It's a commonplace mantra: antibiotic development is in a precipitous decline, especially compared to the heyday of the 1980s and 1990s. Journalists regularly point to charts comparing the 30 or so antibiotics developed in the '80s versus the mere 13 developed between 1998 and 2010. And just yesterday, President Barack Obama issued an Executive Order meant, in part, to get the antibiotic pipeline rolling again.
But Boston University professor Kevin Outterson argues that the disparity is much less stark when taking antibiotic market withdrawals, discontinuations, and general quality into consideration:
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"Twenty of the new antibiotics [made between the '80s and early '90s] were not commercially or clinically successful and were ultimately withdrawn or discontinued from the market," writes Outterson in a post for The Incidental Economist. "An additional six antibiotic drugs were formally withdrawn for safety-related reasons, while for others, safety questions played a role in limiting clinical and commercial success."
"Since 1980, antibiotics have suffered market withdrawals at triple the rate of all other FDA-approved drugs."
In fact, after excluding withdrawn, discontinued, and otherwise ineffective antibiotics, there appears to be much less disparity between the decades when it comes to the antibiotic pipeline:
This isn't to say that the relative lack of new antibiotics isn't a problem -- it certainly is. But Outterson's analysis is yet another example of the strong practical effect that post-market activities can have on therapeutic trends.