In the midst of the antimicrobial discovery conundrum: an overview

Antibiotics have been the most transformative medicines in the history of human health. Although once considered a mainstay in the pipeline of most major players in the pharmaceutical industry, new antibiotic discovery and development efforts have been minimalized as a consequence of challenges attributed to the identification of new chemical matter, the increasing complexity of stringent regulatory requirements, and the dwindling economic incentives that justify the early-stage investments. Catastrophically, this discovery void comes at a time when antibiotic resistance emergence and spread has reached unprecedented levels, fueling the clinical desperation for novel molecules that are not impacted by relevant resistance mechanisms. This review will discuss recent economic and regulatory attempts to revitalize the antibiotic discovery space.