Critical shortage of new antibiotics in development against multidrug-resistant bacteria—Time to react is now

https://doi.org/10.1016/j.drup.2011.02.003Get rights and content

Abstract

Two commercial databases (Pharmaprojects and Adis Insight R&D) were queried for antibacterial agents in clinical development. Particular attention was given to antibacterial agents for systemic administration. For each agent, reviewers were requested to indicate whether its spectrum of activity covered a set of selected multidrug-resistant bacteria, and whether it had a new mechanism of action or a new target. In addition, PubMed was searched for antibacterial agents in development that appeared in review articles. Out of 90 agents that were considered to fulfil the inclusion criteria for the analysis, 66 were new active substances. Fifteen of these could be systemically administered and were assessed as acting via a new or possibly new mechanism of action or on a new or possibly new target. Out of these, 12 agents were assessed as having documented in vitro activity against antibiotic-resistant Gram-positive bacteria and only four had documented in vitro activity against antibiotic-resistant Gram-negative bacteria. Of these four, two acted on new or possibly new targets and, crucially, none acted via new mechanisms of action. There is an urgent need to address the lack of effective treatments to meet the increasing public health burden caused by multidrug-resistant bacteria, in particular against Gram-negative bacteria.

Keywords

Antibiotics
Antimicrobial resistance
Antibiotic resistance
Antibacterial drug development
Novel antimicrobials
Multidrug resistant bacteria
Gap-analysis
EMA
ECDC
ReAct

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The views expressed in this article are the personal views of the authors. Those views may not be understood or quoted as being made on behalf, or reflecting, the position of ECDC, or of the EMA or one of its committees or working parties.

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Ragnar Norrby (Swedish Institute for Infectious Disease Control, Solna, Sweden; ECDC-EMA Working Group), Mair Powell (MHRA, London, United Kingdom; ECDC-EMA Working Group), Dominique L. Monnet (ECDC, Stockholm, Sweden; ECDC-EMA Working Group), Bo Aronsson (EMA, London, United Kingdom; ECDC-EMA Working Group), Irja Lutsar (University of Tartu, Tartu, Estonia; ECDC-EMA Working Group), Ioan Bocsan (Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; ECDC-EMA Working Group), Helen Giamarellou (Hygeia Hospital, Athens, Greece; ECDC-EMA Working Group), Otto Cars (ReAct, Uppsala, University, Sweden; ECDC-EMA Working Group) and Inge C. Gyssens (Radboud University Medical Centre and CWZ Hospital Nijmegen, Nijmegen, The Netherlands; ECDC-EMA Working Group).

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