The World Health Organization says declining private investment and a lack of innovation in the development of new antibiotics are undermining human efforts to combat drug-resistant bacterial infections. Two new reports show that there are not enough new antibiotics in development. The 60 products being developed, including 50 antibiotics and 10 biologics, have little effect compared to existing treatments, while few new drugs have been developed for the most critical drug-resistant bacteria, Gram negative-negative bacteria.
While some preclinical candidates at the early stages of testing are more innovative, it will take years to be available to patients.
The two reports focus on antimicrobials in clinical trials and antimicrobials in preclinical development. The report found that antibiotic development was largely driven by small and medium-sized enterprises, as large pharmaceutical companies continued to exit the sector.
WHO released a list of priority pathogens in 2017, including 12 types of bacteria, as well as tuberculosis. These germs are resistant to most existing therapies and therefore pose an increasing risk to human health. The list was developed by an independent team of experts led by WHO to encourage the medical research community to develop innovative treatments for these drug-resistant bacteria.
Of the 50 antibiotics currently in clinical trials, 32 are targeted at priority pathogens listed by WHO, but most of the new drugs in development are of limited use compared to existing antibiotics. At the same time, there are only two gram-negative bacteria that can fight multiple drug-resistant geigers, which are spreading rapidly and need to be urgently contained.
Gram-negative bacteria, such as Klebsiella pneumoniae and E. coli, can cause severe and often fatal infections in people with weakened or underdeveloped immune systems, such as newborns, and the elderly. People who undergo surgery and cancer treatment pose a particular threat.
The report highlights the particular lympathy of the new Delhi Metallo-beta-lactamase 1, which is currently under clinical development with only three antibiotics. NDM-1 superbugs are resistant to a variety of antibiotics, including carbapenem, the last line of defense against drug-resistant bacterial infections.
At the same time, the prospects for new antimicrobials for the treatment of tuberculosis and diarrhoea-causing Clostridium difficile are better, with more than half of the drugs in clinical research and development meeting all the innovative standards defined by WHO.
By contrast, antibiotics in pre-clinical trial sdeveloped have shown greater innovation and diversity, with 252 drugs currently targeting WHO’s priority pathogens.
However, these products are still in the early stages of development and still need to be proven to be effective and safe. The most optimistic scenario is that two to five products will be available in about 10 years.