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.
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.