Our pipeline of antibacterial drugs is woefully lacking in our most high priority areas of medical need. In the absence of a reasonable return on their investment in antibacterial drugs, large companies have, for the most part, abandoned the area. Private investment in the research and development of these agents is plummeting, and public support, while important, cannot entirely replace this loss. Small companies have replaced the large ones in providing pipeline compounds. They are more susceptible to financial strain leading to the very real risk of bankruptcy as recently demonstrated by Achaogen and Melinta. I recommend taking three steps to ameliorate this impending crisis. We should provide financial support for the market preferably through a market entry reward or transferable exclusivity vouchers. To achieve this goal, we need to aggressively recruit professionals and patients to our cause who have been or will be affected by a lack of effective antibacterials. Our expert infectious disease societies must provide more timely clinical guidelines for therapy of resistant infections such that recently approved drugs will be used when indicated. We need regulation or legislation requiring manufacturers of antibacterial susceptibility testing devices to provide the ability to test new drugs in a timely manner.

中文翻译：

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抗菌药物：最后的疆界。

在我们最需要医疗的最优先领域中，我们的抗菌药物供应渠道严重缺乏。在抗菌药物投资上没有合理回报的情况下，大公司大多放弃了该地区。这些研究人员的私人投资正在直线下降，尽管很重要，但公共支持无法完全弥补这一损失。在提供管道化合物方面，小公司取代了大公司。正如Achaogen和Melinta最近所证明的那样，他们更容易遭受财务压力，从而导致真正的破产风险。我建议采取三个步骤来缓解这一迫在眉睫的危机。我们应该通过市场准入奖励或可转让的独家优惠券为市场提供财务支持。为了实现这个目标，我们需要积极招募因缺乏有效抗菌素而受到或将受到影响的专业人员和患者。我们的专业传染病学会必须提供更及时的临床指南来治疗耐药性感染，以便在适应症时使用最近批准的药物。我们需要法规或立法，要求抗菌药敏感性测试设备的制造商提供及时测试新药的能力。