The rapid spread of antibiotic-resistant bacteria is a worldwide health crisis, with researchers struggling to keep up with the urgent demand for new drugs that can combat seemingly invincible bacteria. According to the Centers for Disease Control and Prevention, 2 million Americans are infected every year by drug-resistant bacteria, and 23,000 of them die. Yet only two new antibiotics were approved by the U.S. Food & Drug Administration (FDA) between 2008 and 2011 [source: Spellberg].
In 2012, the Alliance for the Prudent Use of Antibiotics (APUA) released a report on the lack of antibiotic development, describing an almost impossible situation for drug researchers. For one, there's no money in the antibiotic game, even though new drugs are desperately needed − long-term therapy for chronic conditions is the cash cow. The Office of Health Economics reported that in 2011, a new antibiotic would be worth about $50 million to a pharmaceutical company. A new musculoskeletal drug? $1 billion [source: Towse].
The APUA report also cited the fact that it's been getting more and more difficult to discover new antibiotics. Because of the resistance problem, the search is more complex, expensive and time-consuming, and it's just not worth it to drug companies because of the low return on investment. The report also blamed the FDA bureaucracy for creating roadblocks in the drug testing and approval process.
But things are looking up. In 2013 and 2014, there was major news in the antibiotic world [source: Nonejuie]:
- In 2014, three new antibiotics were in development to treat skin infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA), a lethal strain that has confounded doctors for decades.
- A team at the University of Notre Dame discovered a new class of antibiotics (oxadiazoles) for possible use in fighting MRSA.
- Researchers at the University of California-San Diego developed an accurate method for pinpointing bacteria-killing molecules that cuts the search time from months to a matter of hours, which could save drug companies lots of time and money.
- MIT doctors found a way to change the bacterial genome in a way that makes it easier for antibiotics to kill bacteria.
- Yet another team of researchers realized that an existing anticonvulsant drug (lamotrigine) can prevent bacteria from building ribosomes, without which they can't function properly. This could lead to another new class of antibiotics that work in a completely different way from any other class − good news when it comes to resistance.
Legislative changes are also paving the way for discovery. In 2012, the GAIN (Generating Antibiotic Incentives Now) Act was signed into law. It allows the FDA to fast-track the development, review and trials of new antibiotics that fight resistant pathogens. Thirty-nine new drugs are in development through the GAIN Act [source: Krans]. U.S. President Barack Obama signed an executive order in 2014 that set up a task force for fighting antibiotic-resistant bacteria, calling it an urgent matter of national security.
- Centers for Disease Control. "Antibiotic Resistance Threats in the United States, 2013." April 23, 2013. (Oct. 16, 2014) http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf
- Cheng, Allen A., Hulming Ding, and Timothy K. Lu. "Enhanced killing of antibiotic-resistant bacteria enabled by massively parallel combinatorial genetics." Proceedings of the National Academy of Sciences of the United States of America, July 14, 2014. (Oct. 16, 2014) http://www.pnas.org/content/111/34/12462.abstract
- Citorik, Robert, Mark Mimee and Timothy K. Lu. "Sequence-specific microbials using efficiently delivered RNA-guided nucleases." Nature Biotechnology, Sept. 21, 2014. (Oct. 16, 2014) http://www.nature.com/nbt/journal/vaop/ncurrent/nbt.3011/metrics/blogs
- Krans, Brian. "Two New Classes of Antibiotic Discovered as Drug Resistance Spreads." Healthline, Oct. 12, 2014. (Oct. 16, 2014) http://www.healthline.com/health-news/two-new-antibiotic-classes-discovered-100114#3
- Nonejuie, Poochit, Michael Burkart, Kit Pogliano, and Joe Pogliano. "Bacterial cytological profiling rapidly identifies the cellular pathways targeted by antibacterial molecules." Proceedings of the National Academy of Sciences, September 2013. (Oct. 16, 2014) http://www.pnas.org/content/110/40/16169
- O'Daniel, Peter I., Zhihong Peng, Hualiang Pi, Sebastian A. Testero, Derong Ding, Edward Spink, Erika Leemans, Marc A. Boudreau, Takao Yamaguchi, Valerie A. Schroeder, William R. Wolter, Leticia I. Llarrull, Wei Song, Elena Lastochkin, Malika Kumarasiri, Nuno T. Antunes, Mana Espahbodi, Katerina Lichtenwalter, Mark A. Suckow, Sergei Vakulenko, Shahriar Mobashery, and Mayland Chang. "Discovery of a New Class of Non-beta-lactam Inhibitors of Penicillin-Binding Proteins with Gram-Positive Antibacterial Activity." Journal of the American Chemical Society, Feb. 11, 2014. (Oct. 16, 2014) http://pubs.acs.org/doi/abs/10.1021/ja500053x
- Spellberg, Brad. "New Antibiotic Development: Barriers and Opportunities in 2012." Alliance for the Prudent Use of Antibiotics Newsletter, 2011. (Oct. 16, 2014) http://www.tufts.edu/med/apua/news/news-newsletter-vol-30-no-1-2.shtml
- Stokes, Jonathan M., Joseph H. Davis, Chand S. Mangat, James R. Williamson, Eric D. Brown. "Discovery of a small molecule that inhibits bacterial ribosome genesis." eLife, Sept. 18, 2014. (Oct. 16, 2014) http://elifesciences.org/content/3/e03574
- Towse, Adrian, and Priya Sharma. "Incentives for R&D for New Antimicrobial Drugs." Office of Health Economics, April 2011. (Oct. 16, 2014) http://www.ohe.org/publications/article/incentives-for-rd-for-new-antimicrobial-drugs-7.cfm
- The White House, Office of the Press Secretary. "Executive Order −- Combating Antibiotic-Resistant Bacteria." Sept. 18, 2014. (Oct. 16, 2014) http://www.whitehouse.gov/the-press-office/2014/09/18/executive-order-combating-antibiotic-resistant-bacteria