rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), held in New Orleans, US, last week.