Two recent reports by WHO concluded that 60 products in current development – 50 of which are antibiotics and 10 are biologics – are not targeting the most harmful resistant strains of gram-negative bacteria. The studies Antibacterial agents in clinical development – An overview of the pipeline for antibacterial clinical development and its subsequent publication, Antibacterial agents in preclinical development have found that antibiotic research and development is primarily driven by small or medium-sized enterprises with large pharmaceutical companies continuing to leave the field.

WHO also pointed out that large pharma companies such as AstraZeneca, Novartis, and Sanofi have stopped developing antibiotics. In 2017, a priority list of pathogens was published by the WHO outlining 12 classes of bacteria as well as tuberculosis that pose an increasing risk to human health because they are immune to most current medications. The independent experts who drew up the list hoped to encourage the medical research company to develop innovative treatments for resistant bacteria.

The report highlights a “worrying gap” in activity against the highly resistant NDM-1 (New Delhi Metallo-beta-lactamase 1), with only three antibiotics in the pipeline. On a more positive note, the pipeline for antibacterial agents for the treatment of tuberculosis and the gastro bug Clostridium difficile is more optimistic, with more than half of the drugs meeting all the breakthrough criteria set by WHO. The pre-clinical pipeline demonstrates more creativity and variety, with the creation of 252 agents to treat priority pathogens from the WHO. Both products are, however, in the very early stages of development, and must still be proven effective and safe.