About My Health Careers Internship MedBlogs Contact us

Physicians Delay Prescribing New Antibiotics For Superbugs

by Ramya Rachamanti on August 26, 2019 at 4:00 PM
Font : A-A+

Physicians Delay Prescribing New Antibiotics For Superbugs

Novel, efficacious antibiotics are prescribed in only about a quarter of infections caused by carbapenem-resistant Enterobacteriaceae (CRE), according to an analysis done by infectious disease and pharmaceutical scientists at the University of Pittsburgh School of Medicine which is published in the journal Open Forum Infectious Diseases.

The study also examined behavioral and economic factors, to see if the trend can be reversed before lackluster sales lead the pharmaceutical industry to stop developing much-needed antibiotics.


"The infectious diseases community spent the past decade saying, 'We need new antibiotics, this is a top priority,' and now we're at risk of sounding like the boy who cried wolf," said lead author Cornelius J. Clancy, M.D., associate professor of medicine and director of the mycology program and XDR Pathogen Laboratory in Pitt's Division of Infectious Diseases. "We have a responsibility to learn why it takes so long for antibiotics to be adopted into practice and figure out what we need to do to ensure the best antibiotics quickly reach the patients who desperately need them."

The U.S. Centers for Disease Control and Prevention has classified CRE as urgent threat pathogens and calls them the "nightmare bacteria." The World Health Organization and Infectious Disease Society of America have designated CRE as highest priority pathogens for development of new antibiotics. At the time of those declarations, polymyxins were the first-line antibiotics against CRE, even though they failed to work in about half the cases and carried a significant risk of damaging the kidneys.

Since 2015, five antibiotics against CRE have gained U.S. Food and Drug Administration (FDA) approval: ceftazidime-avibactam, meropenem-vaborbactam, plazomicin, eravacycline and imipenem-relebactam. Studies, including those conducted at UPMC, have shown that the first three of these antibiotics are significantly more effective at fighting CRE and less toxic than polymyxins (eravacycline and imipenem-relebactam are still too new for conclusive data).

Clancy and his colleagues surveyed hospital-based pharmacists in the U.S. to gauge their knowledge of the new antibiotics and their willingness to use them. The drugs were classified as the "first-line" choice against CRE blood infections by 90% of the pharmacists, pneumonia by 87%, intra-abdominal infections by 83% and urinary tract infections by 56%.

"Clearly hospital-based pharmacists are aware of these antibiotics and believe they are the best choice for the vast majority of CRE infections," said Clancy.

But when the team estimated the number of CRE infections nationwide and used national prescription data to calculate the proportions of old vs. new antibiotics used to treat those infections, they found that from February 2018 through January 2019, the new antibiotics were used only about 23% of the time.

Their use likely started to exceed that of polymyxins only in December 2018, nearly four years after the first of the new antibiotics was approved by the FDA. Even after accounting for CRE infections in which new antibiotics might not be first-choice agents, the team found that use was only about 35% of what was expected based on positioning by hospital-based pharmacists.

Allergan and The Medicines Company, developers of two of the new antibiotics, have sought to exit the antimicrobial field since introducing their drugs because of insufficient returns on investment. Achaogen declared bankruptcy months after attaining FDA approval for a third new antibiotic.

The researchers suggest several reasons for the slow uptake of the new antibiotics, starting with cost. A 14-day course of the new antibiotics costs between $13,230 and $15,070, compared to $305 to $784 for the old drugs.

"Cost is a limitation, but I'm not convinced it is the sole cause of our findings," said Clancy. "Clinicians may not be prescribing the new drugs due to concerns about accelerating antibiotic-resistance or because initial studies on their effectiveness were relatively small. We need to get at the root causes of the disconnect between what the doctors prescribe and what the pharmacists we surveyed believe they should be prescribing, and then find a solution."

Source: Eurekalert

News A-Z
News Category
What's New on Medindia
January is the Thyroid Awareness Month in 2022
Menstrual Disorders
Coffee May Help You Fight Endometrial Cancer
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
MRSA - The Super Bug Antibiotics Eye Infections Natural Antibiotics to Fight Bacterial Infections Vancomycin-Resistant Enterococci (VRE) Boils - Treatment by Drugs Multiple Drug Allergy Syndrome Interaction of Antibiotics with Dairy Products Antibiotic Resistance - An Emerging Global Crisis 

Recommended Reading
Antibiotics are among the most used and abused medications. This article explains some general ......
Antibiotic Resistance - An Emerging Global Crisis
Antibiotic resistance refers to the adaption of bacteria that allows them to grow even in the presen...
Boils - Treatment by Drugs
Diabetes patients have reduced immunity, which makes them more susceptible to skin infections like b...
Eye Infections
Eye infection is a common problem that often causes pain and discomfort to the eyes. Common symptoms...
Interaction of Antibiotics with Dairy Products
Antibiotics like tetracyclines and fluoroquinolones used in the treatment of bacterial infections in...
MRSA - The Super Bug
MRSA infection is the most dreaded hospital or community acquired infection that can become ......
Multiple Drug Allergy Syndrome
Multiple drug allergy syndrome or multiple drug hypersensitivity syndrome is a condition that causes...
Natural Antibiotics to Fight Bacterial Infections
Fighting infections the natural way and preventing them is always more effective than consuming medi...
Vancomycin-Resistant Enterococci (VRE)
Enterococci are a group of gram-negative bacteria that mostly inhabit the human gut. At present ther...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2022

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use
open close
I have read and I do accept terms of use - Telemedicine

Advantage Medindia: FREE subscription for 'Personalised Health & Wellness website with consultation' (Value Rs.300/-)