Superbugs

April 1, 2019
A riveting insider's look at the race to find a cure for antibiotic-resistant infections, one of the most pressing challenges in modern medicine. It's official: Bacteria are outsmarting us. Bacterial strains that are impervious to even the most powerful antibiotics, nicknamed "superbugs," are increasingly common and frighteningly lethal. Physicians are often left with their hands tied, forced to see patients die from infections that could have easily been treated 10 years ago. In this eye-opening book, McCarthy (The Real Doctor Will See You Shortly: A Physician's First Year, 2015, etc.)--an assistant professor of medicine at Weill Cornell and a staff physician at NewYork-Presbyterian Hospital, where he is a member of the ethics committee--breaks down the complex interplay among biomedical researchers, the pharmaceutical industry, the Food and Drug Administration, and clinicians. Unsurprisingly, the most important consideration in this complicated equation is money. Conducting clinical trials to test the efficacy and safety of new antibiotics is expensive, and even when they are approved, the medications may not be hugely profitable for the manufacturer. "A study from the London School of Economics," writes the author, "estimated that, at discovery, the net present value of a new antibiotic was minus $50 million." McCarthy, however, is not deterred, and he agreed to lead a cutting-edge clinical trial involving a brand-new, synthetic antibiotic known as dalba. He pulls no punches as he details the tension between institutional bureaucracy and patient care, often becoming emotional as he describes his patients and their stories. He makes it clear that despite the importance of protocol, there is no time to waste. The author's storytelling is at once urgent and empathetic, a compelling combination that leaves readers feeling informed and optimistic. Insightful and honest, McCarthy effectively combines useful information about the latest advances in microbial research with accounts of the best aspects of humanity.

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April 15, 2019
The superbugs of the title are not irritating insects but rather antibiotic-resistant bacteria with often formidable names?Enterococcus faecium and methicillin-resistant Staph aureus (MRSA)?that are becoming increasingly prevalent and more virulent. Physician McCarthy (The Real Doctor Will See You Shortly, 2015) asks, "Why is it so hard to make a new antibiotic?" His answers include the difficulty of discovering antibiotics, the exorbitant cost of research and development, and the FDA's lengthy and rigorous approval process. Antibiotics can be created by scientists in the laboratory or found in dirt where they are manufactured by microbes. McCarthy describes his clinical study of a new drug, dalbavancin (dalba), for serious skin infections. He formulates a protocol, enrolls volunteer patients and obtains their informed consent, administers the medication, and schedules follow-up. He recounts how "painful" the project was, and declares, "Defending the defenseless was perilous work." Fortunately, his sage mentor, Dr. Walsh, helps him out. McCarthy makes it clear that superbugs are one of the gravest threats in modern medicine, with woefully few new antibiotics on the way.(Reprinted with permission of Booklist, copyright 2019, American Library Association.)