2023: The Year in Infectious Disease


New and novel antimicrobials remain at a crossroads as the path to development and economic viability continue to be serious challenges. Our Editor-in-Chief weighs in on this topic and some of the other most significant ones from this past year.

As we close out 2023, it is a time to reflect on the major developments and approvals of some important therapies and vaccines. For example, the approval this year of 4 RSV immunizations will certainly be beneficial in the years ahead. In fact, we created a series around the topic titled, RSV: A New Era in Prevention, which is a collaborative project with our partners Contemporary Pediatrics and Contemporary OB/GYN. It includes our ongoing RSV Roundtable video series to discuss these significant approvals and how clinicians are counseling patients and families on these immunizations.

In addition, 2023 saw the approval of antimicrobials, the continued development of rapid diagnostics, and the ongoing evolution of concepts such as time-to-treat.

Our Editor-in-Chief Jason Gallagher, PharmD, FCCP, FIDP, FIDSA, BCPS, offered some insights on a variety of topics including what he felt was the most unique development of the year, the FDA approval of Innoviva’s antibiotic, sulbactam-durlobactam (Xacduro). The antibiotic was approved back in May and is indicated for treatment of hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) caused by Acinetobacter baumannii for patients 18 years of age and older.

It is this antibiotic that can serve as a microcosm of the industry and the development of these essential therapies. The scope of the indication is limited, and behind this is the question of whether this can be seen as economically viable in an antimicrobial market that has inherent challenges from development to profitability. Gallagher is intrigued by the approval of this therapy and has previously written about it.

“And among the things that's interesting about that to me is honestly, whether it can be commercially successful,” said Gallagher. “I hope it is. I think it's a wonderful new drug, or a revision of an old drug, to our armamentarium. But, if you asked clinicians for years in infectious diseases what they would like to see as that ideal next drug, I think a lot of people would tell you a targeted agent active against highly resistant gram negatives. Most people would probably say pseudomonas, and ideally oral, but would such an [agent] really be commercially successful?”

In a recent discussion with Contagion, Gallagher also weighed in on RSV immunizations, the evolution of COVID-19 monovalent vaccines, and the reemergence of the investigational antibiotic, ceftobiprole, and its possible approval in April 2024.

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