Sometimes a single chart can jumpstart a movement. This chart certainly qualifies:
Looking at this, you might conclude that the 1980s and early 1990s were the “glory years” for new antibiotic introductions.
But that would only be partially correct. Twenty of the new antibiotics on this chart were not commercially or clinically successful and were ultimately withdrawn or discontinued from the market. An additional six antibiotic drugs were formally withdrawn for safety-related reasons, while for others, safety questions played a role in limiting clinical and commercial success. Since 1980, antibiotics have suffered market withdrawals at triple the rate of all other FDA-approved drugs.
Approval of these drugs didn’t help patients much, nor were the companies rewarded because sales were low. In short, we should not celebrate antibiotic introductions from the 1980s and early 1990s in the way the chart above implies. When discontinued and withdrawn drugs are backed out, the chart looks quite different:
Antibiotics look pretty steady by decade. In other data (not shown) antimicrobial innovation shifted in a massive way to anti-retroviral drugs to treat HIV and to a lesser extent, fungi.
Governments and think tanks are mooting many proposals to boost antibiotic innovation. We must focus on the quality of the new drug, not just the sheer quantity.
h/t to the good folks at CDDEP for help with the charts and for cross-posting.
@koutterson
