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Less profitable antibiotics difficult to access

Monday May 15th, 2017

Less profitable antibiotics that are usually prescribed to treat common bacterial infections are becoming increasingly difficult to find, experts warn today.

This is creating “challenges” – especially when treating sick babies and children, according to Professor Céline Pulcini, of Nancy University Hospital and University of Lorraine, France.

She said doctors are increasingly turning to alternative antibiotic treatments that may encourage the growth of drug-resistant bacteria.

“These are drugs that have been available for many years but they are still effective for treating conditions such as skin infections, cystitis and sore throat. Some of them also have a role to play in tackling drug-resistant bacteria,” she said.

“However, their patents expired many years ago and drug manufacturers may see them as less attractive prospects to register, sell and market in countries around the world.”

Writing in a commentary in Clinical Microbiology and Infection, Prof Pulcini, who is also secretary of the European Society of Clinical Microbiology and Infectious Diseases’ (ESCMID) Study Group for Antibiotic Policies (ESGAP), said older drugs, such as penicillin are still on WHO’s Essential Medicine list and are effective for most infectious diseases.

However, when the older antibiotics are not available, patients need to be treated with alternative antibiotics that may be less effective and are sometimes more expensive.

The research team found that a lack of marketing of older antibiotics is primarily caused by the high costs involved in registering medicines in multiple countries.

Previous research in 38 countries showed that out of 33 older but effective antibiotics, 22 were marketed in fewer than 20 countries.

Prof Pulcini added: “There are additional challenges for treating babies and children. With these patients, doctors often need much smaller doses and different formulations, for example a liquid medicine rather than a tablet. In many cases, no paediatric formulation is available. Bacterial infections can be particularly dangerous for premature babies. But their medical teams may have to contend with adult-sized vials when only a fraction of the dose is needed.”

The authors said that organisations such as WHO and the European Commission had to ensure the availability of antibiotics.

“While it’s important that we continue to look for new effective antibiotics, we must put equal effort into ensuring that patients of all ages have access to existing effective treatments,” said Prof Pulcini.

“The availability of these essential medicines must be made a priority globally. International organisations, such as the WHO, should take the lead here, working with Member States to ensure sustainable global access to all essential antibiotics, in their optimal formulation, quality and cost, to everyone everywhere.

“If no action is taken we will lose these excellent and relatively cheap antibiotics that are needed on a daily basis to treat common bacterial infections worldwide. Instead, we will end up using less efficient antibiotics, leading to worse clinical outcomes for patients, and adding to the problem of antibiotic resistance.”

Pulcini C et al. Commentary: Ensuring universal access to older antibiotics: a critical but neglected priority. Clinical Microbiology and Infection 15 May 2017; doi:10.1016/j.cmi.2017.04.026

Tags: Europe | Pharmaceuticals | World Health

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