Survey Reveals ID Specialists' Therapy Choice for Treatment of Gram-Negative Infections

Decision Resources, a research and advisory firm for pharmaceutical and healthcare issues, finds that the majority (65 percent) of surveyed U.S. infectious disease specialists chose Mercks Primaxin/Tienam (imipenem/cilastatin) as the most efficacious therapy for the treatment of gram-negative infections, when compared to other currently available therapies. The overall clinical success rate of Primaxin/Tienam in treating intra-abdominal infections, its overall bacteriological eradication rate and its overall clinical success rate in treating hospital-acquired pneumonia and complicated urinary tract infections were among the key attributes that surveyed infectious disease specialists indicated as their reason for choosing this therapy as the most efficacious treatment for gram-negative infections.

The DecisionBase 2011 report, "Gram-Negative Infections: Poor Efficacy Against Drug-Resistant Pathogens Leaves Door Open for Emerging Therapies," finds that, in contrast to surveyed infectious disease specialists, the majority (60 percent) of surveyed hospital pharmacy directors (who sit on their hospitals pharmacy and therapeutics committee) consider the markets sales leading therapy, piperacillin/tazobactam (Pfizers Zosyn/Tazocin, generics), to be the most efficacious treatment for gram-negative infections. Accordingly, satisfaction scores for piperacillin/tazobactam among pharmacy directors are higher than those among infectious disease specialists for all efficacy parameters surveyed.

"However, both infectious disease specialists and pharmacy directors indicate lower levels of satisfaction with piperacillin/tazobactams activity against Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacteriaceae," says Decision Resources analyst Charu Vepari, PhD. "This difference could be a result of increasing multidrug-resistant Pseudomonas aeruginosa strains and the rising number of ESBL-copies in Enterobacteriaceae, which render piperacillin/tazobactam less effective in patients with infection due to these drug-resistant pathogens."

The report also finds that surveyed infectious disease specialists and hospital pharmacy directors agree that a drugs activity against Pseudomonas aeruginosa is one of the attributes that most influences their decisions regarding prescribing and formulary inclusion, respectively, for the treatment of gram-negative infections. Clinical data and the opinions of interviewed thought leaders indicate that AstraZeneca/Forest Laboratories CAZ-104 and Cubists CXA-201 may have advantages over sales-leading piperacillin/tazobactam on this attribute.

Additionally, according to surveyed infectious disease specialists and hospital pharmacy directors, a drug with activity against multidrug-resistant Pseudomonas aeruginosa is one of the greatest unmet needs in the treatment of gram-negative infections. Clinical data and the opinions of interviewed thought leaders indicate that CXA-201 and CAZ-104 have demonstrated the potential to significantly fulfill this unmet need.

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