On 20 September, the World Health Organization (WHO) published a report ‘Antibacterial agents in clinical development - an analysis of the antibacterial clinical development pipeline, including tuberculosis’ which finds a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance.
Most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and are only short-term solutions. The report found very few potential treatment options for those antibiotic-resistant infections identified by WHO as posing the greatest threat to health, including drug-resistant tuberculosis which kills around 250,000 people each year. In addition to multidrug-resistant tuberculosis, WHO has identified 12 classes of priority pathogens - some of them causing common infections such as pneumonia or urinary tract infections - that are increasingly resistant to existing antibiotics and urgently in need of new treatments.
The report identifies 51 new antibiotics and biologicals in clinical development to treat priority antibiotic-resistant pathogens, as well as tuberculosis and the sometimes deadly diarrhoeal infection Clostridium difficile. Among all these candidate medicines, however, only eight are classed by WHO as innovative treatments that will add value to the current antibiotic treatment arsenal.
There is a serious lack of treatment options for multidrug- and extensively drug-resistant M. tuberculosis and gram-negative pathogens, including Acinetobacter and Enterobacteriaceae (such as Klebsiella and E. coli) which can cause severe and often deadly infections that pose a particular threat in hospitals and nursing homes. There are also very few oral antibiotics in the pipeline, yet these are essential formulations for treating infections outside hospitals or in resource-limited settings.
To counter this threat, WHO and the Drugs for Neglected Diseases Initiative (DNDi) set up the Global Antibiotic Research and Development Partnership (known as GARDP). On 4 September 2017, Germany, Luxembourg, the Netherlands, South Africa, Switzerland, the UK and the Wellcome Trust pledged more than €56 million for this work.
WHO concludes, however, that new treatments alone will not be sufficient to combat the threat of antimicrobial resistance. [Source: WHO News Release, 20 September 2017. http://www.who.int/mediacentre/news/releases/2017/running-out-antibiotics/en/]