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Title: Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis.
Austin Authors: Tacconelli, Evelina;Carrara, Elena;Savoldi, Alessia;Harbarth, Stephan;Mendelson, Marc;Monnet, Dominique L;Pulcini, Céline;Kahlmeter, Gunnar;Kluytmans, Jan;Carmeli, Yehuda;Ouellette, Marc;Outterson, Kevin;Patel, Jean;Cavaleri, Marco;Cox, Edward M;Houchens, Chris R;Grayson, M Lindsay ;Hansen, Paul;Singh, Nalini;Theuretzbacher, Ursula;Magrini, Nicola
Affiliation: Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
Children's National Health System, George Washington University, Washington, DC, USA
Center for Anti-infective Agents, Vienna, Austria
Verona University Hospital, Verona, Italy
German Centre for Infection Research, Tübingen University Hospital, Tübingen, Germany
World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
European Centre for Disease Prevention and Control, Stockholm, Sweden
EA 4360 APEMAC, Nancy University Hospital, Lorraine University, Nancy, France
Central Hospital, Växjö, Sweden
University Medical Center, Utrecht, Netherlands; Amphia Hospital, Breda, Netherlands
Laboratory for Microbiology and Infection Control, Tel Aviv University, Tel Aviv, Israel
Laval University and Canadian Institutes for Health Research, Québec, QC, Canada
Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator CARB-X, Boston University, Boston, MA, USA
Centers for Disease Control and Prevention, Atlanta, GA, USA
European Medicines Agency, London, UK
US Food and Drug Administration, Washington, DC, USA
Antibacterials Program Biomedical Advanced Research and Development Authority, Washington, DC, USA
Austin Health, Heidelberg, Victoria, Australia
Department of Infectious Diseases and Microbiology, University of Otago, Dunedin, New Zealand
The University of Melbourne, Heidelberg, Victoria, Australia
Issue Date: Mar-2018 2017-12-21
Publication information: The Lancet. Infectious diseases 2018; 18(3): 318-327
Abstract: 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. 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. 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. 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. World Health Organization.
DOI: 10.1016/S1473-3099(17)30753-3
PubMed URL: 29276051
Type: Journal Article
Appears in Collections:Journal articles

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