The index, which rates companies on their contributions to preventing the spread of bacteria that are resistant to antibiotics, found Mylan to be the best of the generic drug makers and rated a little-known company, Entasis, as top among biotechnology companies. The World Health Organization considers antibiotic resistance “a global health emergency that will seriously jeopardize progress in modern medicine,” said its director-general, Tedros Adhanom Ghebreyesus. Growing numbers of people are dying from “flesh-eating” microbes; from infections picked up in hospital and nursing homes; and from strains of pneumonia, tuberculosis, gonorrhea and other diseases that are impervious to most drugs. Such infections kill about 23,000 Americans a year, the Centers for Disease Control and Prevention estimates. Companies were judged by several criteria, said Jayasree K. Iyer, executive director of the Access to Medicines Foundation, which published the new index, called the Antimicrobial Resistance Benchmark. Having new antibiotics in development was important, but so were measures to encourage prudent use of existing drugs. For example, Dr. Iyer said, Glaxo stopped tying sales agents’ bonuses to the volumes they sold and rewarded them for customer service, technical knowledge and how well they help doctors prescribe judiciously. Johnson & Johnson was recognized for its “stewardship” of one of its best new antibiotics, bedaquiline. Instead of selling it to any customer for any human or animal use, the company restricted it to treatment of drug-resistant tuberculosis, which kills about 250,000 people a year. Companies were also rated for clean manufacturing — particularly whether they discharged antibiotic-laden wastewater into rivers or lakes. Research to create the benchmark index was paid for by the British and Dutch governments. The Netherlands-based foundation that issued it is best-known for its biennial Access to Medicines Index, which rates pharmaceutical companies on how they do at making their products available to poor countries. Glaxo has also topped that index ever since it was first issued in 2008. Drug companies have 28 new antibiotics in late stages of development, but only nine are markedly different from existing ones, Dr. Iyer said. “That’s a problem,” she said. “We definitely need to strengthen the pipeline.” More Information On NY Times