Increasing bacterial resistance to antibiotics is becoming a critical problem worldwide. The European Union have set out a ‘roadmap against antibiotic resistance’ to tackle the issue in Europe. In the UK, England’s Chief Medical Officer has suggested the threat of antibiotic resistance is ‘arguably as important as climate change for the world’. A new review by Bassetti et al. published in Annals of Clinical Microbiology and Antimicrobials discusses this fascinating issue and its implications for society, in addition to describing and analysing potential new antibiotics on the horizon.
Despite rigorous infection control, traditional healthcare-associated pathogens are now escaping into the broader community. These multidrug resistant pathogens have been named the ‘ESKAPE pathogens’ (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and Enterobacter species), reflecting their ability to ‘escape’ the effects of common antibiotics. Bassetti et al. explain that the problem is so serious due to the difficulty of finding new antibiotics which are effective against these multidrug resistant bacteria. Since 2000, only three new classes of antibiotics have been approved for human use, and many new antibiotics targeting highly resistant gram negative bacilli, which are needed as a priority, have not even reached phase 2 or 3 trials (only 7 since 2010).
In 2010, the Infectious Diseases Society of America (IDSA) supported an initiative, 10 x ‘20, to develop ten new antibiotics by 2020. This review by Bassetti et al. investigates how close we are to achieving this goal by evaluating present data on old and new classes of antibiotics including cephalosporins, carbapenems, monobactams, aminoglycosides, oxazolidinones and glycopeptides. The authors provide an insight into the usefulness of each drug, and the ongoing trends in antimicrobial development.
This timely review highlights that there are a number of promising antibiotics in development at present. The development of these drugs can give confidence that that we will once again be able to treat bacterial diseases effectively and reliably in the future.