What would you rather spend? You may be able to choose between World War Two-era generic antibiotics, which are being studied by the federal government, or newer meds that drugmakers are developing and cost as much as $100 a day. With more than 18,000 Americans killed annually by MRSA, the deadly, drug resistant staph germs, this is a huge market that’s developing quickly.

“We have used these older drugs with success for years,” says Gregory Moran, a professor of emergency medicine at the Olive View-UCLA Medical Center in Sylmar, California, which is affiliated with the University of California at Los Angeles. “We know they kill bacteria in a petri dish, and we know they work in people. What we don’t have for them are clinical trials,” he tells Bloomberg News.

So the NIH recently awarded $19 million to a research group led by Moran at UCLA and to another led by Henry Chambers III at the University of California at San Francisco. They hope to prove that two types of older antibiotics - sulfa drugs, in use since the 1930s, and clindamycin, first prescribed in the late 1970s - should win FDA approval for MRSA. These older meds are used to treat infections before surgery is required.

But Tony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases, says the grants are only intended to fill a vacuum left by drugmakers. “These are a temporary stopgap. Sooner or later, the microbes will develop a resistance to them, and at the end of the day we’ll need permanent solutions,” he tells Bloomberg, adding that new antibiotics being developed will, ultimately, be needed as staph bacteria mutate and become more resistant even to the sulfa drugs and clindamycin.

But are the new meds truly new?

Johnson & Johnson and Pfizer are readying modified versions of older meds, although Wall Street believes the drugmakers may reap a $1 billion windfall, Bloomberg writes. Two years ago, Pfizer and J&J obtained the drugs from biotechs working on rival antibiotics

However, John Lebbos, director of infectious diseases for Decision Resources, a market research firm, says even more needs to be done. “The number of players in the market has declined. There are a lot of concerns that as out-patient strains acquire broader and broader resistance, the older drugs won’t be as effective,” he tells Bloomberg.

For now, the generics have the advantage, because bacteria haven’t developed broad resistance to them, Moran says. The medicines can forestall complications that would require more expensive drugs, such as Wyeth’s Tygacil, which costs about $100 a day. A typical daily dose of Pfizer’s Zyvox, a synthetic antibiotic used to treat MRSA, is two $60 pills daily for 10 to 14 days.

The grants represent a realization by the NIH that there is a “gap in the current knowledge” about the older drugs and that government needs to step in when market conditions may discourage drugmakers from filling it, Moran says. “We know these drugs work. They are already in wide use. But we want to confirm what doctors are doing, and the trials may change behavior somewhat.”

Source: Bloomberg News