Forgotten antibiotics: an inventory in Europe, the United States, Canada, and AustraliaArchived
While the discovery of antibiotics revolutionised the way we treat patients with bacterial infections, bacteria have become increasingly resistant to antibiotics, mostly due to the misuse of these medicines.
Pulcini C, Bush K, Craig WA, Frimodt-Møller N, Grayson ML, Mouton JW, Turnidge J, Harbarth S, Gyssens IC; ESCMID Study Group for Antibiotic Policies, Clin Infect Dis. 2012 Jan;54(2):268-274.While the discovery of antibiotics revolutionised the way we treat patients with bacterial infections, bacteria have become increasingly resistant to antibiotics, mostly due to the misuse of these medicines. As a consequence, options for treatment of patients infected with multidrug-resistant bacteria are limited to either last-line antibiotics or older antibiotics that were developed several decades ago. These older antibiotics, however, are not always available. The situation is worsened by the fact that only few new antibacterial agents currently are in the pharmaceutical development pipeline.
To assess the availability of selected, potentially useful, older antibiotics, the authors performed a survey in 38 countries, including 35 European countries (26 EU Member States, 4 candidate countries, 3 potential candidate countries and 2 EFTA countries), as well as the United States, Canada and Australia.
From a list of 33 older antibiotics, the authors identified 31 potentially useful systemic antibiotics with activity on resistant bacteria. Most these antibiotics were not available in many countries. For example, 22 of the 33 selected antibiotics were marketed in fewer than 20 of the 38 countries in the survey. Another finding was that the lack of economic sustainability was the primary motive for a company to discontinue marketing of an older antibiotic.
ECDC comment: This is the first comprehensive study assessing the availability of older antibiotics with activity against multidrug-resistant bacteria. While additional efforts are still needed on the prudent use of antibiotics and to improve infection control practices, this study underscores the importance of considering making these potentially useful, older antibiotics available for use in all countries to increase the number of options for appropriate patient therapy and as an additional measure to fight antimicrobial resistance.
