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Interindividual variability in anti-infective therapy

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Interindividual variability in anti-infective therapy

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    1. Interindividual variability in anti-infective therapy Side of Personalized Medicine Juhee Lee Dec 11 2006

    2. Outline Anti-infective therapy Antibiotics Drug resistance Bacterial genotyping and polymorphism Personalized antibiotics

    3. What is infection? Detrimental colonization of a human or animal body by a foreign species Types of infection : 1. Bacterial infection – Tuberculosis(TB), Salmonellosis, anthrax, bacterial meningitis, brucellosis, campylobacteriosis 2. Viral infection – AIDS, Hepatitis B Virus ( HBV), Human Immunodeficiency Virus (HIV), common cold 3. Parasitic infection - amebiasis 4. Fungal infection - aspegillosis 5. Prion infection - transmissible spongiform encephalopathy

    5. Antibiotics

    7. It’s cheaper to treat patients right the first time : treating one MDR-TB patient costs the same as treating 100 with regular TB Antimicrobial resistance is a natural biological phenomenon. But it becomes a significant public health problem where it is amplified many-fold owing to human misuse and neglect. Drug resistance is the most telling sign that we have failed to take the threat of infectious diseases seriously. It suggests that we have mishandled our precious arsenal of disease-fighting drugs, both by overusing them in developed nations and, paradoxically, both misusing and underusing them in developing nations. In all cases, half-hearted use of powerful antibiotics now will eventually result in less effective drugs later Although most drugs are still active, the lengthening shadow of resistance means that many of them may not be for long. In the case of tuberculosis, the emergence of multi drug-resistant bacteria means that medications that once cost as little as US$ 20 must now be replaced with drugs a hundred times more expensive. Other diseases are likewise becoming increasingly impervious as currently effective drugs continue to be underused by patients who do not complete courses, and misused through indiscriminate and over-prescribing. a single treatment course of six months for regular tuberculosis costs as little as US$ 20. With MDR-TB, the costs shoot upward to US$ 2 000, or even more. It’s cheaper to treat patients right the first time : treating one MDR-TB patient costs the same as treating 100 with regular TB Antimicrobial resistance is a natural biological phenomenon. But it becomes a significant public health problem where it is amplified many-fold owing to human misuse and neglect. Drug resistance is the most telling sign that we have failed to take the threat of infectious diseases seriously. It suggests that we have mishandled our precious arsenal of disease-fighting drugs, both by overusing them in developed nations and, paradoxically, both misusing and underusing them in developing nations. In all cases, half-hearted use of powerful antibiotics now will eventually result in less effective drugs later Although most drugs are still active, the lengthening shadow of resistance means that many of them may not be for long. In the case of tuberculosis, the emergence of multi drug-resistant bacteria means that medications that once cost as little as US$ 20 must now be replaced with drugs a hundred times more expensive. Other diseases are likewise becoming increasingly impervious as currently effective drugs continue to be underused by patients who do not complete courses, and misused through indiscriminate and over-prescribing. a single treatment course of six months for regular tuberculosis costs as little as US$ 20. With MDR-TB, the costs shoot upward to US$ 2 000, or even more.

    8. Antibiotic resistance mechanism

    9. Fluoroquinolone resistance

    10. Campylobacter

    11. gyrA polymorphism in Campylobacter

    13. Genotyping analysis by PCR

    14. PCR

    15. Genotyping analysis by PCR

    17. Penicillin Resistance

    19. Streptococcus agalactiae

    20. Heterogeneity of genotype- phenotype correlation

    21. Helicobacter pylori

    23. CYP2C19 pharmacogenetic polymorphism

    25. Cost analysis of drug resistance

    26. Pharmacogenomics Pharmacogenomics could replace 'Trial-and-Error' with science from genome project. Pharmacogenomics has the potential to revolutionize the prevention, diagnosis, and treatment of infectious diseases. Genomics in Drug Target Identification Based on Genome Project, Identify genes to pathogenic organisms BROAD -> NARROW antibiotics spectrum!

    27. REBUTTAL

    28. DNA microarrays for host-microbe interactions

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