Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Biol Chem. Aug 26, 2015; 6(3): 71-77
Published online Aug 26, 2015. doi: 10.4331/wjbc.v6.i3.71
Lack of new antiinfective agents: Passing into the pre-antibiotic age?
Klaus Brandenburg, Tobias Schürholz
Klaus Brandenburg, Forschungszentrum Borstel, Leibniz-Zentrum für Medizin und Biowissenschaften, D-23845 Borstel, Germany
Tobias Schürholz, Department of Intensive Care and Intermediate Care, University Hospital Aachen, 52074 Aachen, Germany
Author contributions: Brandenburg K and Schürholz T contributed equally to this paper.
Supported by German ministry BMBF for financial help, Nos. 01GUO824 and 01GUO826.
Conflict-of-interest statement: The authors have no conflicts of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Klaus Brandenburg, MS, PhD, Professor, Forschungszentrum Borstel, Leibniz-Zentrum für Medizin und Biowissenschaften, Parkallee 10, D-23845 Borstel, Germany. kbrandenburg@fz-borstel.de
Telephone: +49-4537-1882350 Fax: +49-4537-1886320
Received: January 29, 2015
Peer-review started: January 30, 2015
First decision: March 6, 2015
Revised: March 30, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: August 26, 2015
Processing time: 208 Days and 17.5 Hours
Abstract

The lack of newly developed antibiotics, together with the increase in multi-resistance of relevant pathogenic bacteria in the last decades, represents an alarming signal for human health care worldwide. The number of severely infected persons increases not only in developing but also in highly industrialized countries. This relates in first line to the most severe form of a bacterial infection, sepsis and the septic shock syndrome, with high mortality on critical care units. No particular anti-sepsis drug is available, and the therapy with conventional antibiotics more and more fails to provide a survival benefit. Due to the fact that the pharmaceutical industry has withdrawn to a high degree from the development of anti-infectious agents, a huge challenge for health care is approaching in the 21st century. In this article, these problems are outlined and possible alternatives are presented which may be helpful to solve the problem.

Keywords: Antimicrobial resistance; Antibiotics; Sepsis; Antimicrobial peptides; Lipoproteins; Inflammation; Cytokines; Endotoxins

Core tip: The dramatic increase in multiresistance of relevant pathogenic bacteria can be assumed to be one of the main global health care problems of the 21st century. At the same time, the development of new antibiotics decreases considerably from which a significant lack in the health supply for combating infections can be scheduled. In this paper, alternative strategies are discussed which are focused mainly on the development and application of antimicrobial peptides. These can easily be synthesized in high amounts under moderate costs, have usually a high therapeutic index, and do not have a tendency for resistance emergence. Recent developments are presented from which it may be deduced that the most serious form of a bacterial infection, sepsis and septic shock, may be treatable in near future.