Researchers at the University of Illinois Chicago (UIC) have developed a promising new antibiotic that could transform the battle against antimicrobial resistance, making it approximately 100 million times more difficult for bacteria to develop resistance. Despite this breakthrough, financial barriers may prevent this laboratory innovation from reaching patients who desperately need new treatment options.
The development comes at a critical time for Illinois, which is experiencing an alarming rise in drug-resistant infections. The state currently accounts for 15% of all U.S. cases of Candida auris (C. auris), a deadly fungal pathogen that has become increasingly difficult to treat. Cases of C. auris in Illinois have increased dramatically from just 11 in 2017 to 276 in 2022, signaling a growing public health crisis.
The Growing Threat of Antimicrobial Resistance
Antimicrobial resistance represents one of the most significant public health challenges globally, though it receives relatively little media attention. Current projections indicate that between now and 2050, antibiotic-resistant infections could contribute to nearly 170 million deaths worldwide—a figure equivalent to almost 14 times the population of Illinois.
The Centers for Disease Control and Prevention (CDC) reports that infections have increased for six of seven high-priority superbugs in recent years. Economic forecasts suggest that without intervention, antimicrobial resistance could cost the global economy $1 trillion by 2030.
"We're facing a future where common infections could become life-threatening and routine medical procedures too risky to perform," said John Conrad, president and CEO of the Illinois Biotechnology Innovation Organization (iBIO). "Without new antibiotics, minor cuts or urinary tract infections could become untreatable, and surgeries from C-sections to joint replacements might be deemed too dangerous."
The Economic Paradox of Antibiotic Development
Despite the urgent need for new antimicrobials, a fundamental economic paradox has created a significant barrier to development. The cost to develop a new antibiotic typically exceeds $1 billion, yet annual sales often struggle to reach $100 million. This disparity stems from the appropriate medical practice of reserving new antibiotics for only the most necessary cases to prevent further resistance development.
This economic reality has devastated the antibiotic development pipeline. Since 2013, the FDA has approved 10 antibiotics from small companies, but nearly all of these developers have faced severe financial difficulties or bankruptcy. The result is a dwindling pipeline of new antimicrobials precisely when they are most needed.
The PASTEUR Act: A Potential Solution
To address this market failure, policymakers have proposed the PASTEUR Act, which would establish a subscription-like model for antimicrobial medicines. Under this legislation, the federal government would enter into contracts with developers, providing guaranteed payments in exchange for access to newly developed antimicrobials.
"The PASTEUR Act would provide developers the opportunity to earn a predictable return on their investment, regardless of how sparingly the drugs are used," explained Conrad. "This approach recognizes the public health value of having effective antibiotics available when needed, rather than basing compensation solely on volume of sales."
For Illinois, with its robust research institutions including UIC and a growing biotechnology sector, revitalizing antibiotic development could generate significant economic benefits, including new jobs and increased investment in the region.
UIC's Breakthrough Research
The antibiotic being developed at UIC represents a significant scientific advancement. By making it exponentially more difficult for bacteria to develop resistance mechanisms, this compound could potentially remain effective for much longer than current antibiotics.
The researchers have designed the antibiotic to target bacterial mechanisms in ways that would require multiple simultaneous mutations for resistance to develop—a statistical improbability that provides a substantial advantage over existing drugs.
However, without addressing the fundamental economic challenges in antibiotic development, even the most promising laboratory breakthroughs may never benefit patients. The situation underscores the urgent need for policy solutions like the PASTEUR Act to bridge the gap between scientific innovation and patient access.
As antimicrobial resistance continues to grow in Illinois and globally, the stakes couldn't be higher. The choice, as Conrad puts it, is stark: "Fix the market for antimicrobials or face a future where common infections become deadly threats."
