Hospital Anti-Infectives Insight Series

December 2009

Hospital Anti-Infectives Insight Series: Skin and Skin Structure Infections (Europe)

Report Authors
Lisa Arias
Danielle L. Drayton, Ph.D.

Introduction:

Skin and skin structure infections (SSSIs) are one of the most common antibiotic-treated infections in the hospital and encompass a variety of infection types including uncomplicated and severe infections. Currently, the European SSSI market is crowded with generic agents such as early-generation penicillins and cephalosporins, but resistance to many of these agents is driving the need for newer antibiotics to treat SSSIs. In particular, the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections and other resistant pathogens in SSSIs is especially concerning, given their association with higher hospitalization costs and poorer outcomes compared with nonresistant infections. We surveyed European infectious disease specialists to evaluate the drivers of prescribing for SSSIs for current and emerging antibiotics in the hospital setting. We also asked them for their insight into the current and future challenges associated with treating SSSIs in Europe.

Questions Answered in This Report:

  *   Patient population: SSSIs affect a diverse population of patients in the five major European markets: France, Germany, Italy, Spain, and the United Kingdom. What percentage of SSSI patients are treated in hospitals of various sizes in Europe? From where do patients originate and to where are they discharged? What comorbid conditions characterize the SSSI patient population in Europe? What percentage of SSSI patients require an ICU stay in Europe? What percentage of patients receive empiric versus targeted antibiotic therapy for SSSIs? Which pathogens are most commonly identified in SSSI patients in Europe?

  *   Prescribers: A variety of physicians treat patients with SSSIs in Europe. Which specialties are responsible for treating SSSI patients in Europe? Who are the leading prescribers for SSSIs in different lines of therapy? Which specialties prescribe empiric and targeted therapy for SSSIs in Europe? What are the top antibiotics prescribed by different specialties for SSSIs?

  *   Products and treatment patterns: A broad range of antibiotics are used to treat SSSIs, including agents with broad- and narrow-spectrum activity. How are specific antibiotics used in empiric and targeted therapy in SSSIs in Europe? What percentage of antibiotics are prescribed for different lines of therapy? What are the leading products prescribed for SSSIs in Europe? What are the main drivers of prescribing for key products in SSSIs? What are the most important drawbacks of key products used in SSSIs? Which drug attributes influence European infectious diseases specialists in their selection of an antibiotic regimen for SSSIs?

  *   Forecast: Several antibiotics are in late-stage development and will affect the future SSSI market. How will emerging therapies be used in Europe in the treatment of SSSIs? What are the current patient shares of antibiotics prescribed in SSSIs, and how will these shares change in the next five years? Against which products will emerging products primarily compete? How will the generic launch of key products impact future prescribing in Europe? What changes in prescribing trends for SSSIs 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 125 European infectious disease specialists, we examine the use of antibiotics in SSSIs, including the following:

- Analysis of the use of products by treatment intent, line of therapy, and prescribing physician.

- Prescribing behavior for the top specialties prescribing antibiotics for SSSIs.

- 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 European 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 SSSIs.

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