Historical Introduction
Classes of antibiotics
Antibacterial agents by mechanism of action
Mechanim of resistance

Antibacterial agents

During our lifetime we will almost certainly receive several antibiotic treatments and many antibiotics are among the most frequent prescribed drugs.

Antibiotics are life-saving drug for severe infections, such as septicaemia, pneumonia, meningitis, and endocarditis, and are used to efficiently control much of the morbidity associated with non-life-threatening infectious disease; they reduce illness period accellerating the return to normal activities and often provide economic benefit to the individual, as well as to the society, by reducing the number of working days lost. Moreover, infectious complications of many commonly conducted surgical procedures are now preventable by the use of peri-operative antibiotic prophylaxis. They protect cancer patients whose chemotherapy had rendered them temporarily susceptible to a variety of infections. They even cure diseases like ulcers that had been considered uncurable chronic conditions.These benefits have been well known to healthcare professionals and to the public who have developed a perception that such agents are generally safe.

 In recent years, antibiotic use has been extended to agriculture, where it plays an important role in preventing infections and in promoting animal growth.

However things have never been as bad as they are today. Bacteria are becoming multi- and even pan-resistant to the available antibiotics causing life threatening infections. For these patients we are returning to a pre-antibiotic era and we have little to offer but comfort and symtomatic therapy to treat diseases which we have been easily able to cure over the last 50 years.

The past decade has seen an alarming confluence of circumstances antithetical to development of new antibacterials, and most of the very few new drugs under development have problems with their microbiology, toxicity, or pharmacokinetics and pharmacodynamics. Most large pharmaceutical companies have divested themselves of their antibiotic portfolios, and the promise that start-up companies would fill the niche has not been fulfilled. What is left of the field is being stifled by bureaucratic regulations, problems with approval, lack of expertise and a general lack of understanding of how serious the situation is.


April 2011: WHO raises awareness and ‘call for action’ at the World Health Day.




Industry pipeline of Antibiotics in Significant Decline

Source: IDSA from Economist, March 2011



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