Drug-Resistant Infections And New Antibiotic Development
Drug-resistant infections arise when bacteria become intrinsically resistant or acquire resistance to antimicrobial agents, and antibiotic-resistant bacteria that are difficult or impossible to treat have become increasingly common; resistance genes can move between bacteria, while antimicrobial exposure in health care, agriculture, and the environment drives selection, and transmission is shaped by infection control, sanitation, clean-water access, antimicrobial quality, diagnostics, travel, and migration; resistance has now been detected to all antibiotics in clinical use while only a few novel drugs remain in the pipeline, sustaining intense interest in antimicrobial resistance mechanisms and antibiotic discovery, and the development problem is especially acute for Gram-negative pathogens because their outer membrane blocks entry of many antibiotics; this long-running challenge is illustrated by carbapenem-resistant Acinetobacter baumannii, for which no new antibiotic chemical class with activity had reached patients in more than 50 years before recent tethered macrocyclic peptide development, making resistance biology, novel antibacterial targets, and new chemical scaffolds central priorities for infectious-disease research and drug discovery.