India's 'blockbuster' drugs to take on deadly superbugs

In India, a significant challenge is emerging in the form of infections that resist treatment from antibiotics, which are crucial in modern medicine. These infections are particularly prevalent in critical care units, where the most vulnerable patients are treated. Antibiotics have long been celebrated as lifesavers, but they are now facing a formidable opponent: bacteria that have evolved to outsmart these drugs. According to a report from The Lancet, a respected medical journal, antibiotic-resistant infections were responsible for approximately 1. 14 million deaths globally in 2021. In India alone, around 300,000 deaths were attributed to these infections in 2019. This alarming trend highlights the urgent need for innovative solutions to combat antibiotic resistance. Fortunately, there is a glimmer of hope on the horizon. Several promising new drugs developed in India are showing potential in the fight against antibiotic-resistant bacteria. One such drug is Enmetazobactam, created by Orchid Pharma, a company based in Chennai. This drug has made history as the first antimicrobial developed in India to receive approval from the US Food and Drug Administration (FDA). Enmetazobactam works by targeting the bacteria's defense mechanisms rather than attacking the bacteria directly. This innovative approach allows the antibiotic to remain effective against resistant strains. By binding to enzymes that bacteria produce to destroy antibiotics, Enmetazobactam neutralizes these defenses, enabling the antibiotic to effectively kill the bacteria. Clinical trials conducted across 19 countries, involving over 1,000 patients, have demonstrated the drug's effectiveness in treating severe infections such as urinary tract infections, pneumonia, and bloodstream infections. Dr. Maneesh Paul, the lead co-inventor of Enmetazobactam, expressed optimism about the drug's potential, stating that it has shown remarkable potency against evolved bacteria. Another promising antibiotic in development is Zaynich, created by Wockhardt, a Mumbai-based pharmaceutical company. After 25 years of research, Zaynich is currently undergoing Phase-3 trials and is expected to be launched next year. Dr. Habib Khorakiwala, the founder of Wockhardt, described Zaynich as a groundbreaking antibiotic designed to combat major superbugs. In compassionate use cases, Zaynich has been administered to critically ill patients who did not respond to other antibiotics, and all of them survived. This success story has generated excitement and pride in India's pharmaceutical capabilities. Additionally, Wockhardt is also testing Nafithromycin, a three-day oral treatment for community-acquired bacterial pneumonia, which has shown a remarkable 97% success rate in trials. The need for new antibiotics is pressing, as existing treatments face resistance rates as high as 60%. The company anticipates that Nafithromycin could be commercially available by late next year. Furthermore, Bugworks Research, a biopharma firm based in Bengaluru, is collaborating with the Global Antibiotic Research and Development Partnership (GARDP) to develop a new class of antibiotics for serious drug-resistant infections. Although still in early Phase-1 trials, this drug is expected to take five to eight years before it is ready for the market. The CEO of Bugworks, Anand Anandkumar, highlighted the challenges in antibiotic development, noting that the focus of pharmaceutical companies is often on more profitable drugs for conditions like cancer and diabetes, leaving antibiotics underfunded and underdeveloped. A recent report by the Indian Council of Medical Research (ICMR) raised concerns about the rising rates of antibiotic resistance in India. The report analyzed nearly 100,000 bacterial cultures from specialized care hospitals and found that E. coli was the most frequently isolated pathogen, followed by Klebsiella pneumoniae, which can cause severe infections. Alarmingly, the effectiveness of antibiotics against E. coli has sharply declined, while Klebsiella pneumoniae has shown a significant rise in drug resistance. Doctors have reported that some antibiotics are now less than 15% effective against these pathogens, raising concerns about the future of treatment options. The increasing resistance to carbapenems, a critical last-resort antibiotic, is particularly worrisome. Experts emphasize the need for reform in antibiotic prescription practices in India. The widespread use of broad-spectrum antibiotics, which target multiple bacteria types but can also harm beneficial bacteria, contributes to the emergence of drug-resistant strains. Instead, doctors should prioritize narrow-spectrum antibiotics that specifically target the bacteria causing the infection. However, many hospitals lack proper guidelines, leading to indiscriminate prescribing practices. The crowded hospitals in India are hotspots for infections, and the misuse of antibiotics can have dire consequences. Dr. Kamini Walia, a scientist at ICMR, cautioned against the improper use of new drugs, emphasizing the importance of creating mechanisms to prevent misuse. The rapid mutation of bacteria underscores the urgency of a comprehensive approach to combat antibiotic resistance. This includes improving sanitation, hygiene, and vaccination rates, as well as strengthening hospital infection control policies. The message is clear: without immediate action, we risk entering a future where even minor infections could become untreatable.