WHO report confirms that “the world is running out of antibiotics” to treat resistant priority pathogens
The threat of growing antimicrobial resistance hits home as the World Health Organization releases a report that suggests a serious lack of antibiotics in the clinical development pipeline to combat resistant infections.
In February 2017, WHO released the first-ever priority pathogens list, comprised of antibiotic-resistant bacteria from 12 families that are “priority pathogens” in need of new antibiotics to treat them. WHO hoped that by releasing that list would work to drive research and development efforts to create such antibiotics.
“Antimicrobial resistance is a global health emergency that will seriously jeopardize progress in modern medicine,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus commented in WHO’s official press release on the report.
However, the new report found “very few potential treatment options” for infections caused by these priority pathogens. In fact, the majority of the drugs in the pipeline are “modifications of existing classes of antibiotics,” and thus, “are only short-term solutions,” according to the press release.
“There is an urgent need for more investment in research and development for antibiotic-resistant infections including tuberculosis, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery,” Dr. Ghebreyesus stressed.
Although the new report identifies a total of 51 new antibiotics and biologicals that are in development to treat some of the priority pathogens, only 8 were considered to be “innovative treatments that add value to the current antibiotic treatment arsenal” by WHO.
Multidrug- and extensively drug-resistant M. tuberculosis (MDR-TB) is an ever-growing threat, and, according to the press release, there is “a serious lack of treatment options” to fight it. In fact, Mycobacterium tuberculosis is one of the 10 leading causes of death worldwide, however, this was another neglected area when it came to new drug development.
“Only seven new agents for TB are currently in clinical trials. Of these, four are in phase 1, and only one compound is in phase 3. This is especially problematic because treatment of TB infections requires a combination of at least three antibiotics,” according to the report. “Novel treatment regimens of short duration that are assembling non-toxic drugs are desperately needed.”
Other neglected areas in drug development involve gram-negative pathogens, including Acinetobacter and Enterobacteriaceae—such as Klebsiella and E. coli—that are particularly prominent in hospitals and nursing home facilities. Furthermore, there are not many oral antibiotics in the pipeline, which is also problematic, as these antibiotics are typically used to treat harmful infections outside of hospitals or in settings where resources are limited, according to the press release.
“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 defense,” Director of the Department of Essential Medicines Dr. Suzanne Hill, stressed in the press release.
In an effort to address these neglected areas of drug development, WHO has joined up with the nonprofit Drugs for Neglected Diseases Initiative, to create the Global Antibiotic Research and Development Partnership, and several countries have collectively pledged over 56 million dollars to go towards this effort.
However, new drugs to treat these infections are not enough to win the fight against antibiotic resistance. Health care institutions need to channel their efforts into strengthening and improving infection control efforts, and health care professionals need to ensure that they are using antibiotics appropriately, and. To this end, WHO is working on developing new guidance on “the responsible use of antibiotics in the human, animal, and agricultural sectors.”