What is antibiotic resistance?

Antibiotics kill bacteria, but through the force evolution, some bacteria become able to overcome once effective doses of antibiotics. In laboratory experiments, normal bacteria have been shown to developed resistance to 1000 times a previously effective dose of antibiotics in as few as 11 days1.

Over time antibiotic treatments create a perverse evolutionary pressure to develop resistance to the once effective treatment. A course of antibiotics may eliminate most of the bacteria, but natural mutations and horizontal gene transfer may cause more resistant bacteria to survive. In this non-competitive environment, these resistant variants can proliferate greatly.

Since the advent of antibiotics in the early 20th century, we have been in an uphill battle against antibiotic resistance. After the introduction of a new antibiotic, resistant bacterial strains can begin to appear with in the first year2,3 (Figure 1). Antibiotic resistance is an inherent byproduct of antibiotic therapy and the solution is exploring alternative medications, rather than feeding the cycle of resistance; antivirulents represent a way to break this cycle.

  1. Baym, Michael, et al. “Spatiotemporal microbial evolution on antibiotic landscapes.” Science 353-6304 (2016): 1147-1151.                                                                                                                    
  2. US Department of Health and Human Services. “Antibiotic resistance threats in the United States, 2013.” Centers for Disease Control and Prevention(2013).                                                               
  3. Ventola, C. Lee. “The antibiotic resistance crisis: part 1: causes and threats.” Pharmacy and Therapeutics 40.4 (2015): 277.

What are antivirulents?

Antivirulents are not lethal to bacteria by themselves, and essentially render the bacteria inert. Antivirulents, also known as antivirulence agents, function by blocking bacterial virulence factors including toxins. By blocking a bacteria’s ability to produce and release toxins, antivirulents decrease the harmful effects associated with these kinds of infections and allow the body’s immune system to more effectively combat the pathogen. Indeed, thus far in vitro experiments have shown no resistance to our novel antivirulent.

Some other benefits of Q2Pharma’s breakthrough antivirulence technology is effective reduction of biofilm formation and potentiation of antibiotics. Biofilm formation is a natural proliferative mechanism for bacteria, but this property of bacterial growth has significant effects in the context of clinical care and effective treatment. Bacteria are inclined to form stratified colonies on surfaces, such as a wound or the inside of the gastrointestinal tract. These structures significantly attenuate the effects of antibiotics. Experiments with Q2Pharma’s novel antivirulance agents have shown reduced biofilm thickness, as well as potentiation of antiobiotic efficacy against MRSA and C. diff. Our first-in-class antivirulent, F19, has great promise in the fight against antibiotic resistance and towards the pursuit of more effective medicines.

As the abundance and lethality of antibiotic resistant bacteria increase due to the unavailability of a viable alternative to antibiotics, there are ever-growing consequences in clinical treatment and society more broadly.

Clinical and economic burden

Since antibiotic resistance occurs because of natural evolutionary processes we can fight it, but never eliminate it. To further complicate this, in the past three decades fewer antibiotics have been developed to combat these pathogens compared to previous years(Figure 2).

In a 2016 report commissioned by the United Kingdom government, researchers postulated that in the year 2050 as many as 10 million people could die per year from antibiotic resistant bacteria2. In 2018, the World Health Organization reported 500,000 people with suspected antibiotic resistant bacterial infections across 22 countries3. Humanity is dealing with a growing public health crisis and Q2Pharma is committed to developing novel solutions to this imminent threat.

The proliferation of antibiotic resistant bacteria is of growing concern globally and comes with significant human, as well as financial cost. MRSA is the most widespread multi-drug resistant bacterial infection worldwide. MRSA costs the US healthcare system up to $34 billion a year and accounts for over 8 million additional hospital days for affected patients1. Further, resistant strains of C. diff cost the USA $1,000,000,000/year and the average cost for a single patient with a C. diff infection is between $18,000 to $29,000. Afflicted patients are hospitalized 6 to 13 days longer than patients with nonresistant infections1,4. Modern antibiotics are becoming increasingly ineffective in treating these diseases and Q2Pharma is here to offer a solution.

  1. Centers for Disease Control and Prevention, Office of Infectious Disease Antibiotic resistance threats in the United States, 2013. April 2013. Available at: http://www.cdc.gov/drugresistance/threat-report-2013. Accessed October 8, 2018.                                                                                                                                                                             
  2. Review on Antimicrobial Resistance. Tackling drug-resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance, 2016.

  3. World Health Organization. “High levels of antibiotic resistance found worldwide, new data shows.” Saudi Medical Journal 39.4 (2018): 430- 431.

  4. Centers for Disease Control and Prevention. “Nearly half a million Americans suffered from Clostridium difficile infections in a single year.”  CDC Newsroom Release (2015).