The antibiotic paradox: why companies can’t afford to create life-saving drugs

As the COVID-19 pandemic caught hold early this year, a small drug company outside Philadelphia was struggling to market a compound that could help patients battling for their lives.

Paratek Pharmaceuticals had spent more than 20 years developing and testing an antibiotic named omadacycline (Nuzyra), which went on sale in the United States in 2019 for use against bacterial infections. Although antibiotics can’t fight the virus that causes COVID-19, almost 15% of people hospitalized with the disease go on to develop bacterial pneumonias, some of which are resistant to existing antibiotics.

Before COVID-19, antibiotic resistance was estimated to kill at least 700,000 people each year worldwide. That number could now climb as more people with the viral disease receive antibiotics to treat secondary infections, or to prevent infections that come from being on a ventilator. That’s where a drug such as omadacycline might help — if it can be delivered to people in time to save lives.

“COVID is a wake-up call,” says Evan Loh, chief executive of Paratek, which has offices in Pennsylvania and Boston, Massachusetts. Diagnostics, antibodies and vaccines are all key to preparing for a pandemic, he says, and “We need antibiotics, to give people the best chance of surviving this particular infection.” But drug makers who produce antibiotics face unique challenges.