title: Forgotten antibiotics: a follow-up inventory study in Europe, the USA, Canada and Australia.
abstract: 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.
authors.affiliation: Service des maladies infectieuses et tropicales, Université de Lorraine Faculté de médecine, Centre hospitalier régional universitaire (CHRU) de Nancy, Nancy, France. Electronic address: celine.pulcini@univ-lorraine.fr.
authors.forename: Céline
authors.initials: C
authors.lastname: Pulcini
authors.affiliation: ReAct-Action on Antibiotic Resistance, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Simone
authors.initials: S
authors.lastname: Mohrs
authors.affiliation: University Medical Centre Ljubljana, Ljubljana, Slovenia.
authors.forename: Bojana
authors.initials: B
authors.lastname: Beovic
authors.affiliation: Department of Medicine, Radboud University Nijmegen Medical Centre, and Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; Hasselt University, Hasselt, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Gyssens
authors.affiliation: Center for Anti-Infective Agents, Vienna, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Theuretzbacher
authors.affiliation: ReAct-Action on Antibiotic Resistance, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Otto
authors.initials: O
authors.lastname: Cars
mesh_terms: D000900:Anti-Bacterial Agents / Q000600:supply & distribution*; D001315:Australia; D002170:Canada; D004864:Equipment and Supplies; D005060:Europe; D006801:Humans; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic stewardship; Bacterial resistance; Drug approval; Drug marketing