The development of new antibiotics remains alarmingly neglected, report authors of an Infectious Diseases Society of America (IDSA) public policy article. The article, appearing today in Clinical Infectious Diseases, is a progress report on the IDSA’s 10 × ’20 Initiative, which was launched in 2010 to promote the development of 10 new antibiotics by 2020.
Only 2 new antibiotics, telavancin and ceftaroline fosamil, have been approved since 2009, the authors noted. They also said that the number of new antibiotics annually approved for sale in the United States has continued to dwindle and that the number of large multinational pharmaceutical companies actively developing antimicrobial drugs is still declining.
The gravest concern, according to the report, is the absence of drug candidates to combat infections caused by gram-negative bacilli (GNB), especially the “ESKAPE” pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species), which cause significant morbidity and mortality.
The IDSA identified 7 new drugs in development for treatment of infections caused by multidrug-resistant GNB. However, the society pointed out that there is no guarantee that any of these drugs in development will gain approval of the US Food and Drug Administration (FDA). Even if they become available, none of these 7 drugs will work against the most resistant bacteria.
“We’re losing ground because we are not developing new drugs in pace with superbugs’ ability to develop resistance to them,” said Helen W. Boucher, MD, lead author of the policy paper and a member of the IDSA’s board of directors, in a release. “We’re on the precipice of returning to the dark days before antibiotics enabled safer surgery, chemotherapy, and the care of premature infants. We’re all at risk.”
The IDSA calls for a multipronged approach to increase the number of new antibiotics. The society urges new economic incentives to encourage antibiotic research and development; clarification of the FDA’s requirements for antibiotic approval; increased research funding; improved infection prevention; and new public health efforts, including better data collection, improved surveillance of drug resistance, and more prudent use of antibiotics.