Challenges in the development of novel antibiotics

The key lessons from the Covid-19 pandemic, of the need to adequately invest in new drugs/vaccines to meet the challenges of new pathogens, are equally applicable to the ongoing fight to address antimicrobial resistance (AMR). Investment in new antibiotics (“push”) appears to be bearing some fruit, but lack of innovation and an overreliance on β-lactamase inhibitors (BLIs) are worrying. Going forward, the application of machine learning /artificial intelligence may enhance innovation. In contrast, appropriate reimbursement for new antibiotics (“pull”) is still in its infancy. The World Health Organization (WHO) has indicated that the early-phase AMR portfolio is dominated by small companies that need rapid return on their capital investments; however, unless governments and pan-governmental bodies can do more to address the financial side of this equation, then this will act as a significant barrier toward restocking the conserved antibiotics armory of last resort antibiotics. To restate the obvious, AMR is a global problem that requires a global solution.