Associated with this problem is the massive use of antibiotics as a COVID-19 (co)treatment worldwide 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, which is predicted to add to the ongoing emergence of AMR 25, 26, 27, 28, 29. A perhaps overlooked aspect of concern with the COVID-19 pandemic is the high numbers of secondary infections, often associated with multidrug-resistant bacteria, which are observed especially in hospitalized patients and those with already compromised immune systems 11, 12. The anticipated death toll caused by drug-resistant infections over the next years and decades may be compared with the global fatality rate of the current SARS-CoV-2 (COVID-19) pandemic ( ), which has already led to multibillion-dollar investments in vaccine development, repurposing existing drugs and antiviral discovery. It is estimated that at least 700,000 people worldwide die each year as a result of drug-resistant infections, and this could rise to as much as 10 million by 2050 if the problem of AMR is not addressed 9, 10. This is of major public concern, since most areas of modern medicine are inconceivable without access to effective antimicrobial treatment 8. The overuse and misuse of antibiotics in healthcare and agriculture, together with inappropriate waste management and environmental transmission, have led to substantially increased antimicrobial resistance (AMR) 1, 2, 3, 4, 5 and associated bacterial persistence 6, 7.

This article is conceived as a general roadmap with the central aim of promoting and accelerating translational science in the early stages of novel antibiotic discovery towards lead candidate development. Nature Reviews Chemistry volume 5, pages 726–749 ( 2021) Cite this article

Towards the sustainable discovery and development of new antibiotics

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