BSAC Vanguard Series: The future of drug development and the tension between access and excess.

There is a crying need for a new broad-spectrum antibiotic. The global unmet need has energized governments and researchers alike. We may soon have the next antibiotics coming to the aid of patients after a drought of over half a century. However, we need to traverse a complex causeway between access to new antibiotics and their overuse. In an ICU setting where time is premium, identifying the causative organism and its resistance pattern in the time window is often impossible; physicians may be forced to prescribe the latest antibiotics. This practice in the long term may give rise to a rapid spread of resistance among microbes. There is an urgent need to do a cost-benefit analysis of easy access and use of the new antibiotics.