Compounding the problem is the fact that few drug companies are voluntarily developing new antibiotics. One of the essential principles of the capitalist system is that you should only invest money in projects that will make money, and there seems to be little money in antibiotic development for the large private drug companies that must take major financial risks to develop any drug. Shareholders are generally interested in profits rather than philanthropy.
According to this timeline there were 20 antibiotics developed between 1990 and 1999 but only 6 entered use between 2000 and 2009.
It therefore falls to public funds to stimulate interest in antibiotics in the public interest. In the US the Infectious Diseases Society of America has joined in the fight to try to persuade the US government to promote the development of new antibiotics.
IDSA members enacted the 2012 Generating Antibiotic Incentives Now (GAIN) Act, which incentivizes antibiotic development by providing a 5-year extension of market exclusivity for new drugs that treat serious or life-threatening infections.
However, pharmaceutical companies are still facing significant economic, scientific and regulatory barriers, she said. Nowhere is this more evident than with carbapenem-resistant Enterobacteriaceae (CRE), which the CDC deemed the “nightmare bacteria” in 2013. With no safe or effective antibiotic treatments available, up to 50% of patients with CRE bloodstream infections die. Meanwhile, there are only a handful of novel antibiotics currently in development for CREs. All of these are unlikely to be approved by the FDA, given that they still face risk of failure in clinical trials.