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 |