Perspective from Amesh Adalja, MD, FIDSA
September 19, 2017
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WHO: ‘Serious lack’ of antibiotics in development to address resistance

Perspective from Amesh Adalja, MD, FIDSA
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Tedros Adhanom Ghebreyesus
Tedros Adhanom
Ghebreyesus

In a new report, WHO warned of a “serious lack” of new antibiotics in development to address the growing threat of antimicrobial resistance.

The world health agency said that as of May, the antibiotic pipeline included 51 antibiotics and 11 biologicals but few innovative solutions. It said the pipeline is filled with short-term fixes — drugs that are modifications of existing classes of antibiotics.

A dried-up pipeline and insufficient investment in basic science, drug discovery and clinical development means there are fewer potential treatments for important antibiotic-resistant infections like drug-resistant tuberculosis, which kills 250,000 people each year, according to WHO.

The agency also singled out gram-negative pathogens Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriaceae, including Klebsiella pneumoniae and Escherichia coli, as “the most critical priority for antibiotic research and development” because “strains are emerging worldwide that cannot be treated with any of the antibiotics currently on the market.”

“Antimicrobial resistance is a global health emergency that will seriously jeopardize progress in modern medicine,” WHO Director Tedros Adhanom Ghebreyesus, PhD, said in a statement. “There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery.”

According to WHO, seven new agents for TB are currently in clinical trials, including just one in phase 3 development.

The agency said nine of 11 biologicals in early-stage development target priority pathogens Staphylococcus aureus and P. aeruginosa, but it is unclear if such treatments could serve as real alternatives to antibiotics. It said the pipeline includes few oral antibiotics, which are essential for treating infections outside of the hospital or in resource-limited settings.

According to WHO, based on the average 7-year development time from phase 1 to approval, the current pipeline could lead to the approval of 10 antibiotics or biologicals over the next 5 years, which the agency said is insufficient to tackle the impending threat of antimicrobial resistance.

It said cooperation by the pharmaceutical industry will be key to bringing new options onto the market and that new treatments must be combined with infection prevention and control and antimicrobial stewardship efforts. – by Gerard Gallagher

Reference:

WHO. Antibacterial agents in clinical development — an analysis of the antibacterial clinical development pipeline, including Mycobacterium tuberculosis. 2017. http://www.who.int/medicines/en/. Accessed September 19, 2017.

Disclosure: Tedros reports no relevant financial disclosures.