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The world is running out of antibiotics

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The World Health Organization has confirmed in a new report that there is a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance.

The report, Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline, including tuberculosis, reveals 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). 

This is alarming because these pathogens can cause severe and often deadly infections that pose a particular threat in hospitals and nursing homes.

Most of the drugs currently being developed 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. This includes drug-resistant tuberculosis which kills around 250,000 people each year.

Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, believes antimicrobial resistance is a global health emergency.

“There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery,” Dr Tedros cautioned.

WHO has also identified 12 classes of priority pathogens which can cause common infections such as pneumonia or urinary tract infections but 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. There are also very few new oral antibiotics being developed, despite these being essential formulations for treating infections outside hospitals or in resource-limited settings.

“Pharmaceutical companies and researchers must urgently focus on new antibiotics against certain types of extremely serious infections that can kill patients in a matter of days because we have no line of defence,” explained Dr Suzanne Hill, Director of the Department of Essential Medicines at WHO.

To counter this threat, WHO and the Drugs for Neglected Diseases Initiative (DNDi) have set up the Global Antibiotic Research and Development Partnership (known as GARDP), with Germany, Luxembourg, the Netherlands, South Africa, Switzerland and the United Kingdom of Great Britain and Northern Ireland and the Wellcome Trust recently pledging more than €56 million.

“Research for tuberculosis is seriously underfunded, with only two new antibiotics for treatment of drug-resistant tuberculosis having reached the market in over 70 years,” Dr Mario Raviglione, Director of the WHO Global Tuberculosis Programme said.

WHO believes that new treatments alone will not be sufficient to combat the threat of antimicrobial resistance, and is developing guidance for the responsible use of antibiotics in the human, animal and agricultural sectors.

The AMA believes the over-prescribing of antibiotics is a threat to the wellbeing of Australians as we remain one of the highest consumers of antibiotics in the industrialised world. The AMA also encourages antibiotics to be responsibly prescribed.