After years of industry-wide disinvestment from antibiotic research, a few large companies are re-investing.

The lowdown: In 1999, Roche was one of the first large pharmaceutical companies to pull out of antibiotic research. Bristol-Myers Squibb, Lilly, Abbott, Bayer and others followed, and Pfizer closed its main antibiotic research centre as recently as 2011. But now, with the threat of antibiotic-resistant bacteria growing, a turnaround may be underway.

Late last year, Roche partnered with Polyphor to re-enter the antibiotic space, paying up to US$550 million biodollars to collaborate on the development of the Phase II macrocyclic peptidomimetic POL7080 for Pseudomonas aeruginosa infections. In January, AstraZeneca and Sanofi made antibiotic investments of their own. AstraZeneca, one of the few companies that has maintained a presence in this area over the past decade, partnered with FOB Synthesis to combine a β-lactamase inhibitor with carbapenem antibiotics. And Sanofi, which spun out its antibiotic research in 2004 but has been re-establishing its interest in the area since 2011, partnered with Fraunhofer-Gesellschaft to identify and optimize novel naturally occurring chemical and biological anti-infective compounds.

“We think it is the right time to get back in,” says John Reed, Head of Pharma Research & Early Development (pRED) at Roche. Advances in clinical trial design, diagnostics and target space have made antibiotic research more appealing now than it was a decade ago, he told Nature Reviews Drug Discovery (see page 170).

Many antibacterial experts, however, remain concerned that the commercial incentives don't yet outweigh the challenges of antibiotic development. Although the GAIN (Generating Antibiotic Incentives Now) Act was enacted in the United States in 2012 to shift the balance (for instance, with 5 additional years of market exclusivity for antibiotics), a bipartisan group of representatives introduced the ADAPT (Antibiotic Development to Advance Patient Treatment) bill to the US House of Representatives in December to, among other things, create an accelerated approval pathway specifically for antibiotics.