Innovation, Nontraditional Antibacterial Drugs, and Clinical Utility

In this Viewpoint, I argue that our view of antibacterial discovery, development, and commercial potential requires a balance between innovation and clinical utility. I suggest that important new clinical utility may be more important to value than whether the compound in question belongs to a novel chemical class or attacks a novel antibacterial target. Novelty in this regard may increase the risk of scientific or clinical failure. So-called nontraditional approaches to antibacterial therapy are often innovative. The attendant challenges depend on whether the compound can be a stand-alone therapy, part of a fixed-dose combination, or whether it is adjunctive to standard therapy. Suitability for pharmacokinetic-pharmacodynamic studies and antimicrobial susceptibility testing is also an important consideration.