Fasciitis

TUESDAY, April 8, 2025 -- Severe and possibly deadly strep infections are on the rise in the U.S., a study published Monday in Journal of the American Medical Association said. The rate of invasive group A strep infections more than doubled from 2013 to 2022, jumping from about 4 cases per 100,000 people to 8 per 100,000, NBC News reported. These infections happen when strep bacteria spread to normally germ-free parts of the body, such as the lungs or bloodstream. Unlike regular strep throat, this type can lead to dangerous conditions like necrotizing fasciitis (flesh-eating disease) or toxic shock syndrome. “Within 24 to 48 hours, you could have very, very rapid deterioration,” Dr. Victor Nizet , a professor of pediatrics at the University of California, San Diego, told NBC News . Cases can transition from "seeming like a routine flu-like illness to rushing the patient to the ICU, fearing for their recovery,” he added. The U.S. Centers for Disease Control and Prevention (CDC) tracked data from 10 states with about 35 million people. In 2013, there were 1,082 cases. By 2022, there were 2,759 cases. In all, more than 21,000 cases were recorded over the period, including nearly 2,000 deaths, NBC News said. “When you see this high number of deaths, extrapolate that across the country — we’re probably well into more than 10,000 deaths,” Nizet said. Dr. Christopher Gregory , a CDC researcher and co-author of the study, said invasive strep now poses a higher threat to both high-risk groups and the general population. The rise may be linked to several issues: For one, more people are living with diabetes or obesity, which weakens the immune system. There's also been a rise in infections among people who inject drugs or experience homelessness. In 2022, the rate of infection among homeless people was 807 per 100,000 — one of the highest ever recorded, NBC News said. Gregory said the rate was “among the highest ever documented worldwide.” Also, strep strains are changing. New strains seem to cause more skin infections, not just sore throats, and some are becoming resistant to antibiotics like macrolides and clindamycin . The infection rate was highest among adults 65 and older, and all adults saw increases. Surprisingly, though, the study didn’t find an overall increase in children, but doctors say they’re seeing more serious cases. “That was, to me, the most shocking part of the study,” said Dr. Allison Eckard , division chief for pediatric infectious diseases at the Medical University of South Carolina. “Because clinically, we really are seeing what feels like an increase." Eckard, who reviewed the findings, said doctors are seeing more severe and more unusual cases, as well as more necrotizing fasciitis. It all raises concern, she said, that and cases "there is something going on more nationally.” She and other experts say more research is needed to understand what’s causing the rise and whether strep strains are becoming more dangerous. They also say a vaccine is badly needed, but progress may be slow due to recent changes at the U.S. Food and Drug Administration (FDA). “The lack of vaccine is devastating,” Nizet concluded. “Of course, we’re concerned about the turn of attitudes at the FDA and the CDC that seem to be putting some sticks in the spokes of the wheel of vaccine development.” Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

Recce Pharmaceuticals has shared positive data from a mid-stage study of its RECCE 327 topical gel (R327G) in acute bacterial skin and skin structure infections (ABSSSIs). The open-label phase 2 trial has been evaluating the safety and efficacy of the candidate when applied directly to the infected area in adults with ABSSSIs, including those with diabetic foot infections (DFIs). After seven days of treatment, 86% of R327G-treated patients had a successful clinical response and, after 14 days, 93% achieved a primary efficacy endpoint. R327G was also shown to be safe and well tolerated, with no serious adverse events reported. Recce said the data confirms the approach for its approved registrational phase 3 DFIs study in Indonesia, adding that it is also expecting to initiate a registrational phase 3 trial in Australia for ABSSSIs and DFIs. ABSSSIs, including DFIs, necrotising fasciitis and post-operative wound infections, are considered a significant healthcare concern, and there is an increased demand from the US Food and Drug Administration for new broad-spectrum antibiotics to address antimicrobial resistance (AMR). Declared by the World Health Organization (WHO) as one of the top ten threats to global health, AMR occurs when bacteria, viruses, fungi and parasites change over time and resist the effects of antimicrobial drugs. As a result, infections become harder to treat and the risk of disease spread, severe illness and death increases. Recce’s chief executive officer, James Graham, said: “These impressive results underscore the potential of our topical gel to meet critical unmet medical needs in infection treatment. “As we advance towards registrational phase 3 trials in Indonesia and Australia, we are encouraged by the rapid efficacy and strong safety outcomes demonstrated in this study.” Sharing a similar sentiment, Alan Dunton, director and chief medical advisor at Recce, said: “These results reflect the broad-spectrum nature and rapid onset of the effect of R327G, which positions us well for the upcoming phase 3 trials in Indonesia and Australia.” WHO has already added R327, along with two other anti-infectives in Recce’s pipeline, to its list of antibacterial products in clinical development for priority pathogens. The FDA has also granted R327 Qualified Infectious Disease Product designation under its Generating Antibiotic Initiatives Now Act, providing Fast Track Designation to the treatment as well as ten years of market exclusivity following approval.

Recce noted that its phase 2 data “aligns with the FDA’s increased demand for novel broad-spectrum antibiotics to address antimicrobial resistance.”\n Recce Pharmaceuticals’ synthetic gel successfully treated a range of skin infections in a phase 2 trial, leading the Australian biotech to point to the anti-infective\'s potential to counter antimicrobial resistance, a growing global threat. A total of 27 out of the 29 evaluated patients (93%) who received the topical gel, dubbed R327G, for 14 days hit the primary efficacy endpoint in the trial, Recce said in a Feb. 19 release. The patients all had some form of acute bacterial skin and skin structure infections (ABSSSI), including some with diabetic foot infections.R327G was also shown to be safe and well tolerated, with no serious adverse events reported, hitting another of the study’s endpoints.“These impressive results underscore the potential of our topical gel to meet critical unmet medical needs in infection treatment,” Recce CEO James Graham said in the release. “As we advance towards registrational phase 3 trials in Indonesia and Australia, we are encouraged by the rapid efficacy and strong safety outcomes demonstrated in this study.” As well as diabetic foot infections, ABSSSIs can also include a flesh-eating infection called necrotizing fasciitis, and post-operative wound infections. The global market for these combined conditions is expected to reach $26 billion by 2032, according to Recce.Despite the growing threat of antibiotic resistance, whereby bacteria have evolved to evade older antibiotics meaning new ones need to be created, the low return on investment means many of the biggest biopharmas have given up working on new antifungals or antibiotics in recent years—although GSK in particular has continued to sign deals and post encouraging clinical results against infections like gonorrhea.In this morning’s release, Recce noted that its phase 2 data “aligns with the FDA’s increased demand for novel broad-spectrum antibiotics (such as R327G) to address antimicrobial resistance.” The Sydney, Australia-based biotech is pitching R327 as both an intravenous and topical therapy that can take on life-threatening infections from Gram-positive and Gram-negative bacteria, including in their superbug forms.Beyond R327, Recce’s pipeline of synthetic polymer anti-infectives also consists of R435 for bacterial infections and R529 for viral infections.“These results reflect the broad-spectrum nature and rapid onset of the effect of R327G, which positions us well for the upcoming phase 3 trials in Indonesia and Australia,” Recce’s Chief Medical Officer Alan Dunton, M.D., said in the release. “Importantly, Recce has also demonstrated that its R327 anti-infective compounds are effective in vitro against diverse species of bacteria, including over 500 clinical isolates, many of which were previously considered drug-resistant.”