Table 1.

Causes of and Solutions to Antibiotic Resistance Crisis

Problem	Causes	Potential Solutions
Difficulty discovering new classes of antibiotics	• Easy to discover antibiotics already discovered	• Find new substrate to screen for new antibiotics
		• Change the screening methodology
		• Consider developing treatments that don’t seek to kill microbes
Economically unattractive to discover and develop new antibiotics	• Companies make more money selling chronic therapies	• New business models for antibiotic development—defense contractor model
	• Antibiotic pricing does not reflect societal value	• Public–private partnerships focused on new antibiotic development
	• Stewardship reduces sales of new antibiotics	• Focus on developing antibiotics for resistant pathogens and unmet need, which will support higher pricing
Regulatory barriers to developing new antibiotics	• Overemphasis on exaggerated statistical concerns outweighing clinical reality and practicality in trial designs	• Regulatory reform so that regulatory standards are rigorous, but also feasible and clinically relevant
Overuse of antibiotics	• Inadequate diagnostics	• Encourage development and use of molecular diagnostics to enable targeting antibiotics and withholding antibiotics from viral infections
	• Treatment regimens are too long for most infections	• More studies on short-course therapy; encouraging short-course therapies clinically; biomarkers to individualize duration of therapy
	• Continue to treat viral infections with antibiotics	• Novel psychological approaches to overuse, including the “gentle nudge” approach of public commitment
		• Enhanced infection prevention