Drug-Resistant Bacteria — Fresh Solutions on the Horizon?

New startups are rethinking antibiotics

In the year 1900, the average life span at birth was 47 years in the US. This number rose to 78.6 years in 2017. One of the reasons — antibiotics. Can you imagine if the antibiotics stop working?

Overuse of antibiotics has made many pathogenic bacteria resistant to antibiotics. The problem is serious enough for the CDC to list 18 drug-resistant microbes as urgent, serious, or concerning threats.

Doctors can prescribe antibiotics sparingly to prevent the rise of drug resistance. But what about bacteria that are already resistant? we need new antibiotics! but, the poor business case of antibiotics keeps big pharma away. Antibiotics are costly to develop with most of the “easy” drug targets already taken. Reduced prescription lowers the potential market of antibiotics. Payers and providers are often reluctant to cover new antibiotics at market rates. This further compounds the problem.

Often companies end up targeting bacterial strains that do not impact enough patients. The pharma company Achaogen developed the novel antibiotic Plazomicin treat carbapenem-resistant Enterobacteriaceae. This deadly bacterial infection affects a tiny fraction of US patients. The drug did not sell well and Achaogen is currently in bankruptcy proceedings. Other antibiotics firms Melinta and Tetraphase have lost market value in the recent past. Melinta has recently acquired Tetraphase.

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A bacteria (yellow) on the surface of a human immune cell (blue). Photo by CDC on Unsplash.

To develop new antibiotics, companies have to somehow offset high development costs. A platform approach to antibiotics can reduce development costs over time. In this, a company can use the same platform modifying certain components to create new drugs. Novel, selective antibiotics that do not promote drug resistance can motivate higher prescription rates. This would require innovative approaches to antibiotics. Here, I highlight two startups developing novel antibiotics therapy.

Locus Biosciences combines bacteriophage with CRISPR Cas3 technology to only target disease-causing bacteria. Cas3 chews up bacterial DNA at specific programmable sites to kill harmful bacteria. This novel, platform approach can rapidly create new antibiotics.

SciBac genetically engineers beneficial bacteria to eradicate disease-causing bacteria while strengthening the microbiome. This is in contrast to traditional “kill-all” antibiotics. SciBac’s approach would reduce antibiotic side-effects. They are currently targeting various antibiotic-resistant bacterial infections associated with Cystic Fibrosis.

Innovative approaches to antibiotics may succeed in addressing the massive increase in antibiotic-resistance. Startups have boldly approached the problems that big pharma has long shunned. Only time will tell if they would succeed or die trying.

A version of this article appeared in 2019 on my blog.

The author has no conflict of interest with any of the entities mentioned in this post.

Trained scientist; Business consultant; Armchair philosopher; I write on various topics including science, climate change, startups, and business.

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