4.2 Scientific barriers

The biggest barrier to new antibiotics may be a lack of investment in the basic, multidisciplinary research that underpins drug discovery and development (Figure 6).

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Figure 6 How scientific barriers can impede antibiotic discovery (Pew Charitable Trust, 2016).

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This figure comprises a schematic showing the pipeline of antibiotic discovery from basic research to discovery research, development and delivery. Each stage is represented by a circular image. In basic research scientists build on biological and chemical understanding. In discovery research scientists search for and/or design compounds that could become medicines. In development, drugs are developed for market before delivery for patient care. There is a vertical line on the schematic between basic research and discovery research which is labelled scientific barriers.

Figure 6 How scientific barriers can impede antibiotic discovery (Pew Charitable Trust, 2016).

Research has focused on identifying compounds that inhibit essential bacterial processes, for example cell wall synthesis. However, other key attributes of antibiotics are poorly understood, hampering efforts to discover new types of drug. The lack of new antibiotics to target infections caused by Gram-negative bacteria is particularly troubling because these are very difficult to treat.

Understanding the unique characteristics of antibiotics that allow them to penetrate cells, and to accumulate within in high concentrations, will enable focused chemical libraries to be created. It will also facilitate targeted screening programmes.

An alternative to discovering new antibiotics is to make existing drugs more effective. You will find out more about this in the next section.