When the whole exceeds the sum of its parts. Squeezing greater cumulative benefit from cross-technology partnerships in bacterial infection

Abstract

OBJECTIVES: Effective care for bacterial infections requires both new antibiotics (ABx) to address antimicrobial resistance (AMR) and appropriate diagnostics (Dx) to guide their use. Diagnostics are essential to identify pathogens, determine susceptibility, and support targeted prescribing, including ruling out unnecessary antibiotic use. However, diagnostics are undervalued in the current market, limiting their availability and integration with antibiotic development. To examine the interplay between antibiotics and diagnostics and assess the potential value of coordinated development and partnerships. METHODS: This paper analyses the antibiotic and diagnostic development landscape, focusing on market dynamics, regulatory frameworks, and collaboration models involving ABx developers, Dx developers, clinicians, and public-sector stakeholders. RESULTS: Antibiotics and diagnostics are rarely developed or introduced in parallel, and available diagnostics often fail to deliver treatment-focused or point-of-care-relevant results. This misalignment hampers the effective deployment of new antibiotics and weakens stewardship. Cross-technology partnerships can improve trial efficiency, enhance market valuation, and support more targeted antibiotic use. Key barriers include fragmented incentives, regulatory misalignment, and financial constraints. CONCLUSION: Better alignment between antibiotic and diagnostic development is critical to maximise clinical impact and support resistance monitoring. Public-sector support could help enable effective partnerships and improve patient outcomes.