Rethinking the unmet need for novel antibiotics

The authors argue that the fundamental challenge in antibiotic development is not only addressing deaths from specific highly resistant pathogens, but more critically overcoming high rates of empiric treatment failure that clinicians face when first treating infections. They propose reframing the problem to focus on developing pathogen-general potentiators—agents that improve the success of empiric therapy across a broad range of infections—which could both reduce treatment failures and offer greater commercial viability to attract sustained investment from the biopharmaceutical industry. This approach aims to realign scientific priorities and economic incentives, potentially revitalising interest in antibiotic R&D by addressing a more pervasive clinical need rather than narrowly targeting specific resistant organisms.