CARB-X partnership pushes development of new antibiotics

TRENTON, N.J. (AP) — For decades, bacteria have been figuring out ways to outsmart the antibiotics that once easily killed them. Partly due to overuse, the bugs’ ability to resist antibiotics is rising, as are the cost and time to treat patients.

Meanwhile, fewer drugmakers are developing new antibiotics, thanks to the economics: Antibiotics are inexpensive, and patients only take them briefly. Drug companies reap far bigger profits from medicines that people take for years.

Drug-resistant bacterial infections annually kill about 23,000 Americans and 700,000 people worldwide. So foundations, government agencies and others are exploring ways to get more new antibiotics approved and make them profitable.

One key effort is CARB-X, short for Combatting Antibiotic Resistant Bacteria-Accelerator. The Boston University-based public-private partnership is funded by health foundations and the U.S., Britain and Germany.

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CARB-X has distributed dozens of grants for research on new antibiotics, vaccines and rapid diagnostic tests.

Executive director Kevin Outterson recently talked to The Associated Press. The conversation has been edited for clarity and length.

Q: How does CARB-X work?

A: Our funders have given us $500 million and a mission to find innovative, early antibiotic research and then fund it until it gets through the first human clinical trials. We take ideas that have just barely left the university lab and nurture them.

Q: What happens next?

A: They can attract more funding from private investors. Several of our “graduates” are now in mid- and late-stage patient testing.

Q: What else is needed?

A: We need better infection prevention, and we need to find a new way to pay for antibiotics.

Q: Why are there so few new antibiotics?

A: A couple decades ago, we had probably 30 large companies making antibiotics and doing research on new ones. Today, there’s probably three large companies making them for the U.S. and Europe. Beyond that, there are more than 100 tiny companies where all the research is being done.

Q: A small company, Achaogen, went bankrupt recently, about a year after it launched its first product, an antibiotic for serious urinary tract infections. What went wrong?

A: Achaogen spent $750 million developing its drug, which is designed for serious, hospital-based superbug infections. In its first year in U.S. hospitals, it sold less than $1 million worth, mainly because it faced an older drug doctors were used to.

Q: Why wouldn’t hospitals use new antibiotics?

A: The most innovative antibiotics are put on the shelf by doctors, saved for the worst cases, to delay bacteria developing resistance. Also, U.S. hospitals try the older, cheaper drugs first because they’re usually paid by the patient’s diagnosis, not by treatment components.

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