The global threat of antimicrobial resistance has been recognized by the World Health Organization, the United Nations and many other expert bodies. The burden of resistant pathogens is immense and only likely to escalate with predictions of millions of deaths annually and massive economic impact. Since antibiotics were available clinically bacteria have become resistant to these drugs with multi-drug resistant mutants now causing many different types of infection. Bacteria have multiple methods of becoming resistant involving target site alteration, access to the cell or modification of the removal of various molecules. Some antibiotics can be affected by all three mechanisms , such as B-lactams, while others succumb to a single change to lose their effectiveness.
Despite major advances in new antibiotics in the 1980-1990's there have been no new classes approved since 2005, daptomycin, thus there is an impetus to identify potential new classes of agents which are safe and effective. Presently there are several novel approaches being studied which may provide some hope for new therapies. These include siderophore modifications of a standard B-lactam, agents which alter the cell membrane, quorum sensing blocking, novel targets which involve protein synthesis and other sites. This presentation will provide a brief refresher on antimicrobial resistance and then focus on a selection of new agents and platforms of research.