Antimicrobial resistance and the race to find new antibiotics

Never has a race against time been framed with such dire warnings of the consequences of failure. But the quest to discover new antibiotics or, at least, find a way of holding back anti­ microbial resistance (AMR) is a stark matter of life or death. Ten million deaths a year by 2050, according to the latest accounting.1 Superbugs overpowering medication is a dilemma snaking through the corri­ dors of political power and racing through hospitals and GP surgeries in the UK. Common infections such as pneumonia will kill again, warns Dr Margaret Chan, director general of WHO, adding: “On current trends, a common disease like gonorrhoea may become untreatable. Doctors facing patients will have to say: ‘I’m sorry – there’s nothing I can do for you’.” The United Nations elevated AMR to crisis level at a meeting at its New York headquarters, on 21 September 2016, signalling unprecedented co­operation from heads of state, who signed up to tackle the root causes of AMR.2 The global fault­lines of antimicrobial resistance – unregulated use, prescrip­ tion profligacy and food­chain contami­ nation among others – have led to a procession of doom­laden predictions with AMR even being ranked alongside terrorism as a threat to mankind. But, despite the bleak outpourings, there is cautious hope for the next generation of antibiotics. Laboratories are humming late into the night exploring new discoveries, ingenious modes of action and the repur­ posing of existing drugs to roll back the antimicrobial resistance frontier. The novel use of some existing drugs, includ­ ing those available over­the­counter, to energise antibiotics is showing promise with a topical nail fungal cream, a diar­ rhoea treatment and the active ingredient of the spice turmeric all contenders for a new class of antimicrobial resistance breakers designed to prolong current antibiotic use while new therapies are being pursued. Governments are also discussing how to recalibrate reimbursement systems to encourage more industry research and development and global awareness campaigns have been launched, such as WHO World Antibiotic Awareness week, to shake all sections of society from inertia. Antimicrobial resistance and the race to find new antibiotics