By: William M. Shafer, Ph.D.
All of the above mentioned action plans, resolutions, and active voices regarding AMR are important. Everyone agrees what we really need to stave-off the impending disaster of AMR bacteria are new antimicrobials that are safe and effective. The National Action Plan for Combating Antibiotic-Resistant Bacteria has a stated goal to “intensify research and development of new therapeutics and vaccines, first-in-class drugs and new combination therapies for treatment of bacterial infections”. This action plan calls for the development by 2020 of at least two new antibiotic drug candidates as well as 3 drug candidates or probiotics that could be used as alternatives to classical antibiotics. Overall, this plan is consistent, but not as aggressive, with an earlier recommendation from the Infectious Diseases Society of America (IDSA), which called for ten new antibacterial drugs by 2020. The boldness of the “10 X 20 Initiative” proposed by IDSA in 2010 with its associated challenges was compared to the pronouncement of President Kennedy in 1961 that within 10 years man would walk on the moon
A major breakthrough for the search for a new antibacterial treatment recently made by Kim Lewis Ph.D. (Northeastern University) and colleagues  gives reason for optimism. This new antibiotic, teixobactin, was isolated from an unculturable bacteria during a hunt for novel antibiotics. Teixobactin inhibits bacterial cell wall biosynthesis by a novel process heretofore not exploited. It has proven safe and effective in curing experimental infections in mice and bacteria have difficulty developing resistance; the latter point deserves a cautionary note since bacteria are notorious for their capacity to resist antibiotics. All of these properties point towards a new therapeutic option for treating AMR bacterial infections and hopefully teixiobactin will ultimately move into clinical trials. Regardless of the future of teixobactin, similar academic basic research enterprises must be encouraged and nurtured with funding and industrial partners for important clinical trials. Towards this end, it is important to note that the aforementioned National Action Plan calls for a consortium between academia and industry to facilitate antibiotic development.
Despite the gloom and doom of predictions regarding AMR and how this will impact the future of global public health, I have to remain optimistic that with political and financial support that science will meet the challenges of AMR. Otherwise, it would be difficult to sleep at night as I worryingly contemplate a return to the pre-antibiotic era.
1. Hampton T. 2015. Novel programs and discovers aim to combat antibiotic resistance. JAMA. Published on-line June 3, 2015.
2. Infectious Diseases Society of America. 2010. The 10 X 20 Initiative: Pursuing a global commitment to develop 10 new antibacterial drugs by 2020. Clinical Infectious Disease. 50: 1081-1083.
3. Ling LL, Schneider T, Peoples AJ, Spoering AL, Engels I, Conlon BP, Mueller A, Schäberle TF, Hughes DE, Epstein S, Jones M, Lazarides L, Steadman VA, Cohen DR, Felix CR, Fetterman KA, Millett WP, Nitti AG, Zullo AM, Chen C, Lewis K. 2015. A new antibiotic kills pathogens without detectable resistance. Nature 517: 455-59.
Additional websites of interest:
www.antibiotic-action.com: This site is from my colleague Laura Piddock Ph.D. of the University of Birmingham in the UK. Laura has been a leading investigator in antibiotic resistance research and public information regarding dangers of AMR.
www.cdc.gov.drugresistance/threat-report-2013/: You can download a pdf of 114 pages (!) to get the important statistics regarding AMR bacteria and threat levels.
www.idsociety.org/AR_Policy/: This site from the IDSA has many useful sub-sites regarding multiple aspects of AMR, including one on “Antibiotics in Agriculture”
www.niaid.nih.gov/topics/antimicrobial resistance/pages/default.aspx: Provides important information from the NIH regarding intra- and extra-mural efforts on AMR. The current and future efforts on AMR can be downloaded as a pdf.
http://www.eurosurveillance.org: A nice website to keep informed regarding AMR matters in Europe
In addition to these websites, one might also wish to view the movie “Resistance” which can be downloaded from Netflix. I also highly recommend the PBS “Frontline” special: “Hunting the Nightmare Bacteria”
Dr. William Shafer is a Professor of Microbiology and Immunology at the Emory School of Medicine (SOM), the Director of the Emory Antimicrobial Resistance and Therapeutic Discovery Training Program, as well as the Co-Director of the Emory Antibiotic Resistance Center and Senior Research Career Scientist (Atlanta, VA).