Antibiotics are powerful medicines that fight bacterial infections. They either kill bacteria or stop them from reproducing, allowing the body’s natural defenses to eliminate the pathogens. Used properly, antibiotics can save lives. But growing antibiotic resistance is curbing the effectiveness of these drugs. Taking an antibiotic as directed, even after symptoms disappear, is key to curing an infection and preventing the development of resistant bacteria.

Antibiotics don’t work against viral infections such as colds or the flu. In those cases, physicians often prescribe antiviral drugs, which fight infection by inhibiting a virus’s ability to reproduce. There are several different classes of drugs in the antiviral family, and each is used for specific kinds of viral infections. (Unlike antibacterial drugs, which may cover a wide spectrum of pathogens, antiviral medications are used to treat a narrower range of organisms.) Antiviral drugs are now available to treat a number of viruses, including influenza, human immunodeficiency virus (HIV), herpes, and hepatitis B and C. Like bacteria, viruses mutate over time and develop resistance to antiviral drugs.

 

Modern medicine needs new kinds of antibiotics and antivirals to treat drug-resistant infections. But the pipeline of new drugs is drying up. The last new class of antibiotics to be approved was the lipopeptides (e.g., daptomycin) discovered in 1987.

 

Major pharmaceutical companies have limited interest in dedicating resources to the antibiotics market because these short-course drugs are not as profitable as drugs that treat chronic conditions and lifestyle-related ailments such as high blood pressure or high cholesterol. Antibiotic research and development is also expensive, risky, and time consuming. Return on that investment can be unpredictable, considering that resistance to antibiotics develops over time and eventually makes them less effective.

 

New antiviral drugs are also in short supply. These medicines have been much more difficult to develop than antibacterial drugs because antivirals can damage host cells where the viruses reside. Today, there are more antiviral drugs for HIV than for any other viral disease, transforming an infection that was once considered a death sentence into a manageable chronic condition. But novel drugs are needed to combat other epidemic viral infections such as influenza and hepatitis B. 

 

Several programs have been developed to stimulate research and development of new vaccines and medicines. In 2007, the U.S. Department of Health and Human Services formed the Biomedical Advanced Research and Development Authority, which provides an integrated, systematic approach to the development and purchase of the vaccines, drugs, therapies, and diagnostic tools necessary for public health medical emergencies. This group has supported the development of several treatments and vaccines.

 

The Cures Acceleration Network (CAN) provision of the Patient Protection and Affordable Care Act, signed into law by President Obama in March 2010, is designed to move research discoveries through to safe and effective therapies by awarding grants through the National Institutes of Health (NIH) to biotech companies, universities, and patient advocacy groups. In 2012, CAN was moved to the newly authorized National Center for Advancing Translational Sciences (NCATS) within the NIH. CAN continues to explore ways to accelerate the movement of “high-need cures,” including drugs, from the bench to the bedside. And nonprofit organizations dedicated to accelerating the discovery and clinical development of new therapies to treat infectious diseases are bringing together philanthropists, medical research foundations, industry leaders, and other key stakeholders to forge effective collaborations.

 

Along with efforts to develop new vaccines and medicines, increased vigilance is needed to reduce the overall use of antibiotics. This can be accomplished by reducing infections that lead to the need for antibiotics in the first place. Increasing vaccination rates and improving sanitation and the availability of clean water worldwide are three effective ways to realize this goal. Other strategies include avoiding antibiotic use for growth promotion in animals and restricting the use of medically important drugs across the board, in both humans and animals. Polices that support these strategies and restrict overall use should prolong the effectiveness of antibiotics.