The global fight against anti- microbial resistance could be dramatically undermined by current treatments for cystitis and bladder conditions and, the current treatments often do not work!
At UroPharma it is our contention that the oral route for delivery of antibiotics to treat cystitis is fundamentally flawed and undermines the worldwide drive against antimicrobial resistance. Many millions of people a year (the majority being women) suffer from these debilitating and sometimes deadly conditions.
Treating diseases of the bladder has unique challenges, which I will oversimplify to get the point across.
When antibiotics are taken orally (the most common method), they not only can cause damage to the gut microbiome, but also the absorbed antibiotic is then dripped into the bladder - and this, substantially, is where the problem lies.
The antibiotic may arrive at a time when the bladder is full, empty or anywhere in-between. If the bladder is full, the antibiotic initially arriving will be diluted substantially, potentially well below a sufficient 'killing concentration.' This offers bacteria a “window of opportunity” to take action to survive, potentially to develop resistance in the time the drug can take to reach a therapeutic concentration, thus undermining the efficacy of the perceived “therapeutic concentration.”
It is not inevitable that uropathogens will mutate or expedite producing defences against the progressively building antibiotic threat but it offers a, hitherto, unappreciated opportunity to do so.
Additionally, antibiotic treatments are dosed for systemic infections operating within a narrow pH, but the pH of bladder urine can vary by a very significant degree (over 300,000fold, being pH 4.4-9.9 ), also undermining the ability of the antibiotics to do their job effectively. An antibiotic’s minimum inhibitory concentration (MIC) is established based on strict in vitro criteria that mimic systemic conditions, which do not necessarily apply within the urinary cavity.
Because of the very substantial numbers of patients treated annually for cystitis using orally administered antibiotics, the chances for developing AMR are an obvious, but incalculable risk- and this will undermine the battle to tackle this scourge. Even as new antibiotics are developed, if they are delivered orally, we will still face the same challenges.
That is why we believe clinical practice must change and treatments for these conditions should be delivered, whenever acceptable, direct-to-bladder.
UroPharma has invented and patented what will be the world's first licensed direct-to-bladder drainage and drug delivery system, getting the right drug concentration to the right place at the right time.
In a nutshell, clinical practice for the treatment of the bladder must change or gut microbiome damage and AMR will continue to grow as threats to vulnerable patients and global healthcare more broadly.
Contact me if you would like to know more.
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