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The demise of Achaogen has been blamed on the peculiar features of the antibiotics market,
Achaogen的破產被歸咎于抗生素市場的獨特特征，
rather than the poor business decisions of its managers.
而不是其管理者糟糕的商業決策。
The low number of cases that are suitable for potential treatment with novel antibiotics makes it hard to recruit enough patients for clinical trials.
適合使用新型抗生素進行潛在治療的病例數量較低，這使得招募足夠數量的病人進行臨床試驗變的困難。
Take carbapenem-resistant Enterobacteriaceae (or CRE for short), which Achaogen went after.
以耐碳青霉烯類腸桿菌（簡稱CRE）為例，Achaogen就是做這個。
These bacteria kill half of those whose bloodstream they infect. But CREs cause only a tiny fraction of bacterial infections in American hospitals.
這些細菌會殺死一半的血液被感染者。但在美國醫院中，CRE僅引起了很小一部分的細菌感染。
Firms get around this by having their new antibiotics approved for more common ailments treatable with existing drugs, such as urinary-tract infections.
公司通過讓他們的新抗生素得到批準并用于現有藥物可治療的更常見疾病來規避這一問題，比如尿路感染。
At the same time, they publish results from small observational trials of the new drugs showing good recovery rates for hospital patients with CRE infections
與此同時，他們公布了這些新藥的小型觀察性試驗結果，結果表明感染了CRE的住院患者有良好的康復率
—counting on doctors to prescribe the medicines off-label for CRE.
—指望醫生能夠為CRE開出未被臨床試驗認可的藥物。
In the case of Achaogen, a small study showed that plazomicin was indeed safer and more effective for CRE than colistin,
以Achaogen為例，一項小型研究表明plazomicin確實比粘菌素更加安全有效，
a highly toxic antibiotic of last resort from the 1950s. Yet plazomicin did not make a dent in colistin use.
粘菌素是一種源于20世紀50年代的最后一種劇毒抗生素。但plazomicin的問世并沒有減少粘菌素的使用。
A CRE antibiotic by Melinta that has been on the market for over a year is not selling well, either.
Melinta的CRE抗生素已上市一年多，但銷量也不好。
That could be because few doctors know about the new treatments.
這可能是因為知道這種新治療方法的醫生并不多。
The firms which sell them lack the marketing dollars that big pharma firms shower on new drugs,
銷售它們的公司缺乏大型制藥公司投入新藥的市場資金，
says Alan Carr, an analyst at Needham, an asset manager in New York.
Needham分析師兼紐約資產經理阿蘭·卡爾表示。
It takes time for new antibiotics to make it into clinical guidelines,
新抗生素列入臨床指南需要時間，
such as those of the Infectious Diseases Society of America, which are updated infrequently.
比如美國感染病學會的那些，其更新并不頻繁。
American hospitals, meanwhile, avoid new antibiotics because they end up footing the bill, which can run to several thousand dollars per patient.
同時，美國醫院會避免使用新抗生素，因為最終他們需要自己買單，每名病人要花幾千美元。
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