Chemical Biology Ventures, Abingdon, Oxfordshire, UK; Abgentis, Edgbaston, Birmingham, UK; Persica Pharmaceuticals, Canterbury, Kent, UK.
Transcrip Partners Reading, Berkshire, UK.
Lancet Infect Dis. 2016 Feb;16(2):239-51. doi: 10.1016/S1473-3099(15)00466-1. Epub 2016 Jan 13.
Antibiotics have saved countless lives and enabled the development of modern medicine over the past 70 years. However, it is clear that the success of antibiotics might only have been temporary and we now expect a long-term and perhaps never-ending challenge to find new therapies to combat antibiotic-resistant bacteria. A broader approach to address bacterial infection is needed. In this Review, we discuss alternatives to antibiotics, which we defined as non-compound approaches (products other than classic antibacterial agents) that target bacteria or any approaches that target the host. The most advanced approaches are antibodies, probiotics, and vaccines in phase 2 and phase 3 trials. This first wave of alternatives to antibiotics will probably best serve as adjunctive or preventive therapies, which suggests that conventional antibiotics are still needed. Funding of more than £1·5 billion is needed over 10 years to test and develop these alternatives to antibiotics. Investment needs to be partnered with translational expertise and targeted to support the validation of these approaches in phase 2 trials, which would be a catalyst for active engagement and investment by the pharmaceutical and biotechnology industry. Only a sustained, concerted, and coordinated international effort will provide the solutions needed for the future.
抗生素在过去 70 年中挽救了无数生命，推动了现代医学的发展。然而，抗生素的成功似乎只是暂时的，我们现在预计将长期甚至永远面临寻找新疗法来对抗抗药性细菌的挑战。需要采取更广泛的方法来解决细菌感染问题。在这篇综述中，我们讨论了抗生素的替代品，我们将其定义为针对细菌的非化合物方法（除经典抗菌剂以外的产品）或针对宿主的任何方法。处于 2 期和 3 期临床试验阶段的最先进的替代品是抗体、益生菌和疫苗。这波抗生素替代品可能最好作为辅助或预防性疗法，这表明仍然需要使用传统抗生素。需要在 10 年内投入超过 15 亿英镑来测试和开发这些抗生素替代品。投资需要与转化专业知识相结合，并针对支持这些方法在 2 期临床试验中的验证，这将是制药和生物技术行业积极参与和投资的催化剂。只有持续、协调和协调一致的国际努力才能为未来提供所需的解决方案。
