Forgotten antibiotics: a follow-up inventory study in Europe, the USA, Canada and Australia

Céline Pulcini, Simone Mohrs, Bojana Beovic, Inge Gyssens, Ursula Theuretzbacher, Otto Cars, ReAct Working Group on Old Antibiotics the ESCMID Study Group for Antibiotic Policies, Bojana Beovic, Golubinka Bosevska, Marcel Bruch, Karen Bush, Otto Cars, Lidija Cizmovic, Nick Daneman, Béatrice Demoré, Aleksander Deptuła, Uga Dumpis, Aoife Fleming, Niels Frimodt-Mǿller, Helen Giamarellou, Ljiljana Gojkovic-Bukarica, Thorolfur Gudnason, Inge Gyssens, Hakan Hanberger, Stephan Harbarth, Arjan Harxhi, Todor Kantardjiev, Doubravka Kostalova, Vladimir Krcmery, Katrin Kurvits, Endre Ludwig, Outi Lyytikäinen, Alasdair MacGowan, Simone Mohrs, Síle O'Connor, Leonardo Pagani, George L. Petrikkos, Gabriel Adrian Popescu, Céline Pulcini, Lul Raka, José Ramón Paño Pardo, Liliana Cristina Ramos Dias, Hege Salvesen-Blix, Gunnar Skov Simonsen, Evelina Tacconelli, Ursula Theuretzbacher, John Turnidge, Rolanda Valintėlienė, Vera Vlahović-Palčevski, Peter Zarb, Helena Zemlickova

The objective of this study was to update a 2011 survey, conducted on behalf of the ESCMID Study Group for Antibiotic Policies (ESGAP), studying the availability of old but clinically useful antibiotics in North America, Europe and Australia. This follow-up survey was performed in 2015 in 40 countries among specialists from the pharmaceutical, infectious diseases and microbiology sectors in North America, Europe and Australia in order to assess the availability through usual marketing processes of 36 systemic antibiotics (addition of 3 antibiotics compared with the 2011 survey) selected for their ability to treat infections caused by resistant bacteria and their unique value for specific criteria. The questionnaire was sent by e-mail to national contacts belonging to ESGAP and ReAct networks. In all, 39 of the 40 countries participated in this survey. The number of available antibiotics differed considerably from one drug to another as well as from one country to another (e.g. 7 antibiotics available in Estonia, 24 in France). Overall, 25/36 selected antibiotics were marketed in 20/39 countries or less. From 2011 to 2015 (data available for both periods in 37 countries for 33 antibiotics), the number of available selected antibiotics increased in 13 countries and decreased in 17. In conclusion, despite the ongoing bacterial resistance crisis, the situation regarding the availability of 'forgotten antibiotics' has worsened since 2011. Urgent measures are needed to ensure better availability of these antibiotics on a global scale as a conservation measure to ensure sustainable and responsible use of antibiotics.