Antibiotic Discovery: State of the State

D espite increasing resistance among clinically important gram-negative and gram-positive pathogens to many common antibacterial agents, many large pharmaceutical companies are showing decreased interest in this product area that is so critical to public health. This downturn in antibacterial discovery and development, in turn, is leaving us vulnerable to emerging resistance, particularly to recently arrived vancomycin-resistant Staphylococcus aureus and multiply resistant, gram-negative bacilli for which we do not have adequate antimicrobial therapy in the United States. We believe that such pathogens represent a public health threat whose urgency deserves both regulatory and legislative relief. Dealing with this threat could provide opportunities for larger companies to regain a strong presence in this area. However, action should be taken soon before critical expertise disappears.