Rising Antibiotic Resistance Rates in European Hospitals Continue to Drive Shifts in Treatment of Gram-Negative Infections

BURLINGTON, Mass., May 15, 2014 /PRNewswire/ -- Decision Resources Group finds that the majority of surveyed hospital-based infectious disease and critical/intensive care specialists in the EU5 (France, Germany, Italy, Spain and the United Kingdom) reported increases in infection rates due to key drug-resistant Gram-negative pathogens (GNPs) over the past two years. Further, insights from physicians indicate that concerns over drug resistance are driving changes in treatment practices. Although piperacillin-tazobactam remains the preferred choice for empiric treatment for most Gram-negative infections (GNIs), a high percentage of respondents prefer using carbapenems in empiric therapy, suggesting that these agents, typically reserved for later-line use, are increasingly being prescribed as frontline therapies. Surveyed physicians also reported a significantly lower empiric treatment success rates in GNIs compared with our 2012 study, possibly driven by increasing GNP antibiotic resistance rates.  

Other key findings from the TreatmentTrends report entitled Gram-Negative Infections 2014 (EU):

• Physician concern and increasing rates of key drug-resistant pathogens:  65 percent of surveyed physicians indicated increased rate of infections caused by extended-spectrum beta-lactamase- (ESBL) producing Enterobacteriaceae, and 57 percent of respondents reported increased rates of multi-drug-resistant (MDR) Pseudomonas aeruginosa over the past two years. Respondents are particularly concerned over MDR GNPs, with 79 percent and 74 percent of surveyed physicians reporting a high level of concern regarding MDR P. aeruginosa and MDR Acinetobacter infections, respectively, for which few treatment options remain available.  
• Anticipated prescribing of ceftolozane/tazobactam and ceftazidime/avibactam: Surveyed European physicians are highly receptive to new treatment options that will target resistant Gram-negative pathogens. Almost 90 percent of respondents are willing to prescribe Cubist's ceftolozane/tazobactam (CXA-201) and AstraZeneca/Forest's ceftazidime/avibactam (CAZ-AVI), while 80 percent would prescribe both therapies, if available. Despite key differences in spectrum of activity, likely prescribers do not perceive these emerging products to be well differentiated and do not prefer either agent for the treatment of GNIs due to key pathogens.

Comments from Decision Resources Group Infectious Disease Therapy Leader Mladen Tomich, Ph.D.:

• "As few options remain for targeting highly resistant GNPs such as MDR P. aeruginosa and Acinetobacter, physicians are increasingly turning to last resort therapies for these pathogens, including colistin, despite its notable toxicity. Hence, there is ample opportunity in the EU5 hospital market for novel agents that are efficacious against resistant and MDR GNPs and have a more favorable safety profile."
• "While signaling a pressing need for novel antibiotics for GNIs, physicians are concerned about future resistance development to both current and emerging therapies. Our findings indicate that a narrower activity spectrum that includes efficacy against key resistant and MDR pathogens may be an important driver of hospital uptake of antibiotics, as physicians look to de-escalate broad-spectrum empiric therapy following pathogen confirmation in order to minimize resistance development."

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SOURCE Decision Resources Group