Bad Bugs, No Drugs: No ESKAPE! An Update from IDSA（2009）

楚楚

Bad Bugs, No Drugs: No ESKAPE! An Update from the Infectious Diseases Society of America
Helen W. Boucher,1 George H. Talbot,2 John S. Bradley,3,4 John E. Edwards, Jr,5,6,7 David Gilbert,8 Louis B. Rice,9,10
Michael Scheld,11 Brad Spellberg,5,6,7 and John Bartlett12
The Infectious Diseases Society of America (IDSA) continues to view with concern the lean pipeline for novel
therapeutics to treat drug-resistant infections, especially those caused by gram-negative pathogens. Infections
now occur that are resistant to all current antibacterial options. Although the IDSA is encouraged by the
prospect of success for some agents currently in preclinical development, there is an urgent, immediate need
for new agents with activity against these panresistant organisms. There is no evidence that this need will be
met in the foreseeable future. Furthermore, we remain concerned that the infrastructure for discovering and
developing new antibacterials continues to stagnate, thereby risking the future pipeline of antibacterial drugs.
The IDSA proposed solutions in its 2004 policy report, “Bad Bugs, No Drugs: As Antibiotic R&D Stagnates,
a Public Health Crisis Brews,” and recently issued a “Call to Action” to provide an update on the scope of
the problem and the proposed solutions. A primary objective of these periodic reports is to encourage a
community and legislative response to establish greater financial parity between the antimicrobial development
and the development of other drugs. Although recent actions of the Food and Drug Administration and the
110th US Congress present a glimmer of hope, significant uncertainly remains. Now, more than ever, it is
essential to create a robust and sustainable antibacterial research and development infrastructure—one that
can respond to current antibacterial resistance now and anticipate evolving resistance. This challenge requires
that industry, academia, the National Institutes of Health, the Food and Drug Administration, the Centers
for Disease Control and Prevention, the US Department of Defense, and the new Biomedical Advanced Research
and Development Authority at the Department of Health and Human Services work productively together.
This report provides an update on potentially effective antibacterial drugs in the late-stage development
pipeline, in the hope of encouraging such collaborative action.