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Antimicrobial resistance: antibacterial clinical development pipeline
  1. Stephanie Kohl
  1. Correspondence to Stephanie Kohl, Department of Policy & Advocacy, European Association of Hospital Pharmacists, Brussels, Belgium; Stephanie.Kohl{at}

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The WHO released a report that provides an overview on the antibacterial agents in clinical development. It is a follow-up action related to the list of priority antibiotic resistance pathogens that was drawn up as part of WHO’s Global Action Plan on Antimicrobial Resistance. The report shows a serious lack of new antibiotics, since most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and are thus short-term solutions.

The analysis focused on 62 antibacterial products (51 antibiotics and 11 biologicals) that were as of May 2017 in phases I–III of clinical development and had not yet received a market authorisation for human use. In addition, to classifying the antibacterial products by type, pathogen category, phase of clinical development and expected activity against priority pathogens, the report also analysed their innovativeness. Only 8 out of the 33 antibiotics that are being developed for priority pathogens fulfilled at least one of the four criteria that were used to assess innovativeness. These criteria include (1) absence of cross-resistance to existing antibiotics, (2) new chemical class, (3) new target and (4) new mechanism of action.

Overall, the report shows that the antibacterial agents currently in clinical development are insufficient to mitigate the threat of antimicrobial resistance (AMR). Consequently, more investment is needed in basic science, drug discovery and clinical development. Furthermore, the report calls for more innovative products as these are required against pathogens with no cross-resistance or co-resistance to existing classes.

In addition to the presentation of the findings, the report also highlights the important role of antimicrobial stewardship. The development of new antibiotics is not sufficient to mitigate the threat of AMR, wherefore it needs to go hand in hand with infection prevention and control activities. As outlined in the European Association of Hospital Pharmacists’ …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.