India is now developing its own novel antibiotics to stop resistant infections—a much-needed development because more infections there resist the one-two antibiotic punches that would stop bacterial pathogens in the Global North.
Researchers at Christian Medical College in Vellore, India, and their colleagues summarized the developments on July 31 in Nature Communications.1
India is the world’s most populous country, and AMR incidence is higher there than in Europe and North America. AMR threats include two World Health Organization priority pathogens: carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Enterobacterales (CRE).
Since resistant bacteria have bolstered their biological defenses, novel antibiotics are needed to stop or kill them. Yet for years, as AMR worsened in the Global South, most new antibiotics were developed in Europe and North America to tackle North American isolates, while India was best known for generics and not-quite-reliable testing of experimental drugs.
Experimental drugs or drug combinations work through a variety of mechanisms and have either been approved since 2020 or are in late-stage clinical trials. These include India’s first novel antibiotic—a novel variant of the fluoroquinolone class that targets methicillin-resistant Staphylococcus aureus (MRSA). They also include the first antimicrobial that was invented in India and first approved in the US. This drug, called cefepime-enmetazobactam, helps treat complicated urinary-tract and kidney infections (UTIs) that resist other drugs. Using these drugs is likely to reduce reliance on a last-resort antibiotic class called polymyxins, which can cause kidney damage and is mostly avoided in the North.
Funding for the development of the new antimicrobials came from the Indian government, along with CARB-X, a large public-private partnership, and GAARDP, a nonprofit created by WHO and the Drugs for Neglected Diseases Initiative to counter antibiotic resistance.
