Alm Richard A, Lahiri Sushmita D
CARB-X, Boston University, Boston, MA 02215, USA.
Boehringer-Ingelheim, Cambridge, MA 02142, USA.
Antibiotics (Basel). 2020 Jul 17;9(7):418. doi: 10.3390/antibiotics9070418.
The number of antibacterial agents in clinical and preclinical development possessing activity against a narrow spectrum of bacterial pathogens is increasing, with many of them being nontraditional products. The key value proposition hinges on sparing antibiotic use and curtailing the emergence of resistance, as well as preventing the destruction of a beneficial microbiome, versus the immediate need for effective treatment of an active infection with a high risk of mortality. The clinical use of a targeted spectrum agent, most likely in combination with a rapid and robust diagnostic test, is a commendable goal with significant healthcare benefits if executed correctly. However, the path to achieving this will come with several challenges, and many scientific and clinical development disciplines will need to align their efforts to successfully change the treatment paradigm.
临床和临床前研发中针对窄谱细菌病原体具有活性的抗菌剂数量正在增加，其中许多是非传统产品。关键价值主张取决于减少抗生素使用、遏制耐药性的出现以及防止有益微生物群的破坏，与立即有效治疗具有高死亡风险的活动性感染的迫切需求形成对比。靶向谱剂的临床应用，很可能与快速且强大的诊断测试联合使用，如果执行得当，是一个具有显著医疗保健益处的值得称赞的目标。然而，实现这一目标的道路将面临诸多挑战，许多科学和临床开发学科需要齐心协力才能成功改变治疗模式。
