Analysis of antibacterial agents in clinical and preclinical development: overview and analysis 2025

The WHO report “Analysis of antibacterial agents in clinical and preclinical development: overview and analysis 2025” provides a comprehensive global assessment of the antibiotic R&D pipeline as of early 2025. It identifies 90 antibacterial agents in clinical development—50 traditional and 40 non-traditional—targeting WHO bacterial priority pathogens, Clostridioides difficile, Helicobacter pylori, and Mycobacterium tuberculosis. While several new agents have been approved since 2023, overall innovation remains limited: only about one-fifth of traditional antibiotics show no known cross-resistance. The report highlights slow progress in developing paediatric formulations and treatments for critical priority pathogens such as carbapenem-resistant Acinetobacter baumannii and Enterobacterales. Non-traditional approaches—like bacteriophages, antibodies, and microbiome-modulating agents—are expanding but face high attrition rates. WHO concludes that despite incremental progress, the current pipeline is insufficient to counter the escalating global threat of drug-resistant bacterial infections, underscoring the urgent need for coordinated R&D investment, innovative incentives, and policy action to revitalize the antibacterial development ecosystem.