There is a need to develop new or more effective immunisations against respiratory bacteria and viruses, particularly for the prevention of RSV and pneumococcal infections.
Only a few new families of antibiotics are in the pipeline for bacterial respiratory infections. The dramatic shortage of new antibiotics, together with the increasing number of antibiotic-resistant bacteria, is a worrying threat to the global population and a critical challenge for healthcare institutions. New therapeutic strategies, such as monoclonal antibodies acting against different strains of multidrug-resistant bacteria, must be developed.
The future of microbiology will determine many of the advances in respiratory medicine. For example, molecular bacteriology is being revolutionised by the next generation of sequencing methodologies; molecular virology should follow.
Areas of focus in the future should be the development of mechanisms for boosting host defence and innate immunity so that antivirals and antibacterials will be less necessary.