The Need for New Antibiotics

Bad News Bugs and The Need for New Antibiotics

03.28.13 | By Stephanie Fischer

Dr John H Rex, VP and Head of Infection, Global Medicines Development at AstraZeneca, recently spoke about the dangers of antimicrobial resistance on National Public Radio’s “To The Point” show, during which he noted that he is terrified at the prospect of returning to a pre-antibiotic era. We invited him to elaborate on this critical issue in the following guest post. 

As modern medical care is not possible without a reliable arsenal of effective antibiotics, the steady rise of drug-resistant bacteria is an imminent and urgent threat to individual patients and public health. Yet the treatment of infection is an area where there have been few major advances in recent years and the number of companies in this area of research has dropped off steadily.

How did we get ourselves in this predicament? Not so long ago, the global health community mistakenly assumed we had the antibiotics needed to cure most infections.  Several decades’ worth of work had found new classes of effective antibiotics and the conundrum of treating infections was in the rear-view mirror.  Fast-forward to today and we are in a very different place. 

The bad news is that bacteria –or Superbugs – are fighting back.  They are constantly evolving and mutating in a bid to survive and many are successfully developing resistance to previously effective antibiotics.  In fact, I joined the pharmaceutical industry because I was an infectious disease doctor for 15 years and saw an urgent need for new drugs to fight the superbugs that have developed resistance to current antibiotics.

As I explained on “To The Point”, there are three primary challenges associated with bringing new antibiotics to market:

1.       New antibiotics are hard to discover. It is tremendously difficult to find a molecule that kills bacteria but is safe for humans. Fortunately, companies like mine are making significant progress and we are also part of a multi-company consortium sponsored by the European commission to tackle this problem.

2.       New antibiotics are hard to develop. To get any drug to market (not just an antibiotic), you typically need two large Phase III trials involving several thousand people. But if you wait until you have several thousand people with drug-resistant infections, you’re too late and the epidemic has already happened! I’m pleased that important steps are being made to facilitate the regulatory pathways for new antibiotics so that increasingly efficient and cost-effective R&D is possible.

3.       The economics of new antibiotics are not in their favor. As currently available medicines are often generic and relatively inexpensive, the expectation until recently has been that future antibiotics should be similarly priced.

Given the dramatic, curative nature of antibiotics and their corresponding societal value of returning years of life, we must create economic incentives for biopharma companies which have limited dollars and whose investors expect a strong return on investment. We can’t make companies do this work but rather we must make them want to do this work.

AstraZeneca recognizes the need for doctors to have an effective arsenal of antibiotics to fight back against the superbugs. Through our partnerships and pipeline products, AstraZeneca is developing treatments for serious bacterial infections, viral infections and diseases of the developing world as well as diagnostics and the development of novel vaccines.

But we know that doctors need a diverse “toolbox” of antibiotics that won’t come from one company alone. Today’s anti-infective environment is challenging and will require all stakeholders to work together to encourage the development of new antibiotics, as well as the responsible stewardship of antibiotics by healthcare professionals, in order to address the public health threat posed by Superbugs.

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