[loopasam]

A couple of good recent article to understand this complex problem (USA perspective): https://endpts.com/can-we-make-the-antibiotic-market-great-a... and https://endpts.com/biopharma-has-abandoned-antibiotic-develo...

Reasons are mainly: No incentive to develop antibiotics from a legal perspective (FDA), as insurance companies prefer to reimburse the cheap and generic, still working mostly "well enough" for now.

Insurers pay for in-patient antibiotics as part of a lump sum to hospitals known as a Diagnosis Related Group (DRG). Using a cheap antibiotic increases hospital profit margins, while using an expensive new drug could mean that a hospital might lose money by treating a given patient. As a result, hospitals are incentivized to use cheaper antibiotics whenever possible. This puts significant pricing pressure on new antibiotics, which are one of the only type of medicines paid for like this.