Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis
Open accessAbstract
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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The WHO has listed carbapenem-resistant P. aeruginosa as one of the three critical global priority pathogens that require development of new antibiotics.
“The WHO has listed carbapenem-resistant P. aeruginosa as one of the three critical global priority pathogens that require development of new antibiotics.144”
From Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? (2022) · cites this paper as [144]
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- Authors
- Tacconelli, E., Carrara, E., Savoldi, A., Harbarth, S., Mendelson, M., Monnet, D. L., Pulcini, C., Kahlmeter, G., Kluytmans, J., Carmeli, Y., Ouellette, M., Outterson, K., Patel, J., Cavaleri, M., Cox, E. M., Houchens, C. R., Grayson, M. L., Hansen, P., Singh, N., Theuretzbacher, U., Magrini, N., Aboderin, A. O., Al-Abri, S. S., Awang Jalil, N., Benzonana, N., Bhattacharya, S., Brink, A. J., Burkert, F. R., Cars, O., Cornaglia, G., Dyar, O. J., Friedrich, A. W., Gales, A. C., Gandra, S., Giske, C. G., Goff, D. A., Goossens, H., Gottlieb, T., Guzman Blanco, M., Hryniewicz, W., Kattula, D., Jinks, T., Kanj, S. S., Kerr, L., Kieny, M.-P., Kim, Y. S., Kozlov, R. S., Labarca, J., Laxminarayan, R., Leder, K., Leibovici, L., Levy-Hara, G., Littman, J., Malhotra-Kumar, S., Manchanda, V., Moja, L., Ndoye, B., Pan, A., Paterson, D. L., Paul, M., Qiu, H., Ramon-Pardo, P., Rodríguez-Baño, J., Sanguinetti, M., Sengupta, S., Sharland, M., Si-Mehand, M., Silver, L. L., Song, W., Steinbakk, M., Thomsen, J., Thwaites, G. E., van der Meer, J. W., Van Kinh, N., Vega, S., Villegas, M. V., Wechsler-Fördös, A., Wertheim, H. F. L., Wesangula, E., Woodford, N., Yilmaz, F. O., & Zorzet, A.
- Affiliations
- Universitätsklinikum Tübingen (DE)
- University of Geneva (CH)
- University of Cape Town (ZA)
- European Centre for Disease Prevention and Control (SE)
- Växjö Kommun (SE)
- University Medical Center Utrecht (NL)
- Tel Aviv University (IL)
- Université Laval (CA)
- Boston University (US)
- Centers for Disease Control and Prevention (US)
- European Medicines Agency (NL)
- United States Food and Drug Administration (US)
- The University of Melbourne (AU)
- University of Otago (NZ)
- Children's National (US)
- World Health Organization (CH)
- Corresponding author
- Tacconelli, Evelina
- ORCID
- Tacconelli, Evelina
- Carrara, Elena
- Savoldi, Alessia
- Harbarth, Stephan
- Mendelson, Marc
- Monnet, Dominique L
- Kahlmeter, Gunnar
- Kluytmans, Jan
- Carmeli, Yehuda
- Ouellette, Marc
- Outterson, Kevin
- Patel, Jean
- Cavaleri, Marco
- Cox, Edward M
- Hansen, Paul
- Theuretzbacher, Ursula
- Aboderin, Aaron Oladipo
- Al-Abri, Seif Salem
- Benzonana, Nur
- Bhattacharya, Sanjay
- Brink, Adrian John
- Burkert, Francesco Robert
- Cars, Otto
- Dyar, Oliver James
- Friedrich, Alex W
- Gales, Ana C
- Gandra, Sumanth
- Giske, Christian Georg
- Goff, Debra A
- Goossens, Herman
- Gottlieb, Thomas
- Hryniewicz, Waleria
- Kattula, Deepthi
- Jinks, Timothy
- Kanj, Souha S
- Kim, Yang Soo
- Kozlov, Roman S
- Laxminarayan, Ramanan
- Leder, Karin
- Leibovici, Leonard
- Manchanda, Vikas
- Moja, Lorenzo
- Paterson, David L
- Paul, Mical
- Sanguinetti, Maurizio
- Sharland, Mike
- Silver, Lynn L
- Steinbakk, Martin
- Thomsen, Jens
- Thwaites, Guy E
- Vega, Silvio
- Wechsler-Fördös, Agnes
- Wertheim, Heiman Frank Louis
- Wesangula, Evelyn
- Woodford, Neil
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 18
- Issue
- 3
- Pages
- 318-327
- ISSN
- 1473-3099 (ISSN-L)
- OpenAlex
- W2779019546
- Cited by
- 6,142
- References
- 2
- Citations by year
- 2026: 620 · 2025: 823 · 2024: 1031 · 2023: 979 · 2022: 891 · 2021: 741 · 2020: 551 · 2019: 359 · 2018: 127 · 2017: 15 · 2013: 1 · 2012: 1
- FWCI
- 218.74
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- The Lancet Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion)
- bepress Legal Repository (submittedVersion, cc-by-nc-sa)
- HAL (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- AstraZeneca
- GlaxoSmithKline
- Shionogi
- Innovative Medicines Initiative
- Pfizer
- Biomedical Advanced Research and Development Authority
- Roche
- World Health Organization
- Merck Sharp and Dohme
- Wellcome Trust
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Keywords
- antibiotic resistance, priority pathogens, multidrug-resistant tuberculosis, antibiotic development, priority setting, carbapenem resistance, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacteriaceae, vancomycin-resistant Enterococcus faecium, methicillin-resistant Staphylococcus aureus, Helicobacter pylori, Campylobacter, Neisseria gonorrhoeae, Salmonella typhi, community-acquired infections, Gram-negative bacteria
- MeSH terms
- Anti-Bacterial Agents, Humans, Tuberculosis, World Health Organization, Drug Resistance, Bacterial
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