Doctors Tend to Use Older, Toxic Antibiotics to Treat Infections

A study by the National Institutes of Health (NIH) found that physicians, especially those in rural areas, are not utilizing next-generation antibiotics to treat antibiotic-resistant infections.

Each year, drug-resistant bacteria, or "superbugs," are responsible for more than 2.8 million antibiotic-resistant infections and 35,000 deaths in the United States.

To combat the rising prevalence of drug-resistant bacteria, the Food and Drug Administration (FDA) has approved several new next-generation antibiotics that are effective against gram-negative bacteria, which are often more challenging to eliminate. Most recently, the agency approved a novel antibiotic to treat three types of bacteria associated with severe infections.

However, a National Institutes of Health analysis of U.S. hospitals found that doctors tend to favor older generic antibiotics that are less effective than next-generation drugs when treating antibiotic-resistant bloodstream infections. These older medications are also more likely to have adverse side effects.

The study, published on April 19 in Annals of Internal Medicine, found that from 2016 to 2021, healthcare providers slowly increased their use of newer drugs, most often prescribing ceftolozane-tazobactam (Zerbaxa) and ceftazidime-avibactam (Avycaz). However, other next-gen antibiotics were underutilized. Moreover, one new drug — plazomicin (Zemdri) — was not used in any of the hospitals analyzed.

The scientists discovered that nearly 80% of drug-resistant gram-negative infections were treated with older, less safe, and effective antibiotics instead of the newer next-gen drugs.

Why are doctors underutilizing newer, more effective antibiotics?

According to NIH scientists, many of the hospitals analyzed in the retrospective cohort study were smaller facilities located in rural areas of the country. They found that clinicians and healthcare staff were hesitant to use next-generation antibiotics.

Moreover, the expense may be a factor, as newer antibiotics can cost around six times more than older generics.

The research team did find that newer "superbug"-fighting drugs are utilized more often at hospitals equipped with lab tests that allow doctors to determine which antibiotic is effective against the infection.

To address these barriers to next-gen antibiotic use, the scientists suggest that future public health and economic policies expand the availability of these lab tests and develop strategies to overcome cost and other contributing factors.

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