Next-Generation Antibiotics Are Underutilized For Gram-Negative Infections

(CTN News) – There has been an increase in the use of older, generic antibiotics for treating gram-negative infections, despite the approval of next-generation antibiotics for treating gram-negative infections,

As revealed in a study published in the Annals of Internal Medicine on April 19, to coincide with the annual Internal Medicine Meeting, which was held in Boston from April 18 to 20 by the American College of Physicians.

According to a scientific study conducted by Jeffrey R. Strich, M.D., from the National Institutes of Health in Bethesda, Maryland, and colleagues, a retrospective cohort study of 619 U.S. hospitals examined use patterns of recently approved gram-negative antibiotics by the Food and Drug Administration.

In this study, factors associated with their preferential use over traditional generic agents in patients who were suffering from gram-negative infections caused by pathogens displaying difficult-to-treat resistance (DTR) were identified.

In the period between quarters 1 and 2 of 2021, the researchers found that ceftolozane-tazobactam (approved in 2014) and ceftazidime-avibactam (approved in 2015) dominated new antibiotic usage, whereas the number of gram-negative that were subsequently approved was relatively low.

In the overall analysis of gram-negative infection hospitalizations, DTR pathogens were detected in 0.7 percent of the cases. A total of 41.5 percent of DTR episodes involved the use of traditional antibiotics, including polymyxins, aminoglycosides, and tigecycline as reserve antibiotics.

The remaining 79.3 percent included ceftriaxone or other ethionamide antibiotics.

The adjusted probability of receiving newer versus traditional for DTR infections was greater for patients with bacteremia and chronic diseases than for patients with do-not-resuscitate status, acute liver failure, and other nonpseudomonal nonfermenter pathogens such as Acinetobacter baumannii complex and other nonfermenter pathogens.

The authors of the study write that, “there is a stark imbalance between the availability of new antibiotics and unmet needs in the field of pathogen research.” These findings open the door for paradigm-changing measures to be implemented to address these problems.

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