Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis

WHO Pathogens Priority List Working Group

Research output: Contribution to journalArticle

371 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Findings: 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. Interpretation: 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. Funding: World Health Organization.

Original languageEnglish
Pages (from-to)318-327
Number of pages10
JournalThe Lancet Infectious Diseases
Volume18
Issue number3
DOIs
Publication statusPublished - 1 Mar 2018

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Tuberculosis
Anti-Bacterial Agents
Bacteria
Research
Community-Acquired Infections
Multidrug-Resistant Tuberculosis
Carbapenems
Campylobacter
Delivery of Health Care
Acinetobacter baumannii
Enterococcus faecium
Salmonella typhi
Methicillin
Clarithromycin
Decision Support Techniques
Mortality
Neisseria gonorrhoeae
Gonorrhea
Pylorus
Fluoroquinolones

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Discovery, research, and development of new antibiotics : the WHO priority list of antibiotic-resistant bacteria and tuberculosis. / WHO Pathogens Priority List Working Group.

In: The Lancet Infectious Diseases, Vol. 18, No. 3, 01.03.2018, p. 318-327.

Research output: Contribution to journalArticle

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T1 - Discovery, research, and development of new antibiotics

T2 - the WHO priority list of antibiotic-resistant bacteria and tuberculosis

AU - WHO Pathogens Priority List Working Group

AU - Tacconelli, Evelina

AU - Carrara, Elena

AU - Savoldi, Alessia

AU - Harbarth, Stephan

AU - Mendelson, Marc

AU - Monnet, Dominique L.

AU - Pulcini, Céline

AU - Kahlmeter, Gunnar

AU - Kluytmans, Jan

AU - Carmeli, Yehuda

AU - Ouellette, Marc

AU - Outterson, Kevin

AU - Patel, Jean

AU - Cavaleri, Marco

AU - Cox, Edward M.

AU - Houchens, Chris R.

AU - Grayson, M. Lindsay

AU - Hansen, Paul

AU - Singh, Nalini

AU - Theuretzbacher, Ursula

AU - Magrini, Nicola

AU - Aboderin, Aaron Oladipo

AU - Al-Abri, Seif Salem

AU - Awg. Jalil, Nordiah

AU - Benzonana, Nur

AU - Bhattacharya, Sanjay

AU - Brink, Adrian John

AU - Burkert, Francesco Robert

AU - Cars, Otto

AU - Cornaglia, Giuseppe

AU - Dyar, Oliver James

AU - Friedrich, Alex W.

AU - Gales, Ana C.

AU - Gandra, Sumanth

AU - Giske, Christian Georg

AU - Goff, Debra A.

AU - Goossens, Herman

AU - Gottlieb, Thomas

AU - Guzman Blanco, Manuel

AU - Hryniewicz, Waleria

AU - Kattula, Deepthi

AU - Jinks, Timothy

AU - Kanj, Souha S.

AU - Kerr, Lawrence

AU - Kieny, Marie Paule

AU - Kim, Yang Soo

AU - Kozlov, Roman S.

AU - Labarca, Jaime

AU - Laxminarayan, Ramanan

AU - Leder, Karin

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background: 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. Methods: 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. Findings: 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. Interpretation: 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. Funding: World Health Organization.

AB - Background: 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. Methods: 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. Findings: 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. Interpretation: 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. Funding: World Health Organization.

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