Arlington Medical Resources (AMR) finds that surveyed clinicians cite extended-spectrum beta-lactamase (ESBL)-producing E. coli and K. pneumoniae as the most concerning resistant pathogens in hospital-acquired gram-negative infections.

These pathogens are resistant to commonly prescribed first-line antibiotics (e.g., penicillins, cephalosporins), and physicians must tailor therapy accordingly when managing these infections.

"With increasing antibiotic resistance among key gram-negative pathogens, beta-lactam/beta-lactamase inhibitors and carbapenems are used for their potent broad-spectrum activity against gram-negative pathogens, including resistant strains," said Lisa Arias, analyst.

Physicians have several agents to choose from when prescribing empiric therapy for suspected gram-negative infections, but Pfizer’s Zosyn is one of the leading agents prescribed for these infections. This beta-lactam/beta-lactamase inhibitor has experienced widespread success in the hospital setting owing to its broad-spectrum activity, coverage of Pseudomonas, and physician familiarity with it.

The new report entitled Hospital Anti-Infectives Insight Series: Gram-Negative Infections also finds that based on the increases in resistance rates among gram-negative infections, surveyed infectious disease specialists foresee several important changes in their prescribing patterns in the next five years. They anticipate increasing their prescribing of newer antibiotics such as Johnson & Johnson’s Doribax and Pfizer’s Tygacil, in addition to the other currently available carbapenems and the older agent colistin.

Specialists also indicated that they would reduce their use of quinolones. These findings highlight specialists’ concern regarding the need to increase prescribing of reserved agents to treat pathogens that are developing resistance to commonly used first- and even second-line agents.

Source: AMR