Emerging antibiotics with resistance risk before clinical use

Emerging antibiotics with resistance risk before clinical use

Researchers from the Hun-Ren Biological Research Center Szeged, Hungary, have made a worrying discovery about the future of antibiotics. Two recently published studies published just days apartNatural microbiologyAndScience Translational Medicinefound that resistance to new antibiotics can develop even before they are widely used, reducing their effectiveness from the start. The studies focused on five critical bacterial species that cause major hospital infections and examined 18 new antibiotics, some already on the market and others still in development.

No antibiotics are free of resistance

“New antibiotics are often marketed as resistance-free, but this claim is based on limited data“says Csaba Pál, PhD, principal investigator.”Our research highlights a key problem: Antibiotic development tends to prioritize broad-spectrum activity—that is, the number of bacterial species a drug targets—over long-term sustainability. While many new antibiotics do indeed offer a broader spectrum, this does not guarantee that they will remain effective in clinical use in the long term. “

The studies found that resistance to almost all antibiotics tested developed rapidly, defying previous expectations. For example, Teixobactin, once hailed as a revolutionary drug, was thought to be less prone to resistance. However, research found that bacteria can adapt to this, leading to cross-resistance to other critical antibiotics. Alarmingly, the team also found that resistance mutations already exist in bacterial populations, likely due to the overuse of older antibiotics and the shared resistance mechanisms between these and new drugs. These pre-existing mutations could render even the newest drugs ineffective shortly after they enter clinical use.

Rethinking antibiotic development

The studies require a fundamental shift in antibiotic development. Pharmaceutical companies must include resistance studies early in the development process to anticipate and mitigate risks before releasing antibiotics. Integrating resistance prediction and genetic monitoring into drug design could reduce failures.

Lejla Daruka, PhD, one of the lead authors, notes, “Some new antibiotics show more promise than others because resistance develops more slowly or only in certain types of bacteria. Understanding why these drugs perform better is the next critical step. “

The studies emphasize the importance of prioritizing antibiotics with novel modes of action to circumvent existing resistance. In cases where only certain bacterial species are susceptible to resistance, narrow spectrum therapy could provide an effective alternative. Finally, the studies emphasize the urgency of responsible antibiotic use to slow the development of resistance and ensure the longer effectiveness of new treatments in the future.

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