Short CommunicationForgotten antibiotics: a follow-up inventory study in Europe, the USA, Canada and Australia☆
Introduction
Bacterial resistance has become an international priority, clearly identified as a global threat to humanity and modern medicine [1]. Innovation, access to existing and new antibiotics, and responsible use must all be pursued simultaneously [2], [3].
In 2011, the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Antibiotic Policies (ESGAP) performed a study which showed that 22 of 33 old but potentially useful antibiotics were marketed in fewer than 20 of the 38 included countries in Europe, the USA, Canada and Australia; economic motives were the major cause for absence of marketing of these antibiotics [4]. This follow-up study, conducted in collaboration with the international network Action on Antibiotic Resistance (ReAct), provides an update of the 2011 data regarding marketavailability of these selected antibiotics in Europe, the USA, Canada and Australia.
Section snippets
Selection of potentially useful antibiotics for assessing market availability
We started from the list used in the 2011 survey and applied the same inclusion criteria. Systemic antibiotics were selected for their potential value against current resistant bacteria and/or for their unique value for specific criteria, as detailed previously [4]. We added three antibiotics to the 2011 survey list: ticarcillin/clavulanic acid (for its value in infections due to Stenotrophomonas maltophilia); ampicillin/sulbactam (for its value in infections due to Acinetobacter baumannii);
Main results
In all, 39 of the 40 invited countries participated in this survey. The number of available antibiotics differed considerably from one drug to another (Fig. 1) and also from one country to another (e.g. 7 antibiotics available in Estonia, 24 in France) (Fig. 2; Appendix B). Of the 36 selected antibiotics, 25 were marketed in 20 or fewer countries (Fig. 1). Detailed data are available in Appendix C, and the sources of information provided by national contacts are listed in Appendix D. Some
Discussion
Overall, the situation regarding the availability of old antibiotics has not improved in Europe, the USA, Canada and Australia, with even fewer antibiotics available now compared with 2011 [4]. The underlying reasons seem mainly economic in addition to lack of awareness and priority among health authorities. Several national contacts also reported severe and sustained shortages of old antibiotics in their countries, compromising patients' access to treatment. Furthermore, the efforts of
Acknowledgements
The authors are grateful to Oliver-James Dyar for help with language editing, and to Nathalie Thilly for help with the statistical analysis.
Funding: None.
Competing interests: None declared.
Ethical approval: Not required.
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Cited by (0)
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This work was presented as a poster at the 26th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), 9–12 April 2016, Amsterdam, The Netherlands.
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ESGAP-ReAct Working Group on Old Antibiotics: Bojana Beovic, Golubinka Bosevska, Marcel Bruch, Karen Bush, Otto Cars, Lidija Cizmovic, Nick Daneman, Béatrice Demoré, Aleksander Deptuła, Uga Dumpis, Aoife Fleming, Niels Frimodt-Mǿller, Helen Giamarellou, Ljiljana Gojkovic-Bukarica, Thorolfur Gudnason, Inge Gyssens, Hakan Hanberger, Stephan Harbarth, Arjan Harxhi, Todor Kantardjiev, Doubravka Kostalova, Vladimir Krcmery, Katrin Kurvits, Endre Ludwig, Outi Lyytikäinen, Alasdair MacGowan, Simone Mohrs, Síle O'Connor, Leonardo Pagani, George L. Petrikkos, Gabriel Adrian Popescu, Céline Pulcini, Lul Raka, José Ramón Paño Pardo, Liliana Cristina Ramos Dias, Hege Salvesen-Blix, Gunnar Skov Simonsen, Evelina Tacconelli, Ursula Theuretzbacher, John Turnidge, Rolanda Valintėlienė, Vera Vlahović-Palčevski, Peter Zarb and Helena Zemlickova.