Beyond new antibiotics: Scientists now target the tricks superbugs use to survive

Bacterial antimicrobial resistance (AMR) was linked to nearly 5 million deaths worldwide in 2019, with about 1.27 million of those deaths directly caused by resistant infections. Global projections put the toll at 39 million deaths between 2025 and 2050, with South Asia, including India, expected to account for close to 12 million of those deaths.

Against that backdrop, researchers are pursuing a strategy distinct from the usual hunt for new antibiotics: disabling the defences bacteria use to survive existing drugs. Bacteria resist antibiotics by producing enzymes that destroy the drug, altering the molecular targets antibiotics are built to bind to, or pumping the drug out of their cells before it can act. Adjuvant therapies target these defences directly, restoring the effectiveness of antibiotics that are already in use rather than racing to invent replacements.

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An Indian antibiotic combination gets global approval

Zaynich, a combination of cefepime and zidebactam developed by Mumbai-based Wockhardt, is one result of this approach. Cefepime is an established antibiotic; zidebactam works alongside it as the adjuvant, blocking the bacterial enzymes that would otherwise destroy cefepime, so the pair remains effective even against multidrug-resistant Gram-negative bacteria.

India's Drugs Controller General approved Zaynich on May 27, 2026, and the US Food and Drug Administration followed on May 29, 2026, clearing it for complicated urinary tract infections, including pyelonephritis. In its Phase 3 trial, run across 530 patients at 64 sites worldwide, the combination showed a markedly higher cure rate than meropenem, an antibiotic typically reserved for tougher infections. Wockhardt says Zaynich is the first new chemical entity fully discovered, developed, and commercialised by an Indian pharmaceutical company to win US approval.

Scientists are developing therapies that disable the defence mechanisms of antibiotic-resistant bacteria, allowing existing antibiotics to work effectively again. Representative image.

IIT Bombay's DNA-based approach to old antibiotics

A second, earlier-stage approach comes from the Indian Institute of Technology Bombay, where researchers Ruchi Anand and P I Pradeepkumar have engineered short synthetic DNA sequences, called aptamers, that block a bacterial enzyme responsible for resistance to macrolide antibiotics such as erythromycin. In lab tests, bacteria treated with these aptamers alongside antibiotics died at higher rates than bacteria given antibiotics alone.

Aptamers are cheaper to synthesise and easier to modify than conventional drug molecules, and the team is exploring delivery through liposomes, a method already used elsewhere in medicine. The researchers say animal studies and further safety testing are still needed before the approach can be tested in patients.

Dr Anjali Mehrotra, an infectious disease specialist not involved in either project, said the approach addresses a problem she sees often in practice. "New antibiotics buy us a few years at most before resistance catches up," she said. "Reviving drugs whose safety we already understand is a faster, cheaper way to stay ahead of resistant infections — and in India, where resistant strains are common in our hospitals, that head start matters."

India recorded some of the highest antimicrobial resistance rates in the world in recent years and is projected to see roughly 2 million AMR-linked deaths by 2050, making the search for such alternatives especially urgent here