New antibiotics targeting Gram-negative bacilli

Abstract

Antimicrobial resistance (AMR) is an emerging global threat. It increases mortality and morbidity rates and places a heavy burden on healthcare systems. Healthcare professionals can address the increasing issue of AMR by advocating responsible antibiotic use and supporting the development of new medications. Despite the economic, logistic, and scientific challenges, it is reassuring that new agents continue to be developed. This review addresses new antibiotics in the pipeline. A review of the literature was conducted including Medline, and Clinicaltrials.org, for approved and in pipeline antibiotics in phase 3 or new drug applications (NDA). We found several new antibiotics and reviewed their current development status, mode of action, spectra of activity, and indications for which they have been approved. The included studies from phase 3 clinical trials were mainly utilized for the treatment of acute bacterial skin and skin structure infections, community-acquired bacterial pneumonia, and pneumonia acquired in healthcare settings. The availability of these agents is limited for high-priority organisms. The identified antibiotics were primarily based on previously known molecules or pre-existing antimicrobial agents. There is a limited number of antibiotics against high priority organisms. New antimicrobial agents targeting the top-priority organisms identified by the World Health Organization are urgently needed. However, some antibiotics target ESBL-producing Enterobacterales, carbapenem-resistant Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa.