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European Biopharmaceutical Review

The Other – Silent – Pandemic

Antimicrobial resistance (AMR) is acknowledged as a global threat for public health. Antimicrobials are crucial to modern medicine as we know it, and the emergence and spread of multidrug-resistant pathogenic bacteria compromise some medical procedure that are taken for granted. This concern was recently highlighted by a survey among UK oncologists; 46% of whom said they fear that AMR could make cancer chemotherapy unviable (1). Indeed, 20% of cancer patients receiving chemotherapy are at risk of developing an opportunistic life-threatening infection. Novel promising cancer therapies, such as CAR T immunotherapy, also expose patients to the development of opportunistic life-threatening bacterial infections (2). With the increase of AMR, physicians may face a Cornelian choice: they could treat a patient suffering with cancer, but they would not be able to cure the multidrugresistant infection that would occur because of the cancer treatment.

The Antimicrobial Crisis

The AMR crisis is worsened by the fact that our antibiotic arsenal is ageing and is not sufficiently renewed. Seventeen different classes of antibiotics are available for the treatment of systemic bacterial infections; 14 of them were introduced into clinical use between 1930 and 1990, a period that was named the ‘golden age’ of antibiotic drug discovery. The situation is complicated by the fact that these antibacterial classes are not effective against all the bacterial pathogens. Bacteria are divided into two main groups based on the composition of their cell walls – the Gram-positives and the Gram-negatives. Gram-negative bacteria have a more complex cell wall than Gram-positives. As a consequence, Gram-negative pathogens are susceptible to much fewer antibiotics than Gram-positives. For the main Gram-positive hospital pathogen, the infamous Staphylococcus aureus (MRSA), two novel classes were introduced at the beginning of the 2000s and offered a solution against multidrug resistance. But, for Gram-negative hospital pathogens, no novel class of antibiotics has been introduced since the carbapenems in the 1980s. This lack of renewal in the antimicrobial arsenal means that clinicians are constrained to use on and on the same antibiotic classes, including the ‘lastresort’ carbapenems, leading to the selection and spread of multidrug-resistant pathogens, and, eventually, a therapeutic dead-end. Thus, there is a clear need to rearm our antibiotic arsenal with completely novel classes of antibiotics with new modes of action, and/or to develop new therapeutic strategies likes phages or host-pathogen relationships.

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Philippe Villain-Guillot has been Nosopharm’s CEO since co-founding the company in 2009. In this first entrepreneurial venture, he grew the company to include a staff of 10 high-skilled employees, established a robust IP portfolio, successfully entered it into highly-selective European R&D IMI consortia dedicated to antibiotic resistance, and dealt a codevelopment agreement with a major European biotech company. Since the inception of the company, Philippe has raised 5.6 million in private equity and 7.8 million in public grants. Philippe holds a PhD in Medicinal Chemistry from the University of Montpellier, France.
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Philippe Villain-Guillot
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