Why is it so difficult to battle antibiotic resistance?

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Credit: Oliver Munday

Before COVID-19, antibiotic resistance was estimated to kill at least 700,000 people each year worldwide. That number could now climb as more people with the viral disease receive antibiotics to treat secondary infections, or to prevent infections that come from being on a ventilator.

[D]rug makers who produce antibiotics face unique challenges.

In a bitter paradox, antibiotics fuelled the growth of the twentieth century’s most profitable pharmaceutical companies, and are one of society’s most desperately needed classes of drug. Yet the market for them is broken. For almost two decades, the large corporations that once dominated antibiotic discovery have been fleeing the business, saying that the prices they can charge for these life-saving medicines are too low to support the cost of developing them. Most of the companies now working on antibiotics are small biotechnology firms, many of them running on credit, and many are failing.

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In just the past two years, four such companies declared bankruptcy or put themselves up for sale, despite having survived the perilous, decade-long process of development and testing to get a new drug approved. When they collapsed, Achaogen, Aradigm, Melinta Therapeutics and Tetraphase Pharmaceuticals took out of circulation — or sharply reduced the availability of — 5 of the 15 antibiotics approved by the US Food and Drug Administration (FDA) since 2010.

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