What if there were no new antibiotics? A look at alternatives

ABSTRACT

Introduction: Bacterial resistance to antibiotics is increasing worldwide, due to the emergence of multidrug-resistant strains. With this panorama, there is a serious danger that we may be entering the ‘post-antibiotic era’.

Areas covered: We assess why so few new classes of antibiotics have been developed in the past years and discuss a variety of treatments that may be able to replace antimicrobials: monoclonal antibodies, bacteriophages, stem cells and anti-virulence agents such as liposomes.

Expert commentary: There are a series of economic, scientific-research and regulatory reasons for the scarcity of new antimicrobials. New approaches are needed to combat infections. Innovative strategies like Eco-Evo drugs and innovative delivery methods such as aerosol or nanoparticle administration require a new management paradigm, in combination with rapid molecular diagnostic tests. Biopharma, clinical researchers, regulatory agencies, governments and investors must work together in the attempts to achieve effective treatment for infections caused by MDR organisms.

KEYWORDS:

• Monoclonal antibodies
• bacteriophages
• antimicrobial agents
• stem cells
• vaccines
• liposomes

Acknowledgment

Thanks to Michael Maudsley for grammatical edition of the final manuscript.

Declaration of interest

J Rello is serving as a consultant/member of speaker bureaus for AstraZeneca, Bayer, Paratek, KENTA, Nabriva and CaloBios. A Perez reported honoraria from LASCCO, The Medicines Company, Debiopharm, INSMED, Aridis Pharmaceuticals Kenta Biotech, ImmunNovative Developments and is Expert of the European Commission for the FP7-HEALTH-2010, Horizon 2020 and EUREKA projects and Expert of the Innovation Fund Denmark. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.