en
Scientific article
Review
English

Critical analysis of antibacterial agents in clinical development

Published inNature Reviews Microbiology, vol. 18, no. 5, p. 286-298
Publication date2020
Abstract

The antibacterial agents currently in clinical development are predominantly derivatives of well-established antibiotic classes and were selected to address the class-specific resistance mechanisms and determinants that were known at the time of their discovery. Many of these agents aim to target the antibiotic-resistant priority pathogens listed by the WHO, including Gram-negative bacteria in the critical priority category, such as carbapenem-resistant Acinetobacter, Pseudomonasand Enterobacterales. Although some current compounds in the pipeline have exhibited increased susceptibility rates in surveillance studies that depend on geography, pre-existing cross-resistance both within and across antibacterial classes limits the activity of many of the new agents against the most extensively drug-resistant (XDR) and pan-drug-resistant (PDR) Gram-negative pathogens. In particular, cross-resistance to unrelated classes may occur by co-selection of resistant strains, thus leading to the rapid emergence and subsequent spread of resistance. There is a continued need for innovation and new-class antibacterial agents in order to provide effective therapeutic options against infections specifically caused by XDR and PDR Gram-negative bacteria.

Keywords
  • Acinetobacter/drug effects
  • Acinetobacter Infections/microbiology
  • Anti-Bacterial Agents/pharmacology
  • Drug Development/trends
  • Drug Resistance, Bacterial
  • Enterobacteriaceae/drug effects
  • Enterobacteriaceae Infections/microbiology
  • Humans
  • Pseudomonas/drug effects
  • Pseudomonas Infections/microbiology
Citation (ISO format)
THEURETZBACHER, Ursula et al. Critical analysis of antibacterial agents in clinical development. In: Nature Reviews Microbiology, 2020, vol. 18, n° 5, p. 286–298. doi: 10.1038/s41579-020-0340-0
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Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal1740-1526
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