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

Journal

DRUG DISCOVERY TODAY
Volume 26, Issue 9, Pages 2084-2089

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.drudis.2021.02.014

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Using novel antibiotics to target multidrug-resistant pathogens can enhance durability and slow resistance development. Recent advancements in understanding bacterial physiology, resistance mechanisms, innovative trial designs, streamlined regulatory pathways, and rapid diagnostics offer solutions to technical and regulatory challenges.
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.

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