Discovery & Stewardship of Narrow Spectrum Antibiotics

APUA board member, Philip Walson, M.D., who is the Editor-in-Chief of Clinical Therapeutics, provided his comments on the recent article, "Optimer Seeks Quick Green Light From FDA for Antibiotic Against Deadly Bug"

It is too early to be sure what the future holds for this new antibiotic, especially compared to much cheaper generic drugs like metronidazole. However, the development of any new antibiotic is welcome and development and commercialization of any so called ``narrow spectrum´´ antibiotics is especially encouraging. The company will now have to convince physicians to adopt a totally new strategy to treating infections; one that includes first making a clear, specific diagnosis and then using a drug designed to treat only the one diagnosed infection and not selecting a ``shotgun´´ approach to all possible infectious agents. If they are successful this should both increase the use of this antibiotic and help to combat excessive, non-specific antibiotic use by training physicians to think differently about the use of antibiotics. This includes considering the development of resistance as a major outcome variable in antibiotic selection. Such thinking can only be welcomed given the rapidly developing rates of multidrug antibiotic resistance which is due at least in part to the overuse of broad spectrum antibiotics.