Challenges and opportunities in the discovery, development, and commercialization of pathogen-targeted antibiotics

• Published in: Drug discovery today Vol. 26; no. 9; pp. 2084 - 2089
• Main Authors: Altarac, David, Gutch, Michael, Mueller, John, Ronsheim, Matthew, Tommasi, Ruben, Perros, Manos
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2021
• Subjects: Animals; Anti-Bacterial Agents - therapeutic use; Antimicrobial Stewardship; Bacteria - drug effects; Bacterial Infections - drug therapy; Biomedical Research; Drug Development; Drug Discovery; Humans; Technology Transfer
• ISSN: 1359-6446; 1878-5832
• DOI: 10.1016/j.drudis.2021.02.014

•Antimicrobial resistance is a direct result of antibiotic use.•Indiscriminate and excessive use of broad-spectrum antibiotics exacerbates the problem.•Rationally designed antibiotics can be optimized to target MDR pathogens.•Pathogen-targeted antibiotics enable streamlined development and regulatory pathways.•Clinical adoption of pathogen-targeted antibiotics would benefit antimicrobial stewardship. The use of antibiotics directly correlates with the increase in antimicrobial resistance (AMR). Targeting novel antibiotics to patients with multidrug-resistant (MDR) pathogens should enhance their durability and slow development of resistance. The discovery, development, and clinical adoption of pathogen-targeted antibiotics have been hampered by technical and regulatory challenges. Growing insights into bacterial physiology and mechanisms of resistance, innovative clinical trial designs, streamlined regulatory approval pathways, and availability of rapid bacterial diagnostics are recent developments that can help address those challenges. Pathogen-targeted antibiotics provide an opportunity to treat patients with the right drug at the right time, leading to improved patient outcomes and better antimicrobial stewardship. Patient-centered pricing and reimbursement reform is needed to incentivize innovation.