Study evaluates use of new antibiotics in US hospitals

An evaluation of knowledge from US hospitals discovered that ceftolozane-tazobactam and ceftazidime-avibactam are probably the most often used new antibiotics, researchers reported this week in Open Discussion board Infectious Illnesses.

Utilizing knowledge from the PINC-AI database, researchers from the College of Maryland carried out a retrospective cohort research of discharges from 832 hospitals from June 2022 by way of Could 2023. The goal of the research was to explain the usage of new gram-negative antibiotics—which proof suggests have been underused—in a latest interval, perceive the scientific indications for which of those antibiotics are used, and evaluate the traits of sufferers handled with the brand new antibiotics towards these handled with piperacillin-tazobactam, a extensively used older gram-negative antibiotic.

Newer medication utilized in solely a fraction of recent admissions

Total, greater than 3.8 million admissions throughout 832 hospitals included an antibiotic prescription. New antibiotics had been prescribed in 9,768 admissions (0.25% of antibiotic-prescribing admissions) throughout 537 hospitals, whereas piperacillin-tazobactam was prescribed in 731,719 admissions (18.8%) and colistin in 570 (0.01%).

Use of recent antibiotics was clustered amongst a small subset of hospitals, with 10 hospitals accounting for 25% of new-antibiotic-associated admissions.

Ceftolozane-tazobactam was prescribed in 4,157 admissions (42.6%), ceftazidime-avibactam in 3,660 (37.5%), eravacycline in 1,213 (12.4%), cefiderocol in 1,060 (10.9%), meropenem-vaborbactam in 456 (4.7%), omadacycline in 104 (1.1%), and imipenem-relebactam in 99 (1.0%). Almost half (46%) of recent antibiotics had been began within the first 3 days of hospital admission, and 70% had been used as definitive remedy. Sepsis (76%), pneumonia (46%), and urinary tract an infection (39%) had been the most typical scientific indications. On common, sufferers handled with new antibiotics had eight extra comorbid circumstances and longer hospital stays (median 13 vs 6 days) than sufferers receiving piperacillin-tazobactam.

The authors say the discovering that new antibiotics are getting used extra often than polymyxins means that observe is lastly catching up with proof. However newer antibiotics are nonetheless being underused.

“Although new Gram-negative antibiotics aren’t used almost as often as workhorses like piperacillin-tazobactam, their use has largely surpassed much less efficient and extra poisonous antibiotics like colistin,” they wrote. “Nonetheless, the latest antibiotics, resembling cefiderocol, meropenem-vaborbactam, and imipenem-cilastatin-relebactam, stay uncommon in scientific observe.”