WHO WE SERVE

The Burden of Antibiotics

The question to be asked is,"Why not microdosing for surgical antibiotic prophylaxis?"

WHY Antimicrobial Resistance

is a Big Deal

Antimicrobial resistance is given the acronym AMR. It is not something most practitioners think of daily, but is a global public health threat. According to the World Health Organization, each year 1.27 million deaths result from AMR. The cause is attributed to the misuse and overuse of antibiotics in humans, plants, and animals. Every country is affected, but the low and middle-income countries are most affected. Due to resistance to antibiotics, infections have become harder to treat. Many skin infections caused by staphylococcus aureus have become resistant to commonly used antibiotics. While there is an urgent need for new antibiotics, drug companies are hesitant to invest their dollars in the new antibiotic pipeline.

Binary Pharmaceuticals believes using common antibiotics judiciously is a step in the right direction to combat AMR. The amount of antibiotics consumed globally for surgical antibiotic prophylaxis is enormous, representing 15% of the world’s use of antibiotics. The Binary Platform incorporates microdoses of antibiotics without the impact to the gut microbiome seen with oral antibiotics. The degree to which cutaneous microdosing affects the human microbiome is unknown. The effects of oral antibiotics and subsequent antibiotic scarring are well documented. The Binary platform has the opportunity to limit the degree of dysbiosis and damage to the microbiome. Antibiotic toxicities should be minimized, and the proven benefits of surgical prophylaxis with this delivery technique have been proven in clinical trials.

The W.H.O. Fact sheet on Antimicrobial Resistance (AMR) is widely quoted.

  1. AMR is a global public threat. It was responsible for 1.27 million deaths in 2019, and was a factor is 4.95 million deaths.
  2. The misuse and overuse of antimicrobial in humans, plants and animals are the main drivers.
  3. The low- and middle-income countries are most affected
  4. AMR places many gains of modern medicine into risk as infections become harder to treat.
  5. There is an urgent need for new antibiotic pipelines.
  6. AMR could result in a $1 Trillion-dollar additional healthcare cost by 2050.
  7. Priorities to address AMR in human health are needed.

Antibiotic

Scarring

In the last ten years, it has become apparent that commonly prescribed antibiotics have persistent long-term effects on the gut microbiome. One well-known expert, Dr. Shaefer Spires from the Duke Center for Antimicrobial Stewardship and Infection Prevention, states: “Even short courses of antibiotics have acute disturbances in the gut microbiome and may take months to recover. Long story short, it’s worse than we thought.”1

Decreased

Bacterial Load

Antibiotics decrease the microbiome’s overall bacteria load. In one study, 20 volunteers were recruited and divided into four groups. Each group received a different antibiotic. They found the overall composition and resistome did not return to normal two months after discontinuation of antibiotics.1 Scientists use the term resistance elements to test and identify the changes in the resistant gene burden. It was found this burden increased significantly for those who had received antibiotics. There are also long-term consequences in the composition of the gut microbiome, even when the overall microbial burden recovers. These resistant elements increase and become incorporated into the gut microbiome. Antibiotic scarring refers to long-term permanent changes in the gut microbiome due to antibiotics.

A simplified explanation of how antibiotics affect the gut flora, is that they disrupt microbial diversity. They may deplete beneficial species of bacteria while allowing opportunistic bacteria to thrive, leading to an imbalance called dysbiosis. When the beneficial bacteria are suppressed, pathogens like Clostridiodes difficile can overgrow, leading to colitis and persistent infections.

Even slight microbial disruptions can lead to an imbalance. The gut microbiome assists in digesting fiber, producing vitamins, and modulating the immune system. Any disruption can lead to infections and inflammatory disease.

Recovery

After a short course of antibiotics, the gut microbiome can take weeks or months to recover. Some species may never return, particularly after a prolonged course of antibiotics. Antibiotic exposure in early life has been linked to an increase in obesity, allergies, and autoimmune disease. The exact strength of this linkage is not known, but neonates, obese children, and children with allergic rhinitis compromise a vulnerable population for antibiotic-associated dysbiosis.

Clinical trials have shown that probiotics can help to some extent and improve H pylori eradication rates. All providers need to consider the deleterious effects of antibiotics on the microbiome before prescribing. The prudent use of antimicrobials can help prevent gut microbial dysbiosis.2

Gut brain connection
We need some sort of caption under the gut brain axis slide.

separate section

Market Potential

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Healthcare acquired infections

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I would like to include the information that is on the Pfizer slide labeled market potential. We will have to put it in a different format.

separate section

Binary’s novel delivery platform

This will be a separate section. This needs to list all the benefits as listed in the Pfizer talk. This also needs to list the components of the kit. This needs pictures and diagrams as well.

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Reference:  

  1. Winston E Anthony et al., “Acute and Persistent Effects of Commonly Used Antibiotics on the Gut Microbiome and Resistome in Healthy Adults,” Cell Reports 39, no 2 (April 12, 2022). https://doi.org/10.1016/j.celrep.2022.110649 
  2. Dhanasekhar Kesavelu, Pramod Jog. “Current understanding of antibiotic associated dysbiosis and approached for its management.” Ther Adv Infect Dis. 2023, Vol 10:1-18. DOI:10.1177/20499361231154443 

 

Binary Pharmaceuticals develops accessible and affordable antibiotic delivery platforms in the interest of public health. 

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