Bacterial infections that resist antibiotics are a major problem in the United States. According to the U.S. Centers for Disease Control and Prevention (CDC), antibiotic-resistant infections are responsible for at least 2 million illnesses and 23,000 deaths each year. In 2015, the U.S. government launched the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB). Guided by the plan, NIAID and other NIH components work with government, academic, and industry partners on a wide range of projects aimed at understanding and controlling antibiotic resistance. To mark this year’s Antibiotic Awareness Week, November 13-19, we highlight a few of these efforts.
Appropriate antibiotic use starts with accurate diagnosis. Among the research projects working toward developing reliable, rapid diagnostics is an innovative test being developed by the NIAID-supported Antibacterial Resistance Leadership Group. This tool analyzes patterns of gene expression in a patient’s blood sample to determine if respiratory symptoms stem from a bacterial infection—which may be susceptible to antibiotics—or are caused by a virus, which are not affected by antibiotics. When doctors can quickly differentiate between bacterial and viral respiratory infections, they can prescribe antibiotics only when appropriate.
Clinical trials are an important way to gather information about experimental antibiotic compounds, reformulations of older drugs, and licensed antibiotics. For example, the NIAID-supported Sexually Transmitted Infections Clinical Trials Group recently completed a Phase 2 trial that found the investigational oral antibiotic Zoliflodacin to be well-tolerated and effective against uncomplicated gonorrhea. Plans are underway to continue testing Zoliflodacin in a Phase 3 clinical trial. Additionally, NIAID-supported investigators are conducting trials to determine the best ways to use licensed antibiotics, studying, for example, how long, how much and whether antibiotic treatment is needed at all. One trial found that shorter treatment for middle ear infections in young children is less effective than the current 10-day treatment recommendation. Other studies found that two off-patent antibiotic treatments (clindamycin and trimethoprim–sulfamethoxazole) work very well against skin infections caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA).
Fostering innovation in antibiotic development requires participation from both the private and public sectors. To meet this goal, NIAID, the Biomedical Advanced Research Development Authority, a component of the U.S. Department of Health and Human Services, and the Wellcome Trust, are collaborating on a global public-private initiative called CARB-X. This program is investing in early discovery and development of novel antibiotics, vaccines, and rapid diagnostics. NIAID is providing technical support and drug development services to CARB-X awardees, including preclinical testing and manufacturing. NIAID is also exploring non-traditional approaches to address antibiotic resistance, such as harnessing good bacteria in the human microbiome to prevent and treat bacterial infections and advancing bacteriophage therapy, which is a virus that can attack and destroy harmful bacteria. In addition, NIAID-supported researchers are using genomic sequencing and other advanced technologies to better understand how bacteria develop antibiotic resistance. Scientists can leverage this information to help inform the development of improved diagnostics, therapeutics, vaccines, and antimicrobial strategies.
To learn more about accomplishments during the first two years of implementation of the National Action Plan for Combating Antibiotic-Resistant Bacteria, check out the Progress Report for Years 1 and 2.
Read more about NIAID’s research on antimicrobial resistance.