The development of non-traditional approaches to prevent and treat bacterial infections

Non-traditional approaches to prevent and treat bacterial infections

Although research is underway to develop new antibiotics, it is essential that other, non-traditional avenues for preventing and treating bacterial infections are also explored to combat the rise in antibiotic resistance. Examples of non-traditional therapies include:

Antibodies

• Antibodies are proteins naturally produced by the immune system to identify, target and help remove potential pathogens.
• Antibodies can specifically target and bind to bacteria and inactive them in a variety of ways.
• These capabilities may be able to be adjusted for novel therapies.

Virulence inhibitors

• Virulence is the severity and degree of damage that a pathogen causes.
• Using molecules to prevent and neutralise the harmful effects of a pathogen's virulence factors (e.g. bacterial toxins) effectively disarms the pathogen.
• Virulence inhibitors could also be used to weaken bacteria defence mechanisms in order to enhance the response of the patient's immune system.

Peptide immunomodulators

• Modulate the immune system in order to enhance its response to a bacterial infection.

Lysins

• A component derived from bacteriophages (viruses that infect bacteria).
• Lysins target and degrade the structure of bacterial cell walls.

Probiotics

• A course of antibiotics can indiscriminately kill any gut bacteria regardless of whether they are harmful pathogens or the beneficial bacteria that colonise our intestines.
• Killing the beneficial bacteria can increase the colonisation of harmful pathogens and their side effects.
• Probiotics are live cultures of microorganisms that restore the beneficial bacteria populations in our gut.
• Using probiotics alongside antibiotics may help maintain a healthy balance of beneficial gut bacteria.

Vaccines

• Vaccines generally contain inactivated disease-causing pathogens, or components that resemble them.
• They stimulate the immune system to recognise and destroy pathogens in order to protect against infection.

Current development of non-traditional approaches to prevent and treat bacterial infections
According to The Pew Charitable Trusts (PEW), there are currently 32 non-traditional products in the pipeline of clinical development in the US to combat systemic bacterial infections. The majority of these are active against a limited range of pathogens and are unlikely to fully substitute or replace antibiotic use. However, they may provide new options for preventing infections from taking hold and for use in combination with antibiotics.

Key findings

• Current analysis shows that of the 32 products in development, 7 are in Phase 1 clinical trials, 21 are in Phase 2 clinical trials and 3 are in Phase 3 clinical trials. So far only one new product has been approved by the FDA.
• Over 1/3 of the products being developed are vaccines, with almost another third being antibodies. The others include probiotics, lysins and immunomodulators.

This remains an ongoing area of research and development. PEW continues to assess and update the list of non-traditional products including the identity of each product and the manufacturer, the type of approach, potential targets and the stage in the clinical development process.