India must focus on innovative drug development, vaccine enhancement, and improving infection control strategies to effectively counter antimicrobial resistance (AMR). From both national and global perspectives, recent advancements in AMR treatment include bacteriophage therapy, nanotechnology, and immunotherapies, among others.
According to Dr. Prabhu Vinayagam, a medical advisor at Orchid AMS, a division of Orchid Pharma, these advancements encompass novel antimicrobial agents. Among these are Cefepime – enmetazobactam, developed by Orchid Pharma, and now approved by the US FDA. This beta-lactamase inhibitor is effective against resistant Gram-negative bacteria responsible for cUTI, VAP, and HAP.
Relebactam is another innovative β-lactamase inhibitor designed to enhance the efficacy of existing antibiotics like imipenem, now authorized for use against resistant Gram-negative bacteria. Additionally, Cefiderocol is a new antibiotic that treats multidrug-resistant (MDR) Gram-negative bacteria by circumventing several resistance mechanisms. Lefamuli, also approved by the US FDA for community-acquired pneumonia, is a pleuromutilin-class antibiotic targeting pathogens resistant to macrolides and fluoroquinolones, Dr. Vinayagam added.
Bacteriophage therapy, employing viruses that specifically target bacteria, is experiencing renewed interest as a potential alternative or complement to antibiotics. Phages offer precision in targeting drug-resistant bacterial strains. Initiatives in India and elsewhere are exploring the integration of phage therapy into clinical practices, he stressed.
Exploration of antibiotic combinations aims to overcome resistance. By amalgamating older antibiotics with newer agents like β-lactamase inhibitors or even non-antibiotic drugs, researchers strive to restore the efficacy of existing antibiotics against resistant bacteria, Dr. Vinayagam told Pharmabiz.
Research on nanoparticles and nanomaterials is underway for their potential to combat bacterial infections, particularly drug-resistant strains. Nanomaterials can disrupt bacterial cell walls or serve as carriers for antibiotics to increase their effectiveness. Emerging efforts in AMR focus on enhancing the immune system’s capacity to combat infections. Monoclonal antibodies that neutralize bacterial virulence factors or facilitate immune recognition of bacterial cells are becoming promising new strategies, he noted.
Pharmaceutical entities concentrating on AMR are pioneering new drugs to fight resistant bacteria. Orchid AMS might explore research into established antibiotic classes, such as cephalosporins, or consider new formulations or combinations with β-lactamase inhibitors or other adjunct therapies to address AMR, he said.
Collaborations between companies and global health organizations or entry into public-private partnerships are increasingly fostering the discovery and distribution of novel antibiotics. Orchid AMS might engage in such partnerships, aiming to develop solutions addressing emerging resistant pathogens, he mentioned.
Given the AMR challenge in India, Orchid AMS may prioritize developing treatments that are both globally effective and specifically tailored for the Indian context, including affordable generic antibiotics for resistant infections. Their drug development strategies are likely to align with WHO guidelines to ensure any new antibiotics or treatments meet standards for efficacy and safety, contributing to the global AMR fight, he proposed.
There’s a scarcity of clinical trials aimed at combating AMR. An agreement with GARDP, a global organization, facilitates market introduction of new research molecules from anywhere. In this context, Orchid has signed an agreement for cefiderocol, a novel Japanese-developed antibiotic, Dr. Vinayagam highlighted.