Vice President of Anti-Infectives Research, Summit Therapeutics
A renewed and sustainable pipeline of effective antibiotics is vital to modern medicine. New thinking offers a patient-centric approach to antibiotic development to tackle resistance and improve health outcomes.
Recent antibiotic drug approvals have largely been based on existing antibiotic classes, providing a stop gap, but not a long-term solution.
“The most recent market launches have been incremental improvements on those old classes of drugs, but the expectation is that resistance to those will continue to develop,” confirms Clive Mason, Vice President of Anti-Infectives Research at Summit Therapeutics, a US/UK based antibiotic discovery company.
An alternative is a more personalised approach that harnesses precision agents that act through new mechanisms, targeting specific pathogens to overcome existing resistance mechanisms.
Protecting the whole person
However, drug resistance is not the only issue that needs to be considered. The detrimental impact that the use of broad-spectrum antibiotics can have on a patient is less well understood, but no less important. Since broad-spectrum agents have the power to kill a range of bacteria – both good and bad – overuse of these drugs can perturb the gut microbiome and weaken an individual’s immune system.
“There is growing evidence that maintaining a diverse microbiome is a key health protection mechanism in humans,” continues Mason. “Broad spectrum agents can obliterate the microbiome and leave patients in a compromised state.”
For example, dysbiosis, a disturbance of the gut microbiome, is a common side effect of extensive antibiotic use and can lead to infection by opportunistic pathogens such as Clostridioides difficile. More targeted therapies that are sympathetic to the microbiome could address the infecting bacteria whilst protecting against further disease.
There is growing evidence that maintaining a diverse microbiome is a key health protection mechanism in humans.
Targeting through diagnostics
Of course, a more targeted approach is reliant on precisely identifying the type of bacterial infection through rapid diagnosis. “Some systems are in use in hospitals, but the key is being able to diagnose rapidly and accurately to allow the physician to prescribe the right drug.” explains Mason.
The good news is that progress on targeted agents is being made. Summit Therapeutics is currently advancing a number of programmes including Phase 3 clinical trials of a novel antibiotic designed to not only target C. difficile infection but also reduce the debilitating burden of disease recurrence.
Success for new antibiotics is not simply dependent on the clinical outcomes, though. Commercial viability is an on-going tension in antibiotic development that needs reconciling for longer term sustainability. “Even with the current antibiotic market challenges, we at Summit believe that success is possible by clearly differentiating over existing therapies to ensure clinical use and reimbursement” concludes Mason.
We are dependent on antimicrobials for so much of modern medicine. To safeguard this, and save lives, we need to embrace and fully exploit antibiotic innovation.