Journal article
Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis.
- Tacconelli E German Centre for Infection Research, Tübingen University Hospital, Tübingen, Germany; Verona University Hospital, Verona, Italy. Electronic address: evelina.tacconelli@med.uni-tuebingen.de.
- Carrara E German Centre for Infection Research, Tübingen University Hospital, Tübingen, Germany; Verona University Hospital, Verona, Italy.
- Savoldi A German Centre for Infection Research, Tübingen University Hospital, Tübingen, Germany.
- Harbarth S World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
- Mendelson M Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
- Monnet DL European Centre for Disease Prevention and Control, Stockholm, Sweden.
- Pulcini C EA 4360 APEMAC, Nancy University Hospital, Lorraine University, Nancy, France.
- Kahlmeter G Central Hospital, Växjö, Sweden.
- Kluytmans J University Medical Center, Utrecht, Netherlands; Amphia Hospital, Breda, Netherlands.
- Carmeli Y Laboratory for Microbiology and Infection Control, Tel Aviv University, Tel Aviv, Israel.
- Ouellette M Laval University and Canadian Institutes for Health Research, Québec, QC, Canada.
- Outterson K Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator CARB-X, Boston University, Boston, MA, USA.
- Patel J Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Cavaleri M European Medicines Agency, London, UK.
- Cox EM US Food and Drug Administration, Washington, DC, USA.
- Houchens CR Antibacterials Program Biomedical Advanced Research and Development Authority, Washington, DC, USA.
- Grayson ML Austin Health, University of Melbourne, Melbourne, VIC, Australia.
- Hansen P Department of Infectious Diseases and Microbiology, University of Otago, Dunedin, New Zealand.
- Singh N Children's National Health System, George Washington University, Washington, DC, USA.
- Theuretzbacher U Center for Anti-infective Agents, Vienna, Austria.
- Magrini N Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland.
- 2017-12-26
Published in:
- The Lancet. Infectious diseases. - 2018
English
BACKGROUND
The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs.
METHODS
We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated. The final priority ranking of the antibiotic-resistant bacteria was established after a preference-based survey was used to obtain expert weighting of criteria.
FINDINGS
We selected 20 bacterial species with 25 patterns of acquired resistance and ten criteria to assess priority: mortality, health-care burden, community burden, prevalence of resistance, 10-year trend of resistance, transmissibility, preventability in the community setting, preventability in the health-care setting, treatability, and pipeline. We stratified the priority list into three tiers (critical, high, and medium priority), using the 33rd percentile of the bacterium's total scores as the cutoff. Critical-priority bacteria included carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, and carbapenem-resistant and third-generation cephalosporin-resistant Enterobacteriaceae. The highest ranked Gram-positive bacteria (high priority) were vancomycin-resistant Enterococcus faecium and meticillin-resistant Staphylococcus aureus. Of the bacteria typically responsible for community-acquired infections, clarithromycin-resistant Helicobacter pylori, and fluoroquinolone-resistant Campylobacter spp, Neisseria gonorrhoeae, and Salmonella typhi were included in the high-priority tier.
INTERPRETATION
Future development strategies should focus on antibiotics that are active against multidrug-resistant tuberculosis and Gram-negative bacteria. The global strategy should include antibiotic-resistant bacteria responsible for community-acquired infections such as Salmonella spp, Campylobacter spp, N gonorrhoeae, and H pylori.
FUNDING
World Health Organization.
The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs.
METHODS
We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated. The final priority ranking of the antibiotic-resistant bacteria was established after a preference-based survey was used to obtain expert weighting of criteria.
FINDINGS
We selected 20 bacterial species with 25 patterns of acquired resistance and ten criteria to assess priority: mortality, health-care burden, community burden, prevalence of resistance, 10-year trend of resistance, transmissibility, preventability in the community setting, preventability in the health-care setting, treatability, and pipeline. We stratified the priority list into three tiers (critical, high, and medium priority), using the 33rd percentile of the bacterium's total scores as the cutoff. Critical-priority bacteria included carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, and carbapenem-resistant and third-generation cephalosporin-resistant Enterobacteriaceae. The highest ranked Gram-positive bacteria (high priority) were vancomycin-resistant Enterococcus faecium and meticillin-resistant Staphylococcus aureus. Of the bacteria typically responsible for community-acquired infections, clarithromycin-resistant Helicobacter pylori, and fluoroquinolone-resistant Campylobacter spp, Neisseria gonorrhoeae, and Salmonella typhi were included in the high-priority tier.
INTERPRETATION
Future development strategies should focus on antibiotics that are active against multidrug-resistant tuberculosis and Gram-negative bacteria. The global strategy should include antibiotic-resistant bacteria responsible for community-acquired infections such as Salmonella spp, Campylobacter spp, N gonorrhoeae, and H pylori.
FUNDING
World Health Organization.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/S1473-3099(17)30753-3
- PMID 29276051
- Persistent URL
- https://sonar.ch/global/documents/232634
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