There are commercial as well as scientific barriers to seeking out new antibiotics (Nature 485, 439–440; 2012). These discourage the pharmaceutical industry from investing in further research and clinical development, particularly as current antibiotics are cheap, usually work satisfactorily and generate profits for their manufacturers and distributors.

Producing new antibiotics is costly, particularly at the clinical-trial stage because of concerns over safety and resistance. Intellectual property is an issue in developing new drugs based on established antibiotic classes.

We could wait until the clinical situation becomes severe enough for the private sector to step in with substantial investment, but that would be risky. A mix of private and public investment might work, particularly if the public sector were to take on some of the commercial risk in clinical trials (see Nature 472, 32; 2011). A pragmatic strategy would be to define the clinical profiles of desirable new antibiotics and then to devise commercially viable routes for delivering them to the clinic.