What to do when antibiotics no longer work?

21 February 2025 Research news item

More and more bacteria are becoming insensitive to antibiotics, so a treatment of antibiotics has no effect. And the increasing resistance to antibiotics can seriously threaten public health. ‘The development of new antibiotics is going slow.’

Imagine you have a bacterial infection, such as pneumonia or septicemia. At that moment millions of bacteria in your body are making you sick. Antibiotics cause stress in these bacteria, causing them to mutate and die. Among those millions of bacteria, there may be one bacterium in which the mutation has favourable results. That bacterium does not die from the mutation but begins to divide. The result: the antibiotic no longer works and the pathogenic bacteria remain in your body

‘In the worst-case scenario, these bacteria will be resistant to all antibiotics, resulting in death,’ says Willem Velema, assistant professor of Physical Organic Chemistry at Radboud University. And according to the World Health Organization, this worst-case scenario is becoming increasingly threatening. The health organisation predicts 10 million deaths annually from antibiotic resistance by 2050. What can be done about this threat?

New paths

The short answer is: develop new antibiotics. But that is easier said than done. ‘The forties and fifties were golden decades for antibiotics. Many of the antibiotics we know today were developed then,’ Velema explains. The development of antibiotics has slowed considerably. ‘There is currently no clear revenue model. Companies prefer to focus on medicine that people have to use structurally, rather than on antibiotics that they no longer need after a single course of treatment.’

Despite the reluctance of companies to develop new antibiotics, Velema is hopeful about the future. He argues that universities are conducting a lot of innovative research. He and his colleagues are exploring new methods to tackle the problem at its root: the aim is not to kill the pathogenic bacteria, but to prevent these bacteria from gaining a foothold.

Hopeful innovation

Velema is positive about the innovations, even though the road to new medication is still long. What helps are the spin-offs that are now emerging to further develop the promising results. ‘Because of the growing attention to antibiotic resistance, governments are more willing to finance these kinds of spin-offs.’ In addition to these small innovative companies, Velema also sees a crucial role for large companies in accelerating the production of new antibiotics. ‘As long as they don't see any profit in it, things will continue to move slowly.’

Velema is curious about the results of a kind of Netflix model that is being tested in several countries, in which governments purchase a package of medicines that includes antibiotics. Such a business model could make the development of new antibiotics more lucrative. ‘Or someone will have to discover how to make resistant bacteria no longer resistant. Then we will have solved the whole problem.’

Photo: Towfiqu barbhuiya via Unsplash

Contact information

Organizational unit: Faculty of Science, Institute for Molecules and Materials
Theme: Molecules and materials, Health & Healthcare