Introduction:
Intra-abdominal infections encompass a range of infections
that vary in severity and treatment-management strategies. Often, these
infections are contracted in the healthcare setting, though patients may
present with intra-abdominal infections from the community. Compared with other
types of hospital-based infections, intra-abdominal infections are more
commonly managed by surgeons. A variety of organisms are involved in these
infections, and therefore treatment for intra-abdominal infections is largely
empiric. Gram-negative and -positive aerobic bacteria and anaerobes are
commonly identified in intra-abdominal infections, including
Escherichia
coli,
Klebsiella pneumoniae,
Bacteroides, and
Enterococci.
Therefore, antibiotic therapy must target the most common pathogens to ensure
therapeutic success; agents with potent broad-spectrum activity and efficacy
against gram-negative and anaerobic organisms are preferred for intra-abdominal
infections. We surveyed infectious disease specialists to evaluate the drivers
of prescribing for intra-abdominal infections for current and emerging
antibiotics in the hospital setting. We also asked them for their insights into
the current and future challenges associated with treating intra-abdominal
infections.
Questions Answered in This Report:
*
Patient population: Intra-abdominal infections affect a diverse
population of patients, and infections come from different sources.
What
percentage of intra-abdominal infection patients are treated in hospitals of various
sizes? From where do patients originate and to where are they discharged? What
comorbid conditions characterize the intra-abdominal infection patient
population? What percentage of patients receive empiric versus targeted
antibiotic therapy for intra-abdominal infections? What are the most
challenging types of intra-abdominal infections to treat? Which pathogens are
identified in intra-abdominal infection patients?
*
Prescribers: A variety of physicians treat patients with
intra-abdominal infections in the hospital and outpatient settings.
Which
specialties are responsible for treating intra-abdominal infections in the
hospital? Who are the leading prescribers in different types of hospitals? For
what percentage of intra-abdominal infection 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 intra-abdominal infections, 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 intra-abdominal infections? Which drug attributes influence
physicians in their selection of an antibiotic regimen for intra-abdominal
infections?
*
Forecast: Several antibiotics are in late-stage development or
have recently launched and will affect the future intra-abdominal
infection market.
How will emerging therapies be used in the
treatment of intra-abdominal infections? What are the current patient shares of
antibiotics in intra-abdominal infections, 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 intra-abdominal
infections 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 intra-abdominal
infections, 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 intra-abdominal infections.
- Patient comorbidities, hospitalization outcomes, distribution
of infection types, settings in which treatment occurs, pathogen distribution,
and average duration of inpatient 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 intra-abdominal infections.