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Fight Against Antimicrobial Resistance: We Always Need New Antibacterials but for Right Bacteria

Molecules. 2019 Aug 29;24(17):3152. doi: 10.3390/molecules24173152.

Abstract

Antimicrobial resistance in bacteria is frightening, especially resistance in Gram-negative Bacteria (GNB). In 2017, the World Health Organization (WHO) published a list of 12 bacteria that represent a threat to human health, and among these, a majority of GNB. Antibiotic resistance is a complex and relatively old phenomenon that is the consequence of several factors. The first factor is the vertiginous drop in research and development of new antibacterials. In fact, many companies simply stop this R&D activity. The finding is simple: there are enough antibiotics to treat the different types of infection that clinicians face. The second factor is the appearance and spread of resistant or even multidrug-resistant bacteria. For a long time, this situation remained rather confidential, almost anecdotal. It was not until the end of the 1980s that awareness emerged. It was the time of Vancomycin-Resistance Enterococci (VRE), and the threat of Vancomycin-Resistant MRSA (Methicillin-Resistant Staphylococcus aureus). After this, there has been renewed interest but only in anti-Gram positive antibacterials. Today, the threat is GNB, and we have no new molecules with innovative mechanism of action to fight effectively against these bugs. However, the war against antimicrobial resistance is not lost. We must continue the fight, which requires a better knowledge of the mechanisms of action of anti-infectious agents and concomitantly the mechanisms of resistance of infectious agents.

Keywords: antimicrobial resistance; drug discovery; multidrug-resistant bacteria; new antibacterials.

Publication types

  • Review

MeSH terms

  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / pathogenicity
  • Acinetobacter baumannii / physiology
  • Aminoglycosides / chemical synthesis
  • Aminoglycosides / economics
  • Aminoglycosides / therapeutic use
  • Anti-Bacterial Agents / chemical synthesis
  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use*
  • Drug Approval / organization & administration
  • Drug Resistance, Multiple, Bacterial*
  • Drugs, Investigational / chemical synthesis
  • Drugs, Investigational / economics
  • Drugs, Investigational / therapeutic use*
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / pathogenicity
  • Enterobacteriaceae / physiology
  • Fluoroquinolones / chemical synthesis
  • Fluoroquinolones / economics
  • Fluoroquinolones / therapeutic use
  • Global Health / economics
  • Global Health / trends*
  • Glycopeptides / chemical synthesis
  • Glycopeptides / economics
  • Glycopeptides / therapeutic use
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / pathogenicity
  • Gram-Negative Bacteria / physiology
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / microbiology
  • Gram-Negative Bacterial Infections / pathology
  • Humans
  • Macrolides / chemical synthesis
  • Macrolides / economics
  • Macrolides / therapeutic use
  • Pseudomonas aeruginosa / drug effects
  • Pseudomonas aeruginosa / pathogenicity
  • Pseudomonas aeruginosa / physiology
  • beta-Lactams / chemical synthesis
  • beta-Lactams / economics
  • beta-Lactams / therapeutic use

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • Drugs, Investigational
  • Fluoroquinolones
  • Glycopeptides
  • Macrolides
  • beta-Lactams