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Drug-resistant “superbugs” pose a dire threat in hospitals, where an antibiotic-resistant germ like MRSA could leave an already sick patient without any treatment options. Superbugs were a topic of concern in the medical community long before COVID-19 was in our vocabulary, says the Levy CIMAR’s Helen Boucher, MD, an infectious disease physician at Tufts Medical Center and interim dean of Tufts University School of Medicine. “It’s a growing problem, and many of us call it a silent pandemic, because it is, ever, ever so much still with us, despite our very appropriate focus on COVID,” she says.\n\n

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The scientific community generally recommends vaccination even in people who have already had COVID-19. \u0022The most common question I’m getting is, ‘How should I time my booster and my flu shot?’\u0022 says Levy CIMAR’s Dr. Shira Doron of Tufts Medical Center. \u0022Or my first COVID vaccine shot, or my second COVID vaccine shot and my flu shot. And the answer is, whatever works for you. There are no rules.\u0022 The only important thing to note, Doron says, is that the flu shot should be given at least one inch apart from your COVID shot if you get them at the same time. People can receive both shots on the same day at the same time, she said, or they can be spaced out over time.

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The discovery of drugs appears to obey a rule christened Eroom’s Law. In a nutshell, the number of drugs approved for every billion dollars’ worth of research and development (R&D) halves every nine years. This pattern has remained largely consistent for over 70 years. Since 1950, the cost of developing a new drug has risen at least 80-fold. A Tufts University study suggests that the cost of developing a drug approved by the U.S. Food and Drug Administration (FDA) rose at least 13 times between 1975 and 2009. By the mid-2000s it was $1.3 billion. In the 1960s, by contrast, costs per drug developed were around $5 million. Timelines, at least pre-Covid, are likewise extended. Eroom’s Law shows that it takes more and more effort and money to develop new drugs. Achieving a pharmaceutical breakthrough is on a trend of increasing difficulty.

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The Levy CIMAR’s Alysse G. Wurcel, M.D., from Tufts Medical Center in Boston, and colleagues assessed disparities in SSTI treatment using data from the national survey of Acute Care Hospital Groups within Vizient Inc. (Oct.16, 2018, to Jan. 13, 2019). The researchers found that Cefazolin was more commonly used in White inpatients versus Black inpatients (13 versus 5 percent), while clindamycin was more frequently used in Black inpatients than White inpatients (12 versus 7 percent). Cefazolin is one of the first-line SSTI treatments. Clindamycin is not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection.

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Using two or more drugs together as treatment is a simple idea with a complicated underpinning. In order to combine drugs to treat complex infections such as tuberculosis, HIV, and most cancers, we have to understand how their mechanisms work together first. One drug may target one pathway, another drug another pathway. If infected cells grow at different rates, some classes of antibiotics kill the fast-growing cells better, while others are better at killing the slow ones. There can be thousands of combinations to measure. If the right combinations are found, such multidrug therapy may increase treatment efficacy and prevent the development of drug resistance, both important long-term goals.

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For decades, Boston has been at the forefront of addressing this crisis, from detecting the first MRSA outbreak to the pioneering work of Tufts University’s Stuart Levy, who showed that giving antibiotics to farm animals fuels resistance and threatens human health. Now the city is leading in another critical way: by serving as the global hub of antibiotic financing. Last week the Centers for Disease Control and Prevention announced that US deaths from antibiotic-resistant infections jumped 15 percent in 2020, after years of steady declines. That follows a study published earlier this year in The Lancet that showed 1.27 million people died globally in 2019 from antibiotic-resistant infections, nearly double the number of deaths caused by HIV/AIDS or malaria.

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The Tufts University Springboard Award, sponsored by by the Office of the Provost, Office of the Vice Provost for Research (OVPR), and Tufts Medical Center, has a new round of winners. Per the Springboard team, \u0022Each of these high-quality, high-impact research, scholarship, and educational initiatives bodes well for vibrant research at Tufts by having an explicit plan leading to extramural funding or other outcomes that further influence research, scholarship, and/or policy.\u0022 Congratulations to all of the winners, and especially to the Levy CIMAR’s own Drs. Alysse Wurcel (TMC), Gabriela Andujar-Vazquez (TMC), Maureen Campion (TMC), Shira Doron (TMC), and Elena Naumova (Friedman), and their colleagues for their important work. Dr. Wurcel and team have been awarded the Springboard prize for their project on \u0022Engaging Stakeholders in New England to Improve Antibiotic Stewardship Practices in Jails and Prisons.\u0022 Dr. Naumova and colleagues won the award for their work on \u0022Famine Archive and Data Hackathons.\u0022

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The ripple effects of the Covid-19 pandemic’s influence on nearly every aspect of health in America are becoming clear. Covid-19 has killed more than one million people in the U.S., a toll mounting by some 350 people a day. A range of other chronic diseases and acute threats to health also worsened during the pandemic, data show, as people missed screenings, abandoned routines and experienced loss and isolation. Per the Levy CIMAR’s own Helen Boucher, MD, Dean ad Interim of the Tufts University School of Medicine, antibiotics, strained resources, and a slip in prevention efforts have led to a rise in resistant infections. Experts say that heart disease and drug overdoses are also among afflictions exacting a higher toll than before.

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Imagine you have 20 new compounds that have shown some effectiveness in treating a disease like tuberculosis (TB), which affects 10 million people worldwide and kills 1.5 million each year. You know that to treat the disease effectively, patients will need a combination of three or four drugs because TB bacteria behave differently in different environments—and in some cases, evolve to become drug-resistant. How do you decide which drugs to test together? Twenty compounds in three- and four-drug combinations offer nearly 6,000 possible combinations.

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Cummings School of Veterinary Medicine at Tufts University (Cummings School) is now recruiting canine patients for a clinical trial testing a 3-day antibiotic treatment for urinary tract infections (UTI). According to an organizational release, researchers in this study are conducting a randomized, placebo-controlled trial to determine if 3 days of the antibiotic amoxicillin is as effective as 7 days for the treatment of UTIs in dogs. The researchers at the Cummings School are hoping if the results verify to be effective, the new treatment course could improve antibiotic compliance, reduce the development of antibiotic-resistant UTIs, make treatment easier for owners, and save money on prescription costs. UTIs are commonly seen in dogs, especially in females.