• Molecular Ideas

Whitepaper: Microbial Mayhem and the Rise of Antibiotic Resistance

Welcome to Molecular Ideas, and thank you for sharing your time with us! Today, we will be discussing one of the most critical public health challenges of our time - antibiotic resistance - including what it is, how it arises, and what we can do about it.


ACHOO!


There are a handful of things in life we automatically reach for when we're not feeling well. When you sneeze, we reach for a tissue. When you have a headache, we reach for an analgesic. When you have flu-like symptoms in the developed world, we call our doctor and ask "Can I get an antibiotic?" And why shouldn't we? After all, they make you better, don't they?


It's no surprise that antibiotics comprise a significant number of entries on the WHO's List of Essential Medicines. They represent life-saving treatments around the world. Antibiotics are commonly referred to as the 'silver bullets' of the pharmaceutical industry. However, these ancient tools could use a little polish. While healthy hygiene habits and vaccines can help prevent certain infectious diseases from taking hold, there is no escaping the presence of bacteria in our lives. They are in our soil, our water, and our air. They are also inside us, helping process food into nutrients, training our immune system, and protecting us from their most lethal kin. It's the handful of species and strains that are infectious, or end up where they are not supposed to be, that cause health problems.


These conditions can range from a case of the sniffles to sepsis - a life-threatening condition in which the body responds to infection by releasing dangerous amounts of cytokines. Left unchecked, these immune-modulating chemicals can trigger widespread inflammation that can lead to a dangerous drop in blood pressure, organ damage, or death in a phenomenon known as a cytokine storm. While tragically seen in many severe COVID-19 cases, it is a concerning clinical possibility as the result of severe bacterial infection as well.


In any case, antibiotics are our first line of defense and our first fallback option. In some cases, they made minor inconveniences of former epidemics like strep and tuberculosis. In other cases, including the ICU and areas of the developing world, they mean the difference between life and death. However, the commercial demands and the social value of these critical molecules are at odds with each other. While governments, companies, and practitioners try to untie this Gordian knot of a public health issue, increasing antibiotic resistance whittles away the tools we have.


We're going to blitz through the history of antibiotics before discussing today's conundrum, industry challenges, and our thoughts on how to address this critical public health need.


The Antibiotic Revolution


The antibiotic revolution took place in three stages in the early to mid-1900's. Alexander Fleming's discovery of penicillin was only the second stage. The real revolution began with a Bayer scientist named Paul Ehrlich, who pioneered a Nobel Prize-winning methodology to identify and synthesize targeted antibiotics.

(Paul Ehrlich, Nobel Prize Portrait from NobelPrize.org Biography)


His process was systematic, meticulous, and rigorous. By modifying a common dye that had an affinity for certain bacteria with unique chemical groups, it became feasible to find an effective antimicrobial agent. It transformed the hypothetical to the systematic; medical innovation simply became a matter of human power, creativity, and time.


Compared to the antibiotics of today, Ehrlich's did not lead to relatively pleasant patient experiences. His first antibiotic, Salvarsan (arsphenamine) contained arsenic. Despite poor side effects, it proved to be very effective against a scourge of the era, syphilis. Moreover, the methodology would pave the way for the first mass-market antibiotic used to counter streptococcus pneumoniae: sulfanilamide (or 'sulfa' for short).


And what did Ehrlich call these wonderful molecules that selectively target bacteria? Zauberkugeln, or 'magic bullets'.


With this rigorous methodology, why does Alexander Fleming get so much credit for discovering antibiotics? Setting aside the geopolitics of the era, there is one essential difference between his discovery and Ehrlich's methodology. Fleming discovered that antibiotics were pre-crafted by organisms and found them to be effective.


Scientifically, this insight uncovered a more complex biochemical ecosystem than previously conceived. However, the real benefit of this discovery was economic. Suddenly, we did not have to derive drugs from our existing knowledge of chemistry and guess which would work against pathogens. Now we could screen, evaluate, and modify existing drug candidates, which drastically saves time and cost. Pharmaceutical companies could invest their resources in what showed promise in a petri dish with a soil sample, rather than only leveraging chemistry. Plus, penicillin was also more effective than sulfanilamide at managing a wider range of bacteria diseases.

(Chemical structures of arsphenamine, sulfanilamide, and penicillin; structures taken from Wikipedia.com)


The implications of this methodology extend well beyond the field of infectious disease control. Cyclosporin A is a critical immunosuppressant drug used to increase the probability of success in organ transplant cases. The Japanese microbiologist Akira Endo isolated citirin, the precursor for mevastatin, from Penicillium citrinum in 1970. While unsuccessful as a drug candidate, it led to the discovery and refinement of other statin molecules that form some of today's most successful drugs.


Many large pharmaceutical companies used to have a policy of providing a small stipend to employees who brought back soil samples from exotic locales to see if there might be a new antibiotic candidate. Leveraging this type of analysis persists today, for research in the highest scientific journals, to the open-source efforts that led to finding new antibiotic candidates in the Dalek statue in BBC Broadcasting House.


By using the approaches of rigorous chemical evaluation and biologic sample screening in tandem, we could enter the third stage of the antibiotic revolution - control. With the use of these 'magic bullets', we could treat diseases precisely that once ran rampant, especially in children, the wounded, and immunocompromised populations.

(Chart depicting the decrease in deaths from infectious diseases following the introduction of widely available antibiotics in the US from The Hamilton Project)


We also discovered new classes of antibiotics that were suitable to treat different diseases based on their unique mechanisms of action, as shown below.

(Table depicting the different known classes of antibiotics in order of discovery; derived from Conly, J., & Johnston, B. (2005) & Lumen Learning).


When we refer to the 'class' of antibiotic, we are referring to the common part of the chemical structure that informs its mechanism of action (or 'MOA'). This means that each class has the potential for countless variations around a common structural theme of the molecule that allows it to selectively interrupt bacteria's critical functions.


For instance, we see below that antibiotics derived from penicillin (otherwise referred to as 'β-lactam' antibiotics) share a common element of their structure called a β-lactam ring. This 'ring' is a four-membered lactam; for those who need a refresh from their organic chemistry course, this is the square in the middle of these molecules with a nitrogen on the right and the double bond to the oxygen (carbonyl group) on the left. This common element to the antibiotic structure enables it to interfere with bacterial cell-wall formation - effectively creating a big hole in a bacterial water balloon.

(Graphic depicting traditional and non-conventional β-lactam antibiotics, taken from Liras, P & Martin, J (2006).)


Resistance is Futile


So, how does antibiotic resistance emerge?


As we say in molecular biology, form fits function. The precise construction of a molecule allows it to interact with another molecule or part of the cell. This miracle of life allows us to carry out trillions of complex biochemical interactions every moment without getting our biochemical wires crossed. Unfortunately, this precision can be a double-edged sword when it comes to antibiotic resistance. If the antibiotic's target changes shape ever so slightly, the antibiotic will not be able to bind - rendering it ineffective.


As we saw above, there are many different targets for different classes of antibiotics. However, bacteria have their own active defenses, including enzymes that can dismantle antibiotics. They also have passive defenses, like tweaks in target structures.


Together, these changes form what we collectively call 'antibiotic resistance'. There are two key sources of these changes - mutations and horizontal gene transfer.


Bacterial mutations can spontaneously occur due to a number of environmental factors, or due to the lesser degree of fidelity that bacterial DNA polymerase possesses when compared with the ones inside our own cells. These mutations are typically brought to light when there are events that wipe out the most common or 'wild type' of bacteria, leaving only those with the right mutations to survive. Over time, these mutations may fade away or remain part of the local population.


Horizontal gene transfer (or 'HGT' for short) refers to any one of three mechanisms where bacteria 'share' short sequences of DNA with each other.


These three mechanisms are referred to as transformation (bacterium picks up a small piece of external DNA from its environment and successfully incorporates it), conjugation (two bacteria meet and one 'injects' a long, circular extracellular piece of DNA called a plasmid into a recipient) and transduction (a bacteria-specific virus called a phage accidentally packages a bit of bacterial DNA inside its capsid, which then gets deposited in another bacteria when the virus infects a new bacterial cell).

(Visualization of the three types of horizontal gene transfer in bacteria, with each quadrant representing a different mechanism; taken from von Wintersdorff et. Al (2016).)


It is not uncommon for the genes to be transferred in this process to be those that encode some element of antibiotic resistance. Whether it is an enzyme that can deactivate an antibiotic or an alternative structure for an antibiotic's target, bacteria with these genes continue to exist and thrive. These mechanisms not only increase the concentration needed to limit growth of the bacteria (the minimal inhibitory concentration, or MIC), but help select for resistant strains already present in the population. This is why antibiotic resistant bacteria often emerge in hospitals - the environment is a battleground in which the most resistant strains proliferate given the selective pressures of high antibiotic usage.


As a result, the last decade alone has seen a startling global uptick in the emergence of antibiotic resistant infections once thought to be under control. Among them is Mycobacterium tuberculosis, the causative agent of TB. In addition to being among humankind's oldest pathogens, it still represents a major health threat to immunocompromised individuals (including HIV+ patients). While cases have been declining steadily in the US since 1975, there has been a steady and assured uptick in cases around the world. This is driven by antibiotic resistance as countries continue to improve sanitation and disease tracking efforts.


As a mini-case study, TB needs a combination of three to four antibiotics to create any sort of clinical remission. While the necessity of combination therapy is partly due to TB's unique 'acid fast' cell wall, the simple truth is that few drugs are effective against TB to begin with. However, decades of using only these drugs (isoniazid & rifampin) selected for multi-drug resistant (MDR) strains. While this has since spurred new innovations for next-generation versions of these treatments and new treatments to accompany them, it's clear that we are fighting a losing battle.


Today, combination therapies for TB typically take no fewer than three or four antimicrobial agents so as to biochemically 'overwhelm' the bacteria. The rationale for this is fairly straightforward - you can ensure a broader spectrum of strains are covered, and potentially create synergy between the two mechanisms. However, nature is just as resilient - we are now seeing extreme-drug resistant (XDR) strains of TB arise, which have terrifyingly limited treatment options.

(Image of the commonly accepted dangerous antibiotic resistant bacteria based on clinical effects and cost; taken from LongitudePrize.org)


On the macro scale, MDR bacterial infections cost US hospitals over $2.4 billion annually.

Bacteria like Escherichia coli, Streptococcus pneumoniae, and Staphylococcus aureus have always represented potentially lethal diseases. Antibiotic resistance has become more and more prevalent in these diseases too - meaning our time to innovate grows short. If you are interested in a tool to evaluate antibiotic resistance to major pathogens, check out the Resistance Map by the Center for Disease Dynamics, Economics, and Policy.


Okay, Sell Me


Unfortunately, not all resistance towards antibiotics is microbial - much of it is financial. While antibiotics once formed the backbone of major pharmaceutical companies, they are mostly a side show today.


Let's quickly review the statistics behind what it takes to get a new pharmaceutical product approved. The Tufts Center for the Study of Drug Development's (CSDD) latest study estimates the average cost of drug development to be approximately $2.558 billion (including the cost of failures), with an average of 10 years to make it to market. Even with a twenty-year patent life, that's already not a lot of time to recoup development costs (assuming you get approved). Even with an impressive 19.1% Phase I to Approval rate, the antibiotic market is rife with substitutes and low comparatively low pricing.


While drug pricing remains a complex issue, there is no denying that certain drugs are remarkably priced. Payers have complex criteria for evaluating which drugs will be added to formularies and how they will be reimbursed; there is also relatively little transparency into how PBMs work to influence pricing and access. (Un)fortunately, even pharmaceuticals can follow the basics of economics.


Proven antibiotics like Amoxil (amoxicillin), Ciprodex (ciprofloxacin/dexamethasone) and Oracea (doxycycline) for common infections work - and they're cheap. Since they were discovered decades ago, they since have become generic drugs - low-cost, easily reimbursed substitutes for their branded counterparts. Economically, generic drugs represent an opportunity for access to critical, life-saving innovations. However, newer drugs that have to directly compete against proven entities limits the ability of companies to charge prices needed to recoup clinical development investments. Many of the antibiotics mentioned above are 'broad spectrum' - they attack multiple species or strains of bacteria through a common weakness. This limits the breathing room available in the market for more than a handful of drugs for a specific disease or type of infection.


This is the opposite of what we typically see in high-growth, urgent need therapeutic categories like oncology. When Merck's Keytruda and BMS' Opdivo were approved in 2014 and 2015 respectively, they were the first PD-1 inhibitors on the market. Shortly after launch, they became some of the best selling drugs on the market.

There are two factors that explain the discrepancy between this example and the antibiotic conundrum.


First, Merck's Keytruda and BMS' Opdivo are highly specific to a given target - PD-1 - that is present in different types of cancer. Most antibiotics are not only broad spectrum, but are unsupported by the degree of specific diagnosis seen in oncology. Put another way - when you last had to go to the doctor for a cold or sinus infection, did they take a culture before prescribing you an antibiotic? Probably not. Conversely, oncolytic drug regimens are often tailored to patients based on their clinical presentation and the tumor's genetic profile.


While effective and rapid-test devices exist for identifying pathogen species and antibiotic resistance profiles, their general adoption is limited. Their use is most often seen in clinics facing a critical public health need (like an outbreak of TB or other serious pathogen) or in critical care environments like the ICU, where bacterial infections are the most likely to have lethal repercussions. Adding an additional process may not be complex for an established medical facility, but becomes more difficult for smaller private practices to execute. Further, waiting for results may require patients to make a second appointment, which creates additional personal and system strain.


Second, there is often a significant amount of basic research from academic labs and clinical research from pharmaceutical companies shared with oncologists to help answer questions about which drugs may be right for their patients. Oncologists are specialists, but almost any practitioner can prescribe an antibiotic, irrespective of specialty. This makes the practitioner education challenge far more difficult.


On the one hand, we have legacy antibiotics that are proven, plentiful, and cheap. One the other hand, more and more pathogens are developing antibiotic resistance to invalidate them. New antibiotics have to face significant market pressures and practitioner habits without always having the benefit of a precise diagnosis to help validate their success.


This begs the question - who is playing in this space, and why?


Exit, Stage Left


In 2019, there were four new antimicrobial drugs approved by the FDA. By all accounts, this made it a remarkable year compared to the last two decades of innovation, as shown below.

(Compilation of images showing the antibiotic approval rates by the FDA of since 1911, with specific focus from 2003 - 2019; taken from 'Less of the Same: Rebooting the Antibiotic Pipeline' by Francesca Tomasi and Andrei, Droc, and Stefan's 2019 publication in Discoveries.)


Examining this data more closely can give us a clear cross-section into the types of organizations still investing in this space. We can segment them into three categories: legacy players, specialized developers, and public-private partnerships.


Legacy Players (e.g.: Novartis, Allergan)


On the whole, legacy players from this space are withdrawing. The market pressures we discussed earlier show that there are generally more lucrative R&D investments to be made in similarly impactful therapeutic categories. However, major companies like Novartis (with Sandoz) and Allergan (now under AbbVie) continue to support the push for new antibiotics.


In July of 2018, Novartis reportedly exited from the antibiotic market citing strong economic and commercial barriers. However, Sandoz recently closed the acquisition of three leading antibiotic brands from GSK for $500 million in February of 2021. This not only revitalizes industry focus on the need to address the shortage of antibiotics, but possibly signals that they are willing to explore additional investments in the space.


Specialized Players (e.g.: Paratek, Melinta, Achaeogen)


There are a handful of younger companies that have brought critical antibiotics to market in recent years. These are worth examining as case studies that bring the issues we've been discussing to light.


The most notable company in the antibiotic space of the last decade is Paratek. Their odyssey of a tale has been well documented in Nature and many other publications. They brought a next-generation version of tetracycline called omadacycline to market under the brand name Nuzyra. While Paratek secured approval for omadacycline in 2018, commercializing and selling the drug has had no shortage of difficulties.


On the one hand, this drug has chemical differences from traditional tetracyclines that makes it more likely to resist traditional resistance mechanisms. It also has both oral and IV formulations that makes it ideal for use against Acute Bacterial Skin and Skin Structure Infections (ABSSSI) and Community-Acquired Bacterial Pneumonia (CABP)-causing bacteria. On the other hand, the post-approval activities needed to generate sales have steep price tags attached to them, especially when they include multi-million dollar post-marketing surveillance studies. While many companies expect this, few have the slow adoption and low price tag of antibiotics to contend with. Paratek was fortunate to receive $283 million funding from US Federal agency, BARDA (Biomedical Advanced Research and Development Authority) that would allow them to keep their doors open long enough to gain traction. The pandemic's unique influence on purchasing antibiotics has also been a boon to the company, as supply from international providers decreases and stockpiling increases.


Other specialized companies in the space have not been so fortunate. Achaeogen was once a golden child of investors and analysts alike for its development on treatments against multi-drug resistant (MDR) bacteria. Their lead asset, Zemdri (plazomicin), was indicated to treat complicated urinary tract infection. Despite receiving approval in June of 2018, the company folded just over a year later with an emergency sale of its assets. Why? Low prices, entrenched prescribing habits, and high costs.


Melinta Therapeutics appeared to have a similar story in early 2020. As the world was about to face the COVID-19 pandemic, the firm was filing for bankruptcy. However, Kimyrsa (oritavancin) was approved to treat Acute Bacterial Skin and Skin Structure Infections (ABSSSI) in March of 2021, reviving the company. Its commercial future remains to be seen.


Public-Private Partnerships (e.g.: TB Alliance, CARB-X & various funds)


Despite the difficulties of commercial success, the urgent public health threat of antibiotic resistance and the lack of agents to counter infectious diseases worries both public and private institutions. As a result, one of three types of partnerships have been formed to align these stakeholders.

The first of these public-private partnership types take the form of research grants and funding for basic research into antibiotics and antibiotic resistance. In addition to infusing funding and interest for labs, these types of initiatives can increase attention for the problem at a global scale, as seen in the Bill & Melinda Gates Foundation's Global Antibiotic Resistance Initiative of $2 billion. Other organizations, including the WHO, also have similar initiatives. These programs help disseminate funds and offer global panels of scientists to review, support, and validate research proposals for novel drug screening.


We have also seen unique private partnerships built with public stakeholders in mind. The AMR Action Fund is a formal commitment by twenty leading biopharmaceutical companies to invest $1 billion collectively in pursuit of novel antibiotics. While this may fall under scrutiny as potential antitrust activity under normal circumstances, the public need for novel antibiotics and the comparatively low commercial value outweighs the risk to citizens and patients. Their goal is to bring 2-4 new antibiotics to market by 2030.


These two types of partnerships provide much-needed funding for basic research, the foundation upon which innovations are built. However, they do not overtly combine funding with the operational expertise of a biopharma company to shepherd novel antibiotic candidates to market. With this in mind, we can explore the third type of public-private partnership: non-profit biopharmaceutical organizations.


In the realm of antibiotics, there are two key archetypes of these non-profit biopharma organizations, which largely differ based on whether they develop or assist in developing a wide range of biopharmaceutical organizations or focus on a particular disease.


The former is epitomized in CARB-X, a world-renowned accelerator that partners with young biopharmaceutical companies to offer non-dilutive funding and operational support for development and commercialization of new antibiotics. Their portfolio is incredibly impressive, spanning multiple assets throughout the discovery and early clinical development phases.


On the other hand, there are some diseases that are so feared and respected across the world that specialized nonprofit biopharmaceutical organizations have risen to address them. One such example is TB Alliance, whose mission is to aid in "the discovery, development and delivery of better, faster-acting and affordable tuberculosis drugs that are available to those who need them." As we've mentioned, MDR- and XDR-TB are major public health threats in the developing and developed worlds. With few tools available to address them, they cost the healthcare system nearly a billion dollars per year in the US alone. Standard treatment regimens call for a combination of isoniazid and rifamycin, as well as 1-2 other drugs.

(TB Alliance stakeholder map; taken from TB Alliance Mission page)


In 2019, TB Alliance celebrated the FDA approval of pretomanid (PA-824). This success came about through the fulfillment of a non-traditional commercial model in which TB Alliance brought together other industry partners, academic researchers, government officials, research institutions & NGOs and patients to maximize effiecint use of resources when designing and developing this drug. Pretomanid diversifies this limited treatment pool significantly and offers hope for a new set of tools to control for this disease. TB Alliance has a robust portfolio of anti-TB agents in pre-clinical and clinical development. Their commitment to addressing this critical unmet need is admirable; their success highlights a potentially replicable model to sustainably develop new antibiotics in spite of traditional commercial challenges and market pressures.


Where do we go from here?


In a post-COVID-19 world, it seems inconceivable that we cannot create new tools to address emerging and existing infectious diseases. A COVID-19 vaccine was developed, authorized, and launched within a year of the disease emerging. The capital, coordination, and commitment clearly exists to address imminent public health threats.


Unlike the urgent and imminent threat of COVID-19, the rise of antibiotic resistance is a saucepan that is steadily and assuredly heating up. On its own, TB regularly kills about half as many people as COVID-19 has each year (as of the writing of this blog) - yet it is only one disease. Antibiotic resistance affects dozens, if not hundreds more of clinically-relevant species and strains. How we address this issue in the coming decade may determine whether we face a new pandemic or more radical interventions for currently commonplace illnesses.


We have some provided some thoughts and recommendations below around how to avoid that outcome for your consideration across commercial, regulatory, and clinical solutions.



Building Nonprofit Biopharmaceutical Companies for Targeted Antibiotic Development (Commercial)


TB Alliance has shown that unique methods and partnerships can help speed a drug candidate from the bench to bedside. Aligning with industry, academics, NGOs, and governments in a nonprofit model dramatically lessens the pressures to be a commercial success in this highly price-sensitive field. Facilitating the development of these partnerships will likely take the work of dedicated scientists and industry professionals with connections across the aisle. We have also seen that both public and private funding exists to capitalize on these opportunities, as well as specialized accelerators to support these initiatives.


Incentivizing Antibiotic Innovation (Regulatory)


Innovation in antibiotics has been stifled due to current commercial circumstances and regulatory pressures. Certain federal initiatives already exist to extend patent lifespans, subsidize basic research, and/or accelerate the regulatory approval process. However, the considerable post-marketing pressures in this space have kept legacy pharmaceutical companies from investing and made the success of younger, more specialized players exceptionally difficult. Additional incentives, including longer extensions of patent life, enabling closer partnership agreements around antibiotic development, and/or additional federal funding should be considered to stimulate further investment in this space.


Increasing Hospital Antibiotic Stewardship Programs (Regulatory)


Following President Obama's 2016 CARB (Combating Antibiotic Resistant Bacteria), we have seen increased adoption in antibiotic stewardship measures that endeavor to improve how antibiotics are prescribed by clinicians and used by patients. Following the COVID-19 pandemic, a federal initiative re-examining how we prescribe antibiotics in the context of hospital bed utilization and clinical outcomes will be critical to continuing the success of this effort in slowing the spread of resistance.


Increased Adoption and Reimbursement of Rapid Screening Technologies (Clinical)


As previously mentioned, clinical screening of isolates is typically saved for extreme circumstances. Traditional culturing methods can take anywhere from 24-48 hours, depending on the isolate. This means that patients and doctors either have to sit with their hands tied out of fear for misusing antibiotics and generating resistance, or taking a shot in the dark. Neither represents an ideal alternative.


Fortunately, several cutting-edge diagnostic companies (including Accelerate Diagnostics and biomerieux) have clinical tools that can identify and validate the antibiotic resistance profile of clinical isolates. Existing devices can already work in 7-24 hours; future innovations could reduce that time. Further adoption of these devices in less critical clinical settings may sufficiently alter prescriber behavior by informing how best we can align drug to microbe. Increasing reimbursement on these tests to limit patient costs will be counterbalanced in the form of significant prescription savings and likely improved clinical outcomes.


Exploring Novel Biologic Antibiotic Modalities (Commercial & Clinical)


As we have discussed today, the vast majority of antimicrobial agents are small-molecule drugs that can easily be formulated for oral and/or IV usage, and easily penetrate cell membranes. Leveraging traditional chemistry and drug manufacturing is notably cheaper than scaling up more complex molecules like enzymes or antibodies. However, exploring the vast field of biologics for novel treatment modalities.


As discussed in our previous post with Ichor Biologics, tailored antibodies can be incredibly effective in treating emerging pathogens. However, they are often far more expensive to develop, manufacture, and distribute than traditional small-molecules due to stability challenges. With the cold-chain demands of the Pfizer and Moderna COVID-19 vaccines, it is conceivable that certain areas of the world will be better equipped to accommodate adoption of these therapies once produced. This leaves the question of cost and economic incentives to be solved by companies and regulators. However, small-peptide molecule, antibodies, and nucleic-acid-based therapies may have potential in this space to address the shortage and limited mechanistic diversity of small-molecule antibiotics.


Additionally, an experimental type of therapy known as phage therapy leverages a cocktail of highly specialized bacteria-killing viruses to address multi-drug resistant and extreme-drug resistant strains of bacteria. Put simply, the enemy of my enemy is my friend. As documented in The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug, this therapy is being explored by a number of federal agencies and shows promise when all other options have been exhausted.


Closing Thoughts


As we (hopefully) begin to bring our COVID-19 pandemic under control, it is critical that we not lose sight of similarly daunting - though no less important - public health challenges. Increasing the diversity of our modalities and mechanisms, identifying clinical pathway improvements, and increasing antibiotic stewardship programs is just the latest chapter in a long story of one of science's greatest medical innovations. Understanding the science and business context by which these drugs are marketed will yield valuable insights into how we can best prevent or prepare ourselves for the full emergence of this silent pandemic.


That’s all for today! Please share this article on your preferred social media channel, and sign up to leave your thoughts, ideas, and opinions in the comments. Let us know if you enjoyed this whitepaper and if there are any subjects you're interested in discussing. Your feedback is always welcome and helps Molecular Ideas grow!

References & Author's Note


As always, a list of sources are linked throughout the post. A complete list of references in APA format can be found here:

Molecular Ideas - Whitepaper References
.
Download • 174KB

Some sources include books I've read over the years; links to purchase them at Northshire Bookstore are also in the body of the text. As of this writing, no Molecular Ideas posts are sponsored. Thank you for reading!

35 views0 comments