Hitting the restart button on antibiotic research

A "sustained and robust pipline of new antibacterial drugs and therapies is critical to preserve public health," states a project team of policymakers and researchers assembled by Pew Charitable Trust, in newly issued report. The broad goal seems achievable with the right level of funding--$50 million to start, and $200 million over a five-year period. The report cites (but does not outright call for) a program similar to the Bill and Melinda Gates Foundation funding for malaria and tuberculosis research as successful models for addressing the need.

The bacterial-infection problem is well known, but while there are multiple organizations working one one or another aspect of it, progress is lacking. No truly new antibiotic has been developed since the 1980s; nearly all of the newly patented products are variations on existing antibiotic mechanisms. Resistant infectious agents, such as MRSA (driven by Staphylococcus aureus) or CRE (carbapenem-resistant Enterobacteriaceae) are on the rise, and others are spreading in parts of the world. Pharma companies, which decades ago had robust antibiotic programs, have significantly withdrawn from the scene, due in part to the difficulty of establishing a commercially viable business. (One of the ironies of the best and newest antibiotics is that their use is restricted to last-resort cases, in order to preserve the drugs' effectiveness.)

A four-step project is recommended by the report:

• Generate and tailor chemical matter for antibacterial discovery
• Conduct key proof-of-concept studies for nontraditional therapies (i.e., not conventional small-molecule chemistry)
• Share data, materials and knowledge across disciplines and between sectors
• [Establish] models for antibiotic study.

The report authors note that these steps "lay a foundation" for sustained discovery and development; not necessarily identify and pursue new drugs. The goal, they say, is to "revitalize innovation."

The report, A Scientific Roadmap for Antibiotic Discovery, is available here.