PHARMACEUTICALS
Our arsenal of antibiotics to fight infections and diseases is rapidly becoming redundant. New weapons are urgently needed to avoid a post- antibiotic apocalypse. But time is running out, Katrina Megget reports
the Wellcome Trusts’ drug-resistant infections team. ‘We need greater investment in developing new ways to treat and protect people from these deadly infections and we need better understanding of how resistance spreads.’ Despite calls for increased R&D, no new classes of antibiotics have been approved since the early 1980s, apart from the approval of linezolid in 2000, and the last new class to treat Gram-negative bacteria was discovered in 1962, Zoubiane says. Big pharma withdrew en masse from the antibiotic space in the 1990s, due to the low returns on the high level of investment required in antibiotic
R&D. Recognising the urgency of the problem, however, in January 2016 more than 90 pharma and biotech companies committed to enhancing antibiotic discovery. The move has been accompanied by more research into understanding resistance mechanisms, as well as a shift to more outside-of-the-box thinking about alternative treatments. The 2016 European Union
approval of anti-Gram-negative drug Zavicefta – a combination of new beta-lactamase inhibitor avibactam, and third-generation cephalosporin antibiotic ceftazidime – is a rare bit of positive news in the antimicrobial resistance (AMR) story. Avibactam
inhibits the beta-lactamase enzymes that deactivate certain antibiotics, and so restores the activity of ceftazidime. In February 2017, the World Health Organization (WHO) published its list of 12 antibiotic-resistant ‘priority pathogens’ that pose the greatest threat to human health (see page 20). Most notable are the Gram- negative bacteria, which possess an additional outer cell membrane and are harder to treat with antibiotics than Gram-positive bacteria. ‘These bacteria have been assessed as the most critical priority for antibiotic R&D, as strains are emerging worldwide that cannot be treated
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