R. Villano - Superbugs & superdrugs: issues and contrast of antibiotic

Raimondo Villano
LCC RM 265 - 267
S U P E R B U G S & S U P E R D R U G S
Issues and contrast of antibiotic
“Life is short, art is long,
the favorable opportunity,
attempting misleading,
the difficult decision”
Hippocrates

Raimondo Villano - Superbugs & Superdrugs4
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Raimondo Villano - Superbugs & Superdrugs 5
Contents index
Sommario 13
Abstract 15
Résumé 17
Abstrakt 19
Abstracto 21
1. A brief history of antibiotics 25
2. Issues and contrast of antibiotic 33
3. Major resistance to antibiotics 49
4. Look back at some super diseases 55
5. Technologies and research directions 65
6. New therapeutic compounds 77
7. Appendix 85
8. Author profile 169

Keywords
antibiotics, resistance, bacteria.
Abstract
You plot historical notes on the concept of antibiosis, on research,
discovery and production of antibiotics and their global role not only
therapeutic but also strategic since World War II. Then, you look at
national and international issues related consumption, misuse and
overuse of antibiotics in humans, in animal husbandry, agriculture,
and thus in the food chain and the environment; policies to combat the
phenomenon of excessive prescription and citizens in the degree of
information and awareness of the risks; guidelines of good practice
behavior of the patient; the main documents of struggle in this
emergency. We make also an analytical overview and a discussion of
some super diseases (tuberculosis, gonorrhea, meningitis, etc.) And
bacterial resistance to major antibiotics. We realize, finally, a survey
on current technologies and addresses of applied research and a
survey on major recent new therapies. Closes work a technical
appendix containing an apparatus essential regulations and
ministerial directives Italian and European Community on the theme.

Issues and contrast of antibiotic
Thanks to antibiotics, then, after World War II, medical science has
been able to obtain the total control of almost all infections. It is to
this class of medications the quality and life expectancy enjoyed by
the more developed countries.
However, antibiotics are also the basis of a substantial modification of
the ecosystem and the environment, not knowing stop the use and
especially the misuse (including disorders of minimal importance) and
the abuse of these drugs by citizens and also on animals, the result
worrying evolves from day to day in a situation 'critical' for the
increase of resistant bacteria to molecules currently available(6)
. In
general, so far the antibiotic resistance is present mainly in hospitals
and in patients with pluripatologie.
Italy is among the first in Europe to antibiotic consumption and with
higher levels of antibiotic resistance(7)
.

The data shows that "every day a half million people take an antibiotic
and that in 60% of cases these drugs are taken to treat respiratory
diseases often caused by viruses.
This means that are used in an inappropriate manner thus causing
double damage. The first to own health, because antibiotics are not
effective against viruses. The second also to the community, because
it encourages the development of non-sensitive germs that will
prevent in the future to antibiotics to perform their function in the
treatment of infections(8)
. "
In Italy 44% of the population received at least one prescription of
antibiotics in 2008, with greater use in children and elderly. In
particular, in that year it was prescribed an antibiotic to 53% of
children and 50% of older people(9)
.
Estimates suggests, also, that consumption in some cases it was even
almost double compared to other countries.
As we age it becomes even greater frequency of antibiotic
prescriptions repeated: patients who received six or more prescriptions

account for 13-14% of the population up to 64 years, 22-24% of the
band 65-74 years and 28-32% of those over 75.
Among the most frequent causes of prescription antibiotic drugs there
are the pathologies: respiratory (over 40%), genitourinary system
(18%), digestive system (13.6%).
In particular, infections associated with the highest number of
antibiotic prescriptions are: cystitis (9.9%), acute pharyngitis (8.3%),
acute bronchitis (5.7%), dental abscess (5.4%), laryngotracheitis (5%).
Classes of antibiotics used in Italy in 2008 were penicillins followed
by macrolides, quinolones and from the cephalosporins(10)
.
In Italy in 2009 the consumption of systemic antibacterial agents has
increased by 2% compared with 2008, when 44% of the population
received at least one prescription antibiotic.
So, it can be estimated that every day in Italy about a half million
people (2.5% of the population) take, outside the hospital, an
antibiotic.

In the hospital, however, it shows that in 2007 were consumed more
than 32 million doses of antibiotics and that about 3-4 million patients
received antibiotic therapy.
Unlike for drugs for chronic conditions, consumed 80% of cases by
ultra cinquantacinquenni, the use of antibiotics is not characterized by
age-dependent variations, except an increase in childhood.
Overall in the Italian regions there is a trend of growth in
consumption, an increase of 13% between 1999 and 2007(11)
.
Italy in 2012 appears to have the highest consumption in Europe of
antimicrobials (antibiotics of both natural and not), especially for farm
animals(12)
.
According to the report Ema, in 2012 in Italy we have been consumed
2,156 tons of antimicrobials is the only country where they have been
exceeding 2,000 tons (together with Spain with 2,055 tons).
In Italy of that total quantity over 1,500 tons are used for animals,
while in 15 countries of the 26 considered the largest share is used for
humans.

Regarding the per capita consumption of antimicrobials for animal
use, Italy is by far the first in front of Cyprus and Spain while for
human consumption is third after France and Belgium.
Between 1999 and 2007 in France there has been a reduction of 16%
in just three years 2008-10 and this country has dropped by about 20%
the number of recipes, information campaigns to citizens and doctors.
Even Italy since 2009 has adopted policies to combat the phenomenon
dell'iperprescrizione of antibiotics, known for decades and "also
characterized by wide regional variation: in Calabria and Sicily,
territories less virtuous to do so, you get to prescribe a quantity of
drugs double or even triple compared to the province of Bolzano. This
means that, in contexts very different between them, is different also
the prescription and especially the demand for antibiotics, due to
cultural reasons(13)
. "
The World Health Organization warned that the situation could have
radical effects on global medicine, economy and society unless global
actions are taken quickly. A lack of effective antibiotics means that

infected patients will need more extensive care, require longer
hospitalizations and die in greater numbers(14)
.
A more rational use of antibiotics would result in a substantial savings
can be estimated, in Italy alone, in many hundreds of millions of euro
a year and certainly a very positive impact on the entire public health.
In the EU infections caused by drug-resistant bacteria they have
produced in 2010 at a cost, in health care costs and productivity
losses, more than 1.5 billion euro(15)
. In 2012 it was estimated that
antimicrobial resistant bacteria cause 25 thousand deaths per year in
the European Union, Iceland and Norway.
In fact, the antibiotic-resistance is steadily increasing around the
world, to certain infections mortality has increased by almost 50%(16)
.
How stress the governments to intervene in this delicate area,
considering the gravity of the problem, the World Health Organization
published in 2012 the book 'The evolving threat of antimicrobial
resistance'.

In 2014, then, the WHO said that resistance to antibiotics has become
a reality and constitutes "a serious threat to public health(17)
."
In 2014 the World Health Organization published the first 'Report on
antimicrobial resistance globally'. The new report takes a picture with
all available so far on antibiotic resistance, by analyzing data from
114 countries.
In the report the UN agency does not mince words and declares a state
of emergency "is one of the most serious health threats, and it is now."
Today, "unless you take significant actions to increase efforts in
preventing infections, and to change the way we produce, use and
prescribe antibiotics, the world will lose what has gradually gained in
terms of public health. And the implications will be devastating. "
The report shows that the crisis of antibiotic resistance is endangering
patients in both developed countries and in those Developing(18)
.
The leadership of the institution, also speak of "post-antibiotic era"
and warn that, "far from being an apocalyptic fantasy, is a very real
possibility for the twenty-first century(19)
" that common infections and

mild wounds can go back and kill urge to action "urgent and
coordinated(20)
."
In particular, the paper focuses on antibiotic resistance for 7 different
bacteria responsible for serious diseases common: infection
Hematologic, diarrhea, pneumonia, urinary tract infections,
gonorrhea. The results are defined 'very worrying' and documenting
antibiotic resistance, in particular those of 'last resort'.
The antibiotic-resistance in the EU is more widespread in the
countries East and South; between them there is Italy, where the
resistance is monitored by the ISS, who pours the data in the network
of European surveillance Ears-Net(21)
.
Faced with a solid network of surveillance, response should be
improved.
The report by the European Center for Diseases Control (ECDC),
published at the Seventh Day of antibiotics November 18, 2014,
boccia Italy in the correct use of antibiotics as has the unenviable

distinction of being the band with the highest resistance percentage for
virtually all bacteria.
Of the increase in resistance to antibiotics developed by certain
bacteria, Italy is largely responsible along with Greece and, to a lesser
extent, Cyprus and Romania.
Therefore, "the situation is critical because today there are many
strains of bacteria, including the one responsible for tuberculosis have
become resistant to all antibiotics available(22)
" and we have only a
few new molecule next to enter the market .
It seems clear risk "of returning to the same situation that existed
before the discovery of antibiotics when an infection even trivial,
since there are no weapons useful to treat it, put lives at risk(23)
." Many
citizens are still poorly informed about the risks from misuse of
antibiotics and the onset of antibiotic resistance; especially young
people appear to be less aware and more prone to errors(24)
. From the
data collected in 2010 in Italy on a sample of 2,200 people, showed
that there are improvements, for example in the association between

prescription medicine and its use (especially in paediatrics): with
more than 80% of the population that associates such drugs to medical
prescription. Among the young only just over 30% know of this
phenomenon, compared with around 70% of adults and 47% of
seniors. In addition, over 40% of young people believe they can buy
antibiotics themselves. The relationship with antibiotics is also
complicated by the wave of influenza details, such as was the case for
the pandemic virus A, Being generated much uncertainty about their
therapeutic role.
In seasonal flu, then, at least half of Italians are aware that the
antibiotic is necessary only in case of complications, and found that
only 30% know that the same rule also applies to new influences, such
as A, and another 30% were undecided on what to do with antibiotics
in a pandemic(25)
.
The European Union in 2011 launched a five-year plan of 12 specific
actions to contribute, first, to change the culture of the use of
antibiotics that still exists among doctors, patients and hospitals,

especially in southern European countries, particularly Greece, Italy
and Spain.
On 11 December 2012, then, the European Parliament, after voting in
favor of the Health Committee on November 6, approved in plenary
(with 588 votes in favor, 16 against and 23 abstentions) a resolution
drafted by Anna Rosbach (Group conservatives and reformists
European).
This measure 'imposed' in the United States and the Union to adopt
immediate measures to tackle more firmly the issue of antimicrobial
resistance.
The Strasbourg parliament asks interventions that pass by the
development of new chemicals to be used more economically than
existing ones and improvement of breeding techniques.
The primary objective, in particular, is to preserve the effectiveness of
existing antimicrobials making responsible use.
To this end, the resolution states that it is a need for better training for
doctors, pharmacists, veterinarians, farmers and more understandable

to the public about the damage caused by improper use of
antimicrobials.
The resolution, then, points the finger on the major efforts that must
be lavish to combat the misuse of antibiotics, through institutional
communication (53% of EU citizens are still convinced that
antibiotics neutralize the virus! ) and on a large effort required in
compliance (patients do not follow or comply with requirements).
The resolution also calls on the Commission to "study the problem of
the use and improper sales of antimicrobial agents with or without
prescription throughout the entire cycle, from the doctor to the patient
through the pharmacist, in terms of behavior of all actors involved ...".
Concerning the use of antimicrobials in the field of human health, the
document stresses that antibiotics should never be available without
prescription.
To this end, the resolution also calls on the Commission to modify the
existing package inserts to include a warning that recommends the use
of the product "prescription-only medicine and in the prescribed

manner", because "inappropriate use of antibiotics can lead to the
development resistance harmful to themselves and others. "
The resolution, then, indicates that the ability to prescribe
antimicrobials for animals should be restricted to veterinarians only
professionally qualified, distinguishing the right to prescribe them
than to trade it, to avoid any economic incentive to sell. In addition,
the measure calls for restrictions on the use of antimicrobials for
veterinary third and fourth generation, that the WHO has classified as
very important for therapies in humans. Finally, the European
Commission Resolution rivoltge the request to classify medicated feed
as drugs in the forthcoming revision of the Code of veterinary
pharmaceuticals.
For its part, then, the President of the United States Barack H. Obama
declares war on antibiotic resistance, which only in the US reaps at
least 23 thousand victims a year. The five-year strategy, outlined in a
presidential executive order of 2014, should be elaborated in detail
later in February 2015 by a government task force.

The government's plan includes, among other things: incentives for
drug discovery; more controlled use of existing drugs; improvements
in the characterization of the use of antibiotics is that bacteria
resistant, even with use of the sequencing of DNA; prize of $ 20
million for those who can make a quick test to detect infections(26)
.
In the face of an effective surveillance network, therefore, it is clear
that the interventions needing to be improved. Some countries have
addressed the problem while others need better sanitation, access to
clean water, infection control in health facilities and a vaccination
program. But to prevent a further rise of antibiotic resistance also
serve further action on antibiotic use and infection control in
hospitals, lungodegenze and territory.
Only with the proper use of antibiotics can give the assurance that you
have in the future of effective treatments against infections.
It is good to remember that antibiotics are drugs that selectively target
the bacteria that cause infection and the doctor choose them on the

basis of an equation with three variables: what molecule for which
patient with what disease.
So, first of all it is identified with accuracy the infection (and often
takes 2 or 3 days to get a clear clinical picture, perhaps with support
of chemical-clinical tests) and, then, it is important to evaluate the
patient's condition. The advice in these circumstances, therefore, is
twofold: not feel neglected if your doctor prescribes an antibiotic
immediately; the onset of a few degrees of fever to avoid self-
administration of an antibiotic that you have at home, and because
there is no automatic link between fever and infection and because it
is fundamental to the doctor will always reserve the prerogative of
choosing the answer adequate. On the other hand, when antibiotic
therapy is appropriate (ie, on medical diagnosis and never for self
prescription), once it has started it is essential to strictly follow the
indications of dose and duration of therapy, because arbitrarily
discontinue treatment prematurely makes bacteria more more 'strong'.

There is, then, the case of repeated use of antibiotics well tolerated,
deemed to have no problems because rarely show side effects.
Instead, already 2 treatment cycles performed at 6 months away can
cause cumulative and persistent changes in the composition of the
bacterial flora (constituted, according to conservative estimates, from
a thousand different types of micro-organisms in the gut), carrying out
important functions(27)
. In addition, centenarians have already
'defeated' cancers and heart disease, the most dangerous for
octogenarians, while infections are the leading cause of death: an
analysis(28)
of about 36 thousand death certificates of British
centenarians emerge in first place deaths from old age (26%),
followed by pneumonia (20%). Cancer and heart disease are at
respectively 5% and 9%, while between 80 and 85 years exceed 25%
and 20%. "In the very old cell replication it is very slow and the
tumors are not dangerous; Moreover, above a certain age will
outweigh the effects of cardiovascular risk factors. The flip side is that
the immune system weakens much, increasing the risk of infection(29)
.

"Centenarians (currently over 16 thousand in Italy, but in 2050 could
exceed 200 thousand), require personalized care: home care, because
they can hardly be hospitalized and therapy can not rely on maximum
levels because the risk of serious side effects, such example kidney
with antibiotics may outweigh the benefits.
In particular, for example, examining the effects of ciprofloxacin
(which rarely gives diarrhea or abdominal swelling) using new
analytical techniques of the bacterial flora, it was found that two
treatment cycles five day conducted six months apart produce a subtle
effect long- term: the replacement of bacterial species resident with
other related, but also the complete disappearance of other(30)
.
The general similarity between strains pre-treatment and post-
treatment would explain, according to the authors of the research, the
low incidence of side effects of the antibiotic tested; however,
researchers show that a bacterial species disappearance could play an
important biological function, for example, produce a protein toxic to
particular pathogens that, in practice, is lost.

This feature may not be felt for years but become relevant when the
particular pathogen invades the gut of the patient. This, therefore,
does not mean that antibiotic, or other, dangerous or going avoided
but again highlights the problem of their judicious use and possible
side effects in the long term.
Antibiotics also may end up even in the food chain: meat, fish, eggs,
milk, fruit or vegetable may contain antibiotic-resistant bacteria.
This is caused by the use and abuse of antibiotics in agriculture is, for
the protection of crops from infection, both in animal husbandry by
farmers to treat diseases and, in low doses, as additives for growth
promotion of animals for production foods, both in industry, for
antibacterial prophylaxis.
Antibiotics in animal husbandry and other activities therefore affect
humans through the food we consume animals treated.
This will accelerate the bacterial mutations, which in turn are fighting
against the antibiotic.

Therefore, the effects on human health are especially serious because
infections with resistant bacteria transmitted by food are hard to cure.
To reaffirm constantly attention to these phenomena is the World
Health Organization (WHO). Despite the use of antibiotics for animal
growth is banned by the European Union since 2006, in many
countries, especially in Eastern Europe, it is still not regulated and do
not need any veterinarian's prescription to buy them(31)
. A worry the
WHO is also resistance to antibiotics used for human use in the
veterinary, for example in 2008 the resistance to fluoroquinolones was
18% in the salmonella bacteria in chicken: in Italy, where there are
many poultry farms, has reached 30%. A confirmation of the positive
effects from reduced amounts of antibiotics in the feed of animals for
human consumption comes from Australia, which has a legislation
which strongly limits the amount administered in farms and from time
prohibits some, including the fluoroquinolones, for the poultry. So the
resistance to ciprofloxacin of Campylobacter jejuni, which causes
severe diarrhea and even death, on 585 citizens positive bacterium

dropped to 2%, against an average of 29% in other Western nations. A
confirmation of the effectiveness of the Australian in Europe are
Norway, who has never allowed the use of antibiotics in animal feed,
and Sweden, which prohibits the administration from 1986: both
countries record low resistance of Campylobacter jejuni(32)
.
In addition, since 2006 the WHO Regional Office for Europe of WHO
has produced the publication "Tackling antibiotic resistance from a
food safety perspective in Europe" with the aim of supporting
Member States in the containment policy that originates from abuse
the use of antibiotics for farm animals. The publication, intended
primarily to politicians and authorities in the fields of public health,
agriculture, food production and veterinary medicine, outlines the
initiatives that can be taken to prevent and contain the phenomenon of
antibiotic resistance transmitted from the food chain. At Community
level, then, it is considering banning the use of antibiotics in animals
destined for human health. In animal health, yet, the European Union
aims to develop new legislation that puts the emphasis on prevention

by strengthening the surveillance of antibiotic resistance and the
consumption of antimicrobials in veterinary medicine.
Italy has long been engaged in food safety, working to reduce dust in
places of farms and companies that produce medicated feed, so you
will not be dispersed in the environment and do not remain in the
subsequent processing(33)
.
There is, then, the problem of watercourses, which can become
perfect 'farms' of resistant bacteria if you do not pay attention to what
they download. This is demonstrated by numerous studies, including
one of the most recent was conducted in a region of India where it is
produced most of the active ingredients of drugs used throughout the
world. From the study in situ in the rivers, by analyzing samples of
water from three sites near Hyerabad (area with 90 factories drugs), it
was found a quantity of antibiotic equal to that which a man would in
the blood during a therapy(34)
. Using a new technique in parallel that
can recognize immediately genes linked to resistance to antibiotics,
experts have found that 2% of all the DNA of the bacteria found in the

water was just the type that confers resistance. The analysis also
showed that the bacteria were resistant to several types of antibiotics,
also not produced at the site analyzed, while in the case of
ciprofloxacin resistance was absent, probably because the amount of
active substance was so high as to break down also the same resistant
bacteria(35)
.
A similar phenomenon has been studied for several years in the waste
of Lombardy by Ettore Zuccato (Mario Negri Institute in Milan),
which effectively remedy purifiers from treatment plants: the modern
ones are able to eliminate much of the drug residues and should be
applied on a large scale, even though they cost more(36)
.
To address the problem require coordinated action on a global scale,
that nations are taking to mitigate and adapt to climate change. The
UN report recommends about a multipronged approach.
“There are remedies worse than the disease”
Publilius Syrus, Sentences

Notes
______________
(6) Guido Rasi, Director General of Italian drug agency (AIFA, surgery a few years ago
to Rai Uno in the field of computer science devoted to this campaign).
(7) Pharmacist 33, ECDC antibiotic resistance in Italy is among the highest in the EU,
January 22, 2013.
(8) Ibid.
(9) Italian Medicines Agency (AIFA), the first report OSMED on antibiotics, 2009.
(10) Pharmacist 33, Too many antibiotics Italians, 18 December 2009 - Year 5, No. 217.
(11) Ratio Agency Italian Drug Agency (AIFA) and Higher Institute of Health (ISS), in
February 2011.
(12) The first joint report by the authorities for medicines (Ema), for Disease Control
(ECDC) and Food Safety Authority (EFSA), referring to 2012 and published January 30,
2015.
(13) Nicola Magrini (Center for evaluation of the effectiveness of health care-CeVEAS
AUSL Modena), Intervenento the presentation of the Report OSMED 2009 on
prescription pharmaceuticals in Italy, July 10, 2010.
(14) Dina Fine Maron, Antibiotic resistance is now rife throughout the whole world,
Scientific American April 30
(15) Framework illustrated 20 November 2011 in Brussels by the European
Commissioner for Health John Dalli and European Commissioner for Research and
Innovation Maire Geoghegan Quinn.
(16) World Health Organization, through its Margaret Chan, Director General of the
World Health Organization, 2012.
(17) Keiji Fukuda, Assistant Director-General for Health Security World Health
Organization (WHO).
Scientific American April 30.
(19) Keiji Fukuda, Ibid.

(20) Keiji Fukuda, Ibid.
(21) Pharmacist 33, WHO Report: the antibiotic resistance is a real threat, May 7, 2014.
(22) Nicola Magrini, Ibid.
(23) Nicola Magrini, Ibid.
(24) Ratio Agency Italian Drug Agency (AIFA) and Higher Institute of Health (ISS), in
February 2011.
(25) Pharmacist 33, Antibiotics, young people still uninformed, February 23, 2011.
(26) ANSA, The US Obama plan against antibiotic resistance, 20 September 2014.
(27) Research conducted by David Relman from Stanford University School of Medicine
and published in the Proceedings of the National Academy of Sciences.
(28) Study of King's College London published by PLoS ONE.
(29) Paolisso Joseph, President Company Italian Gerontology and Geriatrics). ANSA,
centenarians fight cancers and heart problems, no infections, June 5, 2014.
(30) Even more important would be the deepening of the studies about specific functions
of the different types of intestinal bacteria, even if this appears complex for composition
variable from person to person. If you could do it, you might think, before and after
antibiotic treatment, to valutaziore the relative abundance of species that make up the
flora, to give any specific probiotics that promote the recovery of species-specific strains
in danger.
(31) Srdan Matic, Coordinator of Environment and Health of WHO Europe, April 2011.
(32) Study published in Clinical Infectious Diseases in 2006.
Scientific American April 30, 2014.
(34) Study of the researchers at the University of Gothenburg, published by PLoS ONE,
2011.
(35) Ibid.
(36) Pharmacist 33 Antibiotic resistance comes into waterways, February 24, 2011.

SYNTHETIC PROFILE OF THE AUTHOR
______________
“Do not try to become a successful man,
but rather a valuable man”
Albert Einstein
Born in 1960. Lives between Rome and Torre Annunziata. His wife is a
biologist, pharmacist, social assistant and talented professor of sciences in the
Classical and Scientific State High schools; the son is a brilliant university
mathematician. Role: General Manager of Villano International Business
Team from 2012 with 16 business, consulting & service activities (including:
international affairs, high-end real estate, housing, construction and restoration, import-
export, food, computer science, healthcare, art and culture); Member (since 2013),
Associate Professor in History of Health Administration Pharmaceutical Department
(2014) and Honorary Member of Ruggero II University of Florida State (BR, Miami,
Florida, USA, 2015); Trader (since 1976), Independent Financial Trading Operator of
Stocks and Forex (since 1983), Knight Sovereign Military Order of Malta (since 2002,
presented by the Knight of Justice Fr. Giorgio Maria Castriota Scanderbeg, descendant of
Eroe founder of the Kingdom of Albania); President of the Chiron social and
humanitarian Foundation (since 1985); Single Director Chiron Publisher (since 2006).
Academies: History of Sanitary Art -Ministry Cultural Heritage (2001), Neapolitan
Society History of Italy (2008), Noble (2006), already Pontifical Tiberina), Melitensi
Studies (2002), Medical Tradition Smithsonian Institution-USA (2010), International
Society History Pharmacy, Noble Pharmaceutical Chemistry College (ad honorem,
2006). Over 100 conferences and chairs in dozens of congresses. He collaborates with
important national and international magazines. He is Advisory Board Member for the
US publisher DPC, which publishes in over 150 countries. Studies: Classical; Degree and
Enabling: Pharmacy (1985); Certified courses of: Medicinal Plants; Cosmetic
Techniques; Work safety; Food safety; History; Social Doctrine Church; Theology.
Honorary degrees: Humanities and Social Sciences (2009); History and Philosophy
(2010); Communication Sciences (2013); Diplomacy and International Studies (2015).
Master honoris causa: Science Medical Ethics (2010). He was author, organizer and
chairman of Security Course for Managers, obtaining High Patronats of Head of State
and United Nations (2000), Diplomatic Councilor of Aerec dpt ENVA 2011-15,
Secretary of International Committee Biothecnologies Wabt-Unesco 2008-13, member of
World Academy Biomedical Technology (Unesco 2007-12), 11 years in IBD’s Health
Security Scientific Committee (Security Court Company of Judiciary Court Appeal of
Naples), Beaumont Onlus Foundation Cancer Research chaired by Nobel Prize Tarro and
Prefect of Naples (2011-12), European Academic for Economic and Cultural Relations
2004-2015. For 32 years he is a member and holder of an important pharmacy until 2010.
He has been a member since 1990, a 29 years Secretary from 1990 to 1995 (among the
youngest in Italy) and President 2000-01 of Rotary Club Pompei-Vesuvius, 14 years
Delegate Of District Governors 2100-Italy (more than 3.000 Rotarians and around 80

Clubs) and at ICR For Rotary Italia; in National Committee of Italy: Professional Ethics,
World Action, Computer Science; among many international roles: archeology Pompeii-
Carthage; Magna Grecia Prize Committee; author and presenter at the World Rotary
Legislative Council on the International Day for the Protection of Life (2001-04). From
1986 to 1990 President of Naples, National Coordinator and Founder of Young
Pharmacists Federation; National Representative Federative Syndicate. Assistant
Professor of Microbiology in Pharmacy Faculty of Naples University (1985-90, Chair
Prof. Lembo-National Istitut Superior of Health). International Group Member of the
ISHP Pharmacopoeia Study (Berne University, 2012-13). As part of the “World no-
tobacco day” events, he has participated in various initiatives at the Ministry of Health.
Proponents and godfathers of various Honorary Members, including: Archibishop of
Pompeii Francesco Saverio Toppi, since 2013 Servant of God in the Cause of
Beatification and Canonization (Rotary, 1992); Dino De Laurentiis (proposed in 2000),
Hollywood Film Producer and Career Oscar Award (Rotary, 2001); Antonio Greco,
Court of Justice President (Rotary, 2000); Giulio Tarro, virologist and Candidate for the
Nobel Prize of Medicine 2000 and 2015 (Asas, 2011); Gianni Rivera, Vice Soccer World
Champion (Aerec, 2012); Patrizio Polisca, who was already assisting the doctors of Paul
VI and John Paul II and the Pope’s Doctor with Benedict XVI and Francis and Vatican
Health Director; Gualtiero Ricciardi, President of the Institute of Higher Health.
International Awards: Honorary Diploma for Unique Exceptional Services in the 5
Actives of Rotary International President (Evanston 2001: only 100 / year / 1.5 million
members); Benevolence Anti-Crime-Task Force Rotary Italy, Albania, Former
Yugoslavia, S. Marino (Zurich 2001); Sapientia Mundi-Ethics (Rm 2008); Gold Legion-
Work Union (Rm 2010); Veritas in Charitate-Religion (2011); Bonifaciano-Culture and
Society (2011); Norman Ac.-Publishing Gold Medal (Rm 2014); Norman Ac.-Health
Galen (Rm 2014); Norman Ac.-Health Galen 2 ^ ed. (Rm 2015); Norman Ac.-Art photo
Gold Medal (Rm 2015). National awards: Aesculapius-Health patronage Presidency
Council of Italian Ministers (Rm 1987); LXVIII Piccinini Asas-Mi.BAC-Historical-
Scientific Research (Rm 2006); LXV Stramezzi-Health (Rm 2007); Capitoline-
Humanitarian Activity (Rm 2010); Tiberino-Culture (Rm 2012); LXXIV Serono-History
and Literature (Rm 2012), Aerec-Culture (Rm 2013); Certificate of Merit for Public
Health (Rome, DPR 2013): only 269 from 1800; Tiberin-Science (Rm 2014); LXXIV
Piccinini Asas-Mi.BACT-Historical-scientific research (Rm 2014); Silver Medal for
Merit Public Health (Rome, DPR 2016); Special Prize Asas-Mi.BACT-Historical studies
in biomedical and pharmaceutical sciences (Rm 2016). He is the author of a large and
qualified literary production of more than 790 health, professional, scientific, historical,
religious, and artistic publications, most of which are in critical review, indexed and
impact factor reviews; over 50 books (of which 14 with a total of 35 editions and 19
reprints, numerous translations also in English, French, German and Spanish) with
prestigious publishers such as Zanichelli, with patronage from the Ministry of Cultural
Heritage, Unesco, Rotary, University, etc. From nationally-recognized Headquarter
offices in over 120 Italian Libraries (including: Quirinale, National Academy of
Sciences, Ministries) and in more than 40 nations (including National Institute Health-
USA, Nationale de France, Congress UK) Culture, Universities, Museums. At the

Frankfurt Fair he debuted a book. Over 80 multimedia works (in several languages and
multiple editions and reprinting) often of great prestige and published with prestigious
publishers and patrons (including Bayer S.p.A.). Catalogs: Library of Congress UK
Authority (NACO); Bibliothèque nationale de France; Deutsche Nationalbibliothek;
Library of National Institutes of Health (NIH) U.S.A .; Magistrale Library S.M. Malta
Order; Library of the Vatican Foundation Joseph Ratzinger-Benedict XVI; 2000
Outstanding Intellectuals IBC-Cambridge UK since 2010; Opac Sbn with over 200
works; BAC Ministry Authority Card. Various books have appreciations from
institutional authorities, including some European rulers and several times the Head of
State and the Holy Father.
* * *
Some books: Global Information Society, 1996; Rotary for Men, 2001; Safety
Management in Pharmacy (Dr. Renzulli, formerly United Nations Security Adviser,
2004); Art and History Pharmacy (presentation by Prof. Ledermann, President Em.
International Society History Pharmacy, 2 ed., 2006); History and activities of SMOM (4
ediz., 2007); Pharmaceutical Meridianes between secular ethics and catholic moral
(presentation by Prof. Tarro, Nobel Prize Candidate, 3 ed., 2008); Thesaurus
Pharmacologicus (presentation by Italian Pharmacists President Dr. Mandelli 2009);
Time sculpted in silence eternity. Reflections on diacronical investigation for homo faber
memory (presentation by: honorable historical figures Fra’ von Lobstein; prestigious
critics and Rotary International Governor Prof. Carosella, 6 rist, 2010); Pharmaceutical
Activities of the Kingdom of Naples (presentation by President Italian Academy of
Pharmacy History Dr. Corvi, 2010); Logos and theophany in digital time (presentation by
Bishop Trafny, Dpt Science-Faith Pontifical Council Culture, 2012); Religious Aspects
and ecclesial dimension SMOM (2013); Pharmacy Museums: echoing the past for a
future ransom (presentation by Prof. Ledermann, Director of Library Switzerland, 2015);
Photographs - about 200 of his works, selected for philosophical and creative themes
among those realized in over 40 years (2015). Among the multimedia: Art and history
pharmacy notes (patronage Italian Academy of Pharmacy History, 2002); Influenza A /
H1N1 (patronage UNESCO, 2009).
“I've learned so much from you, Mens...
I learned that everyone wants to live on the top of the mountain,
without knowing that true happiness lies in how this mountain has been climbed”
Gabriel Garcia Marquez

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