New classes of antibiotics

Several novel chemical classes of antibiotics are currently in human clinical studies. While most are narrow spectrum agents that inhibit unexploited targets, the susceptible pathogens are clinically important, including staphylococci, pseudomonads, and mycobacteria. Given the paucity of antibacterial agents consisting of novel chemical scaffolds that act on established targets, these new antibacterial scaffolds, which are active against new targets, represent an important advance in the battle against antibiotic resistance. Indeed, most of these compounds are unlikely to be subject to existing compound-based or target-based resistance mechanisms.

► We review 11 new antibiotics with novel structures in clinical trials.
► Most inhibit bacterial targets which are not inhibited by current antibiotics.
► The spectrum ranges from Gram-negative to Gram-positive to mycobacteria.
► Most of the targets have not been explored previously or were explored unsuccessfully in the past.