Statistics of antibiotic pharmaceutical companies (pipeline & R&D Plan)Through the investigation and statistics of the research pipeline of antibiotic pharmaceutical enterprises, we are aware of our human condition as resistant bacteria become more difficult to deal with. Fieldwork on the sale of antibiotics in pharmacies.
Fieldwork was then conducted on the sale of antibiotics in pharmacies, the results show that the sale of antibiotics is still not carried out in accordance with national standards in some areas, It can be purchased by leaving an ID number and contact information rather than by prescription only.
In order to understand the situation of the sale of antibiotics in folk, field investigation was then conducted. We randomly visited six pharmacies in Panyu District, Guangzhou City, two of which are located in busy areas and four are located in urban villages. After investigation, we found that antibiotics can be purchased with an ID card rather than a prescription in five of the six pharmacies. The other one provides online consultation service, which can prescribe online, but the doctors can’t observe the patient's symptoms face to face, they can make judgement only according to the patient's description, which may still lead to the phenomenon of random prescribing of antibiotics. What’s worse, staffs in three of the six pharmacies didn’t know the difference between antibiotics and anti-inflammatory drugs, which may also be a major cause of folk antibiotic misuse, that is, some grass-roots pharmacy staff are not well trained.
Therefore, to reduce the misuse of antibiotics in folk, it is necessary to regulate pharmacies on the one hand, and to raise awareness among patients on the other; but it is not easy to do the former, and for iGEMer, the easy and cost-effective way to influence the public is through science communication, and to this end, we have done a series of science communication work in guiding the public to the correct understanding and use of antibiotics.
See the science communication page for details:
Online science communication based on self-media
https://2020.igem.org/Team:SCUT_China/Education#Online_science
Online science communication based on WeChat about superbugs & antibiotics
https://2020.igem.org/Team:SCUT_China/Education#Deepen_collaboration Public awareness of antibiotic use (questionnaire survey)
We continue to investigate public perceptions and use habits of antibiotics.
The results of the survey were also not encouraging, which triggered our action and thinking of science communication and humanistic medicine.
Summary and Reflection of the Questionnaire Results of Public awareness of antibiotic use is as follows: The questionnaire setting and feedback results are as follows
Lecture@ Prof. Chen Widely resistant gram-negative bacterial infection of clinical treatment)
We acquired a good knowledge of widely resistant gram-negative bacterial infection of clinical treatment from Prof. Chen’s lecture and knew the dose requirements for common antibiotics and their toxic effects on organs and systems.
Our gains and notes are as follows
Interview @ two clinicians
How can we use synthetic biology techniques and constructive thinking to cope with the helpless of mankind in the post-antibiotic Era. After numerous literature surveys and countless brainstorming sessions, engineered bacteriophages were selected among the alternatives to conventional antibiotics, such as lysins, antimicrobial peptides, probiotics and antibodies. Our ideas, solutions, and proposed problems were also discussed with the two clinicians we interviewed. Interview summary 1 Chenggang Ye
(Deputy chief physician of otolaryngology head and neck Surgery department, Jianghan Oilfield General Hospital, Hubei Province)
After completing the interview with Dr. Zhang Jinyong, we contacted Dr. Ye Chenggang. Firstly, we further understood the views of the first-line clinical doctors on the management and control of antibiotics in China. Furthermore, we consulted Dr. Ye on the situation of drug-resistant bacterial infection and treatment in the hospital, as well as his evaluation of our project and his views on public cognition and science communication work
1. The condition of a drug-resistant bacterial infection
Drug-resistant bacterial infections are the most severe in the respiratory department because patients are often put on ventilators. The infection of drug-resistant bacteria generally occurs in hospitals, where patients use ventilator frequently and stay in bed for a long time. Some infections are more serious, especially the complicated drug used in hospital, while the drugs used in daily life are relatively single, so the probability of multi-drug-resistant bacteria infection is not high.
2. Views on our project
Bacteriophages are highly specific, and your project is a good direction, which is very meaningful to solve the phenomenon of drug-resistant bacteria, and if we can ensure that bacteria do not lysis during the treatment, such as your project, theoretically, we can effectively reduce the side effects of treatment. Although bacteriophages are not as broad as most antibiotics, they can be used for targeted drug use in clinical practice for some bacteria cultured, which is more accurate.
3. Views on public cognition and science communication work
Many people confuse antibiotics with anti-inflammatory drugs. It is very common that they are misused. Most of the drugs available in pharmacies are penicillin and cephalosporins, so the frequency of use is very high, which leads to the high resistance rate of drug-resistant bacteria detected in the hospital to these antibiotics, and there are still a large number of non-standard use of antibiotics in the folk, for example, the frequency and amount of usage were not controlled according to the doctor's order.
In the daily work of science communication, doctors usually give advice to patients face to face. However, due to the knowledge level and acceptance of the Chinese people and the large number of patients the doctors receive every day, the explanation can’t be so deep, so the effect is not ideal. Although the hospital sometimes organizes science communication activities, the frequency is not high. The most important thing is that the society and the media should bear the responsibility in this respect, it is far from enough to rely on the strength of doctors alone.
Interview Details:
Interview summary 2 Jinyong Zhang
(Chief physician of Neurology department of Yicheng People's Hospital)
The purpose of this interview is to understand three aspects from the perspective of front-line clinicians: 1. Views on the situation of antibiotic abuse and antibiotic control policy in China. 2. What are the possible causes of antibiotic abuse. 3. Views on patient cognition, doctor-patient relationship and science communication work.
1. Views on antibiotic use and control
At present, China implements hierarchical management and control measures on antibacterial drugs, which are divided into non restricted use level, restricted use level and special use level. Each level of drugs can only be prescribed by doctors with corresponding qualifications. The current management for hospitals and doctors has been quite strict, and even brings inconvenience to doctors. The abuse of antibiotics is mainly concentrated in pharmacies which do not sell medicines according to the regulations, and patients are not used according to the requirements. Therefore, to effectively reduce the abuse of antibiotics, we should start from improving the cognition of patients.
The control of antibiotics is generally good. As to why in pharmacies, especially those in remote areas, antibiotics can be bought without a prescription, this may be limited by China's national conditions. At present, the gap between the rich and the poor in China is still large, the medical conditions in different regions are uneven, people in remote areas are restricted in medical treatment, so we should give them some space for self-medication. If the management is too strict, there may be some disadvantages.
2. Views on the causes of antibiotic abuse
One of the important reasons for the abuse of antibiotics is that many people confuse the concepts of antibiotics and anti-inflammatory drugs. As for why, it may be related to some concepts in traditional Chinese medicine. In traditional Chinese medicine, the symptoms of cold, fever and inflammation are collectively referred to as "lit", and inflammation is a disease in western medicine, Later, western medicine was introduced into China, people found that antibiotics and anti-inflammatory drugs also have the effect of treating “lit”, so antibiotics are also called anti-inflammatory drugs.
3. Views on patient cognition and science communication work
In the past, the common people believed that antibiotics should be used for colds and fevers. Although the government has begun to pay attention to the control of antibacterial drugs in recent years and has also done a lot of science communication work, the results in cognitive correction are not ideal, and it will take a long time for the common people's ideas to be corrected. There are a lot of doctor-patient disputes in the outpatient department due to prescribing drugs. Social media should shoulder the responsibility of science communication. It is not enough to rely on government propaganda alone.
Interview Details:
So far, human practice has shifted from focusing on a social problem and conducting research to formulating and perfecting a synthetic biology solution that specifically addresses this problem.
Determining that the project focused on phages and Pseudomonas aeruginosa, we gained a lot of background knowledge in a short time from the lecture of Prof. Ma and 3rd Superbug Infection and Phage Prevention and Control Summit 2020. Lecture @ Prof Ma.
Academic conference: 3rd Superbug Infection and Phage Prevention and Control Summit 2020.
Scan the code for detailsFor the protection of intellectual property rights, we are not in a position to show you any more details. We are willing to provide iGEMer with content references for the reasonably hosted connection Public, doctors, medical students’ perception of (engineered) phages
We conducted phage questionnaire surveys among different populations to analyze the acceptance of phage products in the future promotion.
We analyzed the questionnaires of health care workers and the general public
Here is the Medical staff’s perception of (engineered) phages
Details are as follows:
Here is the general public s perception of (engineered) phages
Details are as follows:
Interviews @ Prof. Tong (collaboration with DUT_China)
Thank DUT for their invitation. We communicated the design & proposed implementation of our project with professor Tong, which greatly broadened the horizon and promoted our project.
Yigang Tong
(President of School of life science and technology, Beijing University of chemical technology, Formor researcher of molecular microbiology in the Academy of Military Medical Sciences, and director of the Department of omics and bioinformatics, National Key Laboratory of pathogen biosafety, Institute of microbial epidemiology, Academy of Military Medical Sciences.)
1. Research status of phage therapy
At present, phage therapy and its application at home and abroad still stays on that of natural phage. The main reason is the lagging behind of basic research on phage, which manifests as the lack of understanding for the mechanism for infection, cell lysis and replication of certain phage, and due to this, the experiment of phage modification lacks theoretical support, which eventually causes difficulty in product promotion. At present, neither natural nor modified phage has been used as a kind of therapy in clinic at home and abroad. Phage therapy now still stays in the laboratories and comes from animal experiments. Relevant laws and regulations need to be formulated and improved, at present, Shanghai Institute of Phage is qualified for compassionate use of investigational drugs in phage therapy.
2. Endotoxin problems
Early literature indicates that the release of endotoxin and other contents of bacteria can lead to a series of severe adverse reactions. Although situation is not so dramatic when doing later animal experiments, it is theoretical possible, and it can still be a problem. Therefore, it is still necessary to do research on preventing the release of endotoxin and other contents of lytic bacteria.
3. How phage therapy become mature and popularized
Being cleared for clinical use is a sign of maturity of phage therapy. According to modern pharmaceutical theory and strict drug declaration process, pharmaceutical factories have to outline all ingredients and their function of drugs. However, with complex ingredients which hasn’t been thoroughly clarified, it’s difficult for phage drugs to get the approval under such audit. Besides, though phage won’t attack the aboriginal flora in human bodies, it still has a drawback as it is individualized, which means different patients need different drugs, so that the cocktail therapy contains different kinds of phage, and it complicates the ingredients of drugs of phage therapy. For social consensus, since the development of phage therapy is irreversible, and it is usually used when patients are seriously ill and antibiotics doesn’t work, we needn’t worry about protest from the public and media.
Interview details: