Military Medicine on the Cutting Edge

By Debbie Gregory.

Multiple Drug Resistance (MDR) is a condition enabling disease-causing microorganisms (bacteria, viruses, fungi or parasites) to resist distinct antimicrobials.

The U.S. Army Medical Materiel Development Activity (USAMMDA) at Walter Reed National Military Medical Center has been studying the ever-changing battlefield injury treatment. During conflicts in Iraq and Afghanistan, military doctors have seen multi-drug resistance bacterial organisms that previously did not exist. As a result, it has become more difficult to cure various infections. The USAMMDA has been working to develop Arbekacin as an antibiotic treatment for infections caused by MDR bacteria, giving our servicemembers relief from prolonged infections.

Arbekacin is a new antibiotic treatment for multidrug resistant, or MDR, infections. Those types of infections may complicate wounds sustained by soldiers in theater, according to Col. Michael Zapor, an infectious diseases physician at Walter Reed National Military Medical Center.

Arbekacin was originally synthesized from dibekcin in 1973. It has been registered and marketed in Japan since 1990 under the trade name Habekacin. Arbekacin is no longer covered by patent and generic versions of the drug are also available under such trade names as Decontasin and Blubatosine.

Multi-drug resistant organisms, or MDROs, are bacteria resistant to current antibiotic therapy and therefore difficult to treat. MDROs can cause serious local and systemic infections that can be severely debilitating, even life threatening. In the past, MDROs were predominantly confined to healthcare facilities such as hospitals, long-term care facilities, and dialysis centers.

As the face of war is ever-changing, so are the needs of our servicemembers. Before the Iraq war, the pathogenic highly drug-resistant bacteria Acinetobacter attracted little attention. The bacteria entered the bloodstream through open wounds, or through tubes, such as catheters. Initially, it was seen in military personnel being treated for life-threatening injuries in Iraq field hospitals. But hundreds of cases have since been reported, and the Department of Defense says seven service members have died from the bacterial infections. Acinetobacter isn’t new, but its current offspring are superbugs, which are much more dangerous than the original bacteria.