US doctors cut back on unnecessary prescriptions for antibiotics in the 1990s, an encouraging finding that suggests that campaigns to curb overuse of antibiotics seem to be successful. However, when doctors do choose a drug, they are now more likely to use more broad-spectrum antibiotics, which could prove problematic in the future.
Thanks to campaigns during the last decade, doctors are being more careful about prescribing antibiotics for common ailments. However, when they do, they are turning to more expensive treatments, increasing fears of bacteria becoming resistant to broad-spectrum antibiotics. This could reduce the effectiveness of such drugs when they are needed to treat more serious infections.
US research published by the Annals of Internal Medicine found that overall visits involving an antibiotic prescription dropped from 13% to 10% for adult visits and from 33% to 22% of children's visits. In that time, broad-spectrum agents increased from 24% to 48% of antibiotic prescriptions in adults and from 23% to 40% in children.
These broad-spectrum drugs include: azithromycin, for example Pfizer's Zithromax; clarithromycin, Abbott's Biaxin; quinolones, such as Bayer's Cipro; and amoxicillin-clavulanate, GlaxoSmithKline's Augmentin. The average wholesale price for such drugs in 1999 was over $50 for an adult seven-day course, compared with around $5 per seven-day course for narrow-spectrum drugs with generic competitors.
Broad-spectrum antibiotics are effective against types of bacteria that cannot be treated by other, narrow-spectrum antibiotics. These types of bacteria most often cause problems in severe, complicated infections, and are much less likely to be a problem in respiratory tract infections treated in the community. More needs to be done to persuade doctors not to over prescribe broad-spectrum antibiotics, concludes the study.
Datamonitor predicts resistance will become a key issue for all of the currently marketed drug classes by 2010. The reduction in prescriptions of generic antibiotics and the subsequent increased reliance on broad-spectrum antibiotics creates an opportunity for novel classes to capture market share.
In the long term, the shift towards broad-spectrum therapy is likely to be reversed, especially in the hospital setting. The increasing importance of resistant varieties of bacteria will necessitate more focused antibacterial therapy. As such, regulatory bodies are likely to impose greater restrictions on product indications. Companies will need to adapt their pricing and positioning strategies to meet the new challenges of such stricter regulations.
Related research: Datamonitor, "Strategic Perspectives: The Hospital Antibacterial Market" (DMHC1801)
You can download a FREE healthcare report from www.dmfreereports.com