Introduction:
Osteomyelitis is a complex indication in the antibiotic
market because it can be caused by a number of preceding or underlying
conditions such as a prosthetic device or diabetic foot infection affecting the
bone. Osteomyelitis is characterized by prolonged antibiotic treatment that
typically continues long after hospital discharge, often with a parenteral
antibiotic. It is also marked by controversy regarding diagnosis and treatment
strategies; successful therapeutic tissue penetration and eradication of the
infection within the bone are difficult to achieve. Troubling pathogens such as
methicillin-resistant Staphylococcus aureus (MRSA) pose challenges to
treatment; the long treatment duration requires effective antibiotic therapy
with minimal propensity for resistance and excellent safety. The lengthy
treatment and the importance of postdischarge management suggest that agents
that can be administered easily in the outpatient setting (e.g., agents with an
oral formulation, once-daily dosing, low propensity to introduce resistant
strains into the community) and have the appropriate pathogen coverage will
succeed in the osteomyelitis market. We surveyed infectious disease specialists
to evaluate the drivers of prescribing for osteomyelitis among current and
emerging antibiotics in the hospital setting. We also asked them for their
insights into the current and future challenges associated with treating
osteomyelitis both in the hospital and in the outpatient setting.
Questions Answered in This Report:
*
Patient population: Osteomyelitis affects a diverse
population of patients, and infections come from different sources.
What
percentage of osteomyelitis patients fall into different categories (e.g.,
patients requiring surgical debridement, patients receiving MRSA coverage,
patients presenting with osteomyelitis due to a prosthetic device)? What
percentage of osteomyelitis patients are treated in hospitals of various sizes?
From where do patients originate and to where are they discharged? What
comorbid conditions characterize the osteomyelitis patient population? What
percentage of patients receive empiric versus targeted antibiotic therapy for
osteomyelitis?
*
Prescribers: A variety of physicians treat patients with
osteomyelitis in the hospital and outpatient settings.
Which specialties are
responsible for treating osteomyelitis in the hospital and which manage
outpatient treatment? Who are the leading prescribers in different types of
hospitals? For what percentage of osteomyelitis patients and antibiotic courses
are different specialties responsible? Which specialties prescribe monotherapy
and combination therapy?
*
Products and treatment patterns: A broad range of
antibiotics are used to treat osteomyelitis, including agents with broad- and
narrow-spectrum activity.
How are specific antibiotics used in empiric and
targeted therapy and against key pathogens? What percentage of antibiotics are
prescribed for different lines of therapy? What are the leading products
prescribed for osteomyelitis in the hospital? Which drug attributes influence
physicians in their selection of an antibiotic regimen for osteomyelitis? What are
the primary reasons physicians choose certain products for outpatient treatment
of osteomyelitis?
*
Forecast: Several antibiotics are in late-stage
development or recently launched and will affect the future osteomyelitis
market.
How will emerging therapies be used in the treatment of
osteomyelitis? What are the current patient shares of antibiotics in
osteomyelitis, and how will these shares change in the next five years? Against
which products will the emerging products primarily compete? What changes in
prescribing trends for osteomyelitis do infectious disease specialists surveyed
foresee?Scope:
Using clinical audit data from the Arlington Medical
Resources, Inc., (AMR) Hospital Antibiotic Market Guide (HAMG), as well
as insight from surveys of more than 100 infectious disease specialists, we
examine the use of antibiotics in osteomyelitis, including the following:
- Analysis of the use of products by indication, treatment
intent, line of therapy, and prescribing physician.
- Prescribing behavior for the top specialties prescribing
antibiotics for osteomyelitis, both in the hospital and in the outpatient
setting.
- Patient comorbidities, hospitalization outcomes, distribution
of infection types, settings in which treatment occurs, pathogen distribution,
and average duration of inpatient and outpatient therapy.
We analyze the current marketplace and examine prescribing
drivers of the infectious disease specialists surveyed, their reasons for
prescribing key products, unmet needs, and their receptivity to emerging
antibiotics that may be of potential use in osteomyelitis.