Introduction:
Urinary tract infections (UTIs) are one of the most common
hospital-treated indications in the antibiotic market and often can be acquired
in the nosocomial setting. These infections range in severity, and, although
uncomplicated infections are fairly straightforward to treat, complicated
infections and infections with resistant pathogens are a greater treatment
challenge. The majority of UTIs are associated with gram-negative pathogens,
especially
Escherichia coli; thus, treatment relies on empiric therapy
to cover the most commonly identified pathogens. However, because of the
availability of diagnostic tools that allow for relatively rapid confirmation
of infection and identification of the pathogen, therapy for UTIs can be
adjusted and targeted more quickly than in other indications. The UTI market is
marked by a large patient population and widespread use of generic agents, but
there is still opportunity for new agents to exhibit utility against resistant
pathogens and the ability to shorten hospital stays. We surveyed infectious
disease specialists to evaluate the drivers of prescribing for UTIs 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 UTIs.
Questions Answered in This Report:
*
Patient population: UTIs affect a diverse population of
patients, and infections range in severity.
What percentage of UTI patients
are treated in hospitals of various sizes? From where do patients originate and
to where are they discharged? What comorbid conditions characterize the UTI
patient population? What percentage of UTI patients receives empiric versus
targeted antibiotic therapy? Which pathogens are most commonly identified in
UTI patients?
*
Prescribers: A variety of physicians treat patients with
UTIs in the hospital.
Which specialties are responsible for treating UTIs in
the hospital? Who are the leading prescribers in different types of hospitals?
For what percentage of UTI patients and antibiotic courses are different
specialties responsible? Which specialties prescribe monotherapy and
combination therapy in UTIs?
*
Products and treatment patterns: A broad range of
antibiotics are used to treat UTIs, 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 is
prescribed for different lines of therapy? What are the leading products
prescribed for UTIs? Which drug attributes influence physicians in their
selection of an antibiotic regimen for UTIs? Which antibiotics are prescribed
for UTI patients upon hospital discharge?
*
Forecast: Several antibiotics are in late-stage
development or have recently launched and will affect the future UTI market.
What
are the unmet needs in treating UTIs? How will emerging therapies be used in
the treatment of UTIs? What are the current patient shares of antibiotics in
UTIs, 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 UTIs 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 UTIs, 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 UTIs.
Patient comorbidities, hospitalization outcomes, 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 UTIs.