Throughout the workshop, and during a final discussion session, speakers and workshop participants made general observations about the issues associated with antibiotic development to counter resistance. These observations are gathered in this final chapter to capture some of the broad themes emerging from the workshop. These themes should not be seen as consensus conclusions of the workshop and are associated with the individual or individuals who made the observation.
- There is a need for faster methods of isolating potential antibiotics, determining their structure, and characterizing their mechanisms of action. (Aurigemma, Silver, Mobashery)
- There is not enough interaction among the different constituencies that need to be involved in the discovery, development, and use of antibiotics: between clinicians and researchers, between medicinal chemists and biologists, between small companies developing antibiotics and large companies that take them through approval to the market. (Smeltzer, Morones-Ramirez, Silver, Aurigemma, Shaw)
- The mechanisms by which antibiotics enter cells and bypass biophysical barriers need to be better understood. (Silver, Smeltzer)
- The solution to antibiotic resistance lies not just with developing new molecules, but also with better stewardship of current agents as well as improved detection and control to more quickly stop the spread of infectious organisms. Training for medical professionals should be improved. Antibiotics should also be eliminated from animal feed. (Aurigemma)
- There is a need to develop novel screening technologies to identify new targets, with awareness of prior efforts, for drug development. To a large extent, there have been no new targets for antibiotic development discovered since the late 1980s. (Silver, Shaw, Khosla)
- Since the physiochemical properties of antimicrobial agents do not follow the same rules as other classes of pharmaceutical agents, there is a need to develop synthetic and natural product libraries specifically for antibiotic development. (Shaw)
- The search for new antimicrobial agents should focus on molecules that bind to multiple targets or that work in combination with other drugs that target independent microbial processes. (Silver)
- Mining and engineering secondary metabolic pathways can be a productive route to identifying antimicrobial agents with novel molecular structures and mechanisms of action. (Khosla)