Nature's clarion call of antibacterial resistance: are we listening?

Antibiotic resistance is recognized as a major problem worldwide in the management of infectious disease, both in hospital settings and in the community. Therefore, there is an urgent need for new antibiotics, particularly those effective against multidrug-resistant bacteria such as Acinetobacter, Pseudomonas, many Enterobacteriaceae, as well as enterococci and staphylococci. There is also a growing need for new agents with activity against resistant community-acquired pathogens. Major pharmaceutical companies have either abandoned or reduced antibiotic research and development in favor of areas such as chronic illness. In general, the anti-infectives pipelines of pharmaceutical companies are more focused on the antiviral market; however, some large pharmaceutical companies have entered into collaborative discovery projects with smaller companies. Although these smaller companies face many additional challenges, several are still pursuing a wide variety of approaches.