Valuing antibiotics: The role of the hospital clinician.

Autor: Masterton RG; Academy of Infection Management (AIM) Ltd., BioHub at Alderley Park, Alderley Edge, Cheshire SK10 4TG, UK. Electronic address: rgmasterton@aiminfection.org., Bassetti M; Infectious Diseases Clinic, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy., Chastre J; Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France., MacDonald AG; Scottish Medicines Consortium, UK., Rello J; Department of Critical Care, Vall d'Hebron Institut of Research, Centro de Investigacion Biomedica en Red (CIBERES), Barcelona, Spain., Seaton RA; Department of Infectious Diseases, NHS Greater Glasgow and Clyde, and Scottish Antimicrobial Prescribing Group, UK., Welte T; Department of Respiratory Medicine and German Center for Lung Research, Hannover Medical School, Hannover, Germany., Wilcox MH; Department of Microbiology, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK., West P; Academy of Infection Management (AIM) Ltd., BioHub at Alderley Park, Alderley Edge, Cheshire SK10 4TG, UK.
Jazyk: angličtina
Zdroj: International journal of antimicrobial agents [Int J Antimicrob Agents] 2019 Jul; Vol. 54 (1), pp. 16-22. Date of Electronic Publication: 2019 May 11.
DOI: 10.1016/j.ijantimicag.2019.05.012
Abstrakt: The global public health threat of antibiotic-resistant infections as well as the lack of new treatments in clinical development is a critical issue. Reasons for this include diminished commercial incentives for pharmaceutical companies to develop new antibiotics, which part-reflects a shift in antibiotic marketing paradigm from broad deployment to targeted therapy in relatively small patient populations. Such changes are encouraged by antimicrobial stewardship (AMS). Other factors include a lack of recognition in the traditional assessment of new antibiotics by regulators, health technology assessors and payers of the broad range of benefits of new agents, particularly their value to health care, economies and society. Recognising the seriousness of the situation, there have been recent changes and proposals by regulators for modification of the assessment process to accommodate a broader range of acceptable data supporting new drug applications. There is also increasing recognition by some payers of the societal benefit of new antibiotics and the need for financial incentives for those developing high-priority antibiotics. However, progress is slow, with recent publications focusing on industry and strategic perspectives rather than clinical implications. In this opinion piece, we therefore focus on clinicians and the practical steps they can take to drive and contribute to increasing awareness and understanding of the value of antibiotics. This includes identifying and gathering appropriate alternative data sources, educating on AMS and prescribing habits, and contributing to international antibiotic susceptibility surveillance models.
(Copyright © 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.)
Databáze: MEDLINE
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