Hospital-Treated Gram-Negative Infections – Current Treatment – Detailed, Expanded Analysis (EU)

Due to rising antibiotic resistance rates, powerful antibiotics historically reserved for later lines of therapy are becoming standard-of-care treatment for gram-negative infections (GNIs), particularly those acquired in healthcare facilities (e.g., hospitals, nursing homes, long-term care facilities). Rising antimicrobial resistance rates have created an urgent need for new therapies with activity against multidrug-resistant gram-negative pathogens. As a result, commercial opportunities remain, particularly in the hospital setting, for emerging brands demonstrating clinical efficacy in patients with resistant infections, and especially those associated with high rates of mortality. Our Current Treatment content provides deep insights drawn from a survey of 255 physicians (i.e., hospital-based infectious diseases specialists and critical care specialists), regarding how GNI inpatients are being treated in the United States today and factors behind those treatment decisions.

Table of contents

  • Hospital-Treated Gram-Negative Infections - Current Treatment - Detailed, Expanded Analysis (EU)
    • Physician Prescribing Practices
      • Key Findings
      • Patient Characteristics
        • UTIs, cIAIs, and NP Among Hospitalized Patients Are Commonly Due to GNPs
        • Percentage of Hospitalized Patients with Bacterial Infections Due to a Documented GNP by Indication
        • Percentage of Hospitalized Patients with Bacterial Infections Due to a Documented GNP by Pathogen and Indication
        • Percentage of GNI Inpatients with Infections Due to Drug-Resistant E. Coli
        • Percentage of GNI Inpatients with Infections Due to Drug-Resistant Klebsiella spp
        • Percentage of GNI Inpatients with Infections Due to Drug-Resistant Pseudomonas spp
        • Percentage of GNI Inpatients with Infections Due to Drug-Resistant Acinetobacter spp
        • Percentage of GNI Patients Who Are Unsuccessfully Treated in the Outpatient Setting and Consequently Admitted to Hospital
      • Treatment Practices
        • Empiric Therapy Is a Key Driver in the Hospital-Treated GNIs Market
        • Rapid Initiation of Appropriate Antibiotic Therapy Is Crucial in the Management of Hospital-Treated GNIs
        • Majority of Empirically Treated GNI Inpatients Are Successfully Treated
        • Percentage of Inpatients Prescribed Empiric Therapy to Cover GNPs in the Past 12 Months by Country and Indication
        • Percentage of Inpatients Treated Successfully with Empiric Therapy for GNPs in the Past 12 Months by Country and Indication
        • Well-Entrenched, Generic Antibiotics Will Continue to Dominate the GNI Market
        • Patient Share for Hospitalized GN-UTI by Drug Class
        • Patient Share for Hospitalized GN-NP by Drug Class
        • Patient Share for Hospitalized GN-cIAI by Drug Class
        • Patient Share for Hospitalized GN-UTI by Antibiotic
        • Patient Share for Hospitalized GN-NP by Antibiotic
        • Patient Share for Hospitalized GN-cIAI by Antibiotic
        • Duration of Therapy for Hospital-Treated GNIs Varies by Indication, Severity of Infection, and Choice of Antibiotic
        • Mean Days of Therapy Typically Required Prior to Discharge or Stopping Antibiotic Treatment by Indication
        • Nonpharmacological Approaches Are Complementary to Antibiotic Therapy in the Treatment of Hospitalized GNI Patients
        • Clinical Response and Antibiotic Cost Influence Line of Therapy Choice
        • Market Opportunity Exists for Later-Line Antibiotics with Benefits in Safety and Efficacy
        • Percentage of GNI Inpatients Treated with Second- and Third-Line Therapy
        • GNI Inpatients Failing Initial Treatment Are Promptly Moved to Other Lines of Therapy
        • Treatment Failure Rates Among GN-UTI Inpatients
        • Treatment Failure Rates Among GN-NP Inpatients
        • Treatment Failure Rates Among GN-cIAI Inpatients
        • Treatment Failure Rates Among GN-UTI Inpatients by Country and Specialty
        • Treatment Failure Rates Among GN-NP Inpatients by Country and Specialty
        • Treatment Failure Rates Among GN-cIAI Inpatients by Country and Specialty
        • Treatment Discontinuation Rates for Select Antibiotics
        • Treatment Discontinuation Rates for Select Antibiotics by Country
        • Branded Antibiotics Are Most Prescribed as Third-Line Therapy
        • Most Prescribed Antibiotics for GN-UTI Inpatients by Line of Therapy
        • Most Prescribed First-Line Antibiotics for GN-UTI Inpatients by Country and Specialty
        • Most Prescribed Second-Line Antibiotics for GN-UTI Inpatients by Country and Specialty
        • Most Prescribed Third-Line Antibiotics for GN-UTI Inpatients by Country and Specialty
        • Most Prescribed Antibiotics for GN-NP Inpatients by Line of Therapy
        • Most Prescribed First-Line Antibiotics for GN-NP Inpatients by Country and Specialty
        • Most Prescribed Second-Line Antibiotics for GN-NP Inpatients by Country and Specialty
        • Most Prescribed Third-Line Antibiotics for GN-NP Inpatients by Country and Specialty
        • Most Prescribed Antibiotics for GN-cIAI Inpatients by Line of Therapy
        • Most Prescribed First-Line Antibiotics for GN-cIAI Inpatients by Country and Specialty
        • Most Prescribed Second-Line Antibiotics for GN-cIAI Inpatients by Country and Specialty
        • Most Prescribed Third-Line Antibiotics for GN-cIAI Inpatients by Country and Specialty
        • Combination Therapy Is Commonly Prescribed for GNI Inpatients
        • Percentage of GNI Inpatients Treated with Monotherapy or Combination Therapy by Country and Indication
      • Persistency and Compliance
        • Persistency and Compliance Rates Are High Among GNI Inpatients
      • Sequencing of Treatment
        • Piperacillin/Tazobactam and Carbapenems Precede Tygacil or Zerbaxa Treatment
        • Most Common Previous Drug Treatment for GNI Inpatients Who Have Initiated Tygacil
        • Most Common Previous Drug Treatment for GNI Inpatients Who Have Initiated Zerbaxa
      • Recent/Anticipated Changes in Brand Usage/Treatment Approach
        • Branded Antibiotics Will Continue to Gain Uptake in the Next 12 Months
        • Change in Overall Use of Select Antibiotics in the Past and Next 12 Months for Hospital-Treated GNIs
        • Change in Overall Use of Select Antibiotics in the Past 12 Months for Hospital-Treated GNIs by Country
        • Anticipated Change in Overall Use of Select Antibiotics in the Next 12 Months for Hospital-Treated GNIs by Country
    • Physician Insight on Medical Practice
      • Key Findings
      • Drivers of Treatment Selection
        • Efficacy and Cost Drive Treatment Selection for GNI Inpatients
        • Information in Research Publications Greatly Impacts Prescribing Decisions
        • Most Influential Sources of Information on Prescribers' Selection of Antibiotic Treatment
        • Efficacy Against Drug-Resistant GNPs Is a Top Driver of Branded Antibiotic Prescribing
        • Most Important Driving Factor for Prescribing of Select Antibiotics for GNIs
        • Cost and Concern About Antimicrobial Resistance Limit Prescribing
        • Most Important Limiting Factors for Prescribing of Select Antibiotics for GNIs
        • Patients Switch Therapy to Optimize Clinical Success
        • Drivers of Treatment Switching for Select Antibiotics
        • Treatment Discontinuation Occurs Following Clinical Cure
        • Treatment Deferral Is Not an Option for GNI Inpatients
      • Face-to-Face Product Detailing Effectiveness
        • Representatives Have Little Impact on Prescribing Despite High Physician Satisfaction
        • Zinforo, Zevtera, and Zerbaxa Show Similar Distribution of Sales Representative Visits
        • Sales Representative Access to Physicians in Clinical Settings by Country
        • Sales Representative Contact Within the Last 12 Months by Antibiotic Brand
        • Physicians Are Satisfied with Representatives for All Branded Products Probed
        • Recently Detailed Physiciansu2019 Satisfaction with Sales Representatives
        • Product Safety/Tolerability and Use for Resistant GNIs Are Common Topics of Discussion
        • Topics Discussed During the Most Recent Detail for Select Antibiotic Brands
    • Appendix
      • Primary Market Research
        • Percentage of Hospitalized UTI Patients: Complicated vs. Uncomplicated UTI
        • Percentage of Bacterial Pneumonia Patients Segmented by Type of Pneumonia
        • Percentage of Inpatients Prescribed Empiric Therapy to Cover GNPs by Indication
        • Percentage of Hospitalized GNI Patients with Infections Due to Select Drug-Resistant GNPs
        • Most Prescribed Therapies for GN-UTI Inpatients by Line of Therapy
        • Percentage of Physicians Who Use Select Antibiotics to Treat GNI Inpatients
        • Most Prescribed Therapies for GN-NP Inpatients by Line of Therapy
        • Most Prescribed Therapies for GN-cIAI Inpatients by Line of Therapy
        • Patient Share for Hospitalized GN-cSSSI by Drug Class
        • Percentage of Physicians Who Do Not Use Select Antibiotics for GN-UTI Inpatients
        • Percentage of Physicians Who Do Not Use Select Antibiotics for GN-NP Inpatients
        • Percentage of Physicians Who Do Not Use Select Antibiotics for GN-cIAI Inpatients
        • Factors Among Top Three Drivers for Prescribing of Select Antibiotics for GNIs
        • Factors Among Top Three Constrainers for Prescribing of Select Antibiotics for GNIs
        • Agents Among Top Three Previous Drug Treatments for GNI Inpatients Who Have Initiated Tygacil
        • Agents Among Top Three Previous Drug Treatment for GNI Inpatients Who Have Initiated Zerbaxa
        • Sources of Information Among Top Three Most Influential To Prescribing Choice