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市場調査レポート
尿路感染症の耐性率増加が新薬・既存薬にもたらす機会
Stakeholder Opinions: Urinary Tract Infections Growing resistance rates bring opportunities for both new and old drugs
| 発行 |
Datamonitor |
| 出版日 |
2009年04月 |
商品コード |
85286 |
| ページ情報 |
英文 126 pages |
| 価格 |
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Abstract
Introduction
Urinary tract infections (UTIs) include infections of the kidneys, ureters,
and bladder. Escherichia coli is the major UTI pathogen, with emerging
extended-spectrum beta-lactamase (ESBL)-producing strains proving particularly
difficult to treat. Bacterial resistance to the most commonly used UTI drugs
is growing, highlighting the unmet need and opportunity for novel therapies.
Scope of this research
- Disease background, segmentation and epidemiology of UTIs in the US, Japan
and five major European countries
- Overview of unmet needs, current clinical practice, guidelines and
adherence
- Discussion of trends in incidence of major pathogens and therapies as well
as resistance rates
- Outline of diagnosis, treatment and referral patterns
Research and analysis highlights
UTIs are a major driver of ambulatory care utilization. US statistics point to
more than 10 million visits to ambulatory care settings for UTIs per year.
From 1995 to 2006, the incidence of cystitis and UTI in unspecified sites in
the US increased by 10.7%.
Bacterial resistance is the most important factor affecting UTI treatment
options and varies both nationally and locally. Resistance rates as low as 10%
are deemed to be of concern with regards to efficacy of empiric therapy.
Levels of resistance to some older drugs may reach 40-50% in some areas,
rendering these drugs ineffective.
Two old drugs, nitrofurantoin and fosfomycin, have remarkably favorable
resistance profiles and good efficacy for the treatment of cystitis, and
therefore may provide highly useful future treatment options. Given these
compounds' age, they are not widely prescribed, requiring physician education
to improve familiarity and improve their uptake.
Key reasons to purchase this research
- Learn about the significance of UTIs as a an indication for antibacterial
compounds
- Understand and capitalize on clinical unmet needs in the market through
new product development in therapy and diagnosis
- Discover optimal ways to communicate with physicians by supporting efforts
to address gaps in diagnosis, treatment and guideline adherence
Table of Contents
EXECUTIVE SUMMARY
- Scope of the analysis
- Datamonitor insight into the urinary tract infections market
- Contributing experts
- Related reports
- Upcoming related reports
EPIDEMIOLOGY AND DISEASE BACKGROUND
- Etiology and symptoms
- Types of urinary tract infections
- Complicated and uncomplicated urinary tract infections
- Pathogens
- Risk groups
- Epidemiological trends
- 150 million estimated cases of urinary tract infection worldwide each
year
- US
- Europe
- UK
- Germany
- France
- Italy
- No incidence data have been published for Japan or Spain
- Economic burden of urinary tract infections
- US expenditure on urinary tract infection up by 30% between 1994 and 2000
PRESENTATION, DIAGNOSIS AND REFERRAL OPTIONS
- Overview
- Presentation
- Diagnosis
- Urine culture is the gold standard in the diagnosis, although most
physicians rely on the presence of risk factors and/or dipstick testing
- Guidelines for the diagnosis and management of urinary tract infections
are targeted at physicians across the seven major markets
- Physicians have different perceptions of the level of bacteriuria that
is clinically significant
- Cost and time to results limits the use of urine culture to complicated
urinary tract infection cases only
- Referral
- Primary care physicians treat most urinary tract infections, although a
referral may be made in complicated or recurrent cases
- Suggestion of complicated urinary tract infection or an underlying
urologic problem typically lead to hospitalization
- Nosocomial urinary tract infections are treated by the attending
physician
- US organizations are working to educate both patients and physicians on
urinary tract infections
CURRENT TREATMENT OPTIONS AND TRENDS
- Market overview
- Treatment guidelines
- Treatment options
- Penicillins
- Fluoroquinolones
- Trimethoprim products
- Carbapenems
- Older drugs
- FDA notification of tendinitis and tendon rupture risk for
fluoroquinolones
- Resistance of bacterial pathogens to urinary tract infection therapies
- Growing levels of bacterial resistance have rendered a number of leading
urinary tract infection drugs ineffective in many regions
- Increasing fluoroquinolone resistance threatens effectiveness of
therapies and future treatment choices
- Susceptibility and resistance data suggests more prominent future roles
for nitrofurantoin and fosfomycin
- Emerging pathogens
- Treatment choice
- Efficacy against pathogens is highly influential in treatment choice for
urinary tract infections, although safety and cost also play a role
- Treatment by site of infection
UNMET NEEDS AND NEW DEVELOPMENTS
- Recently approved therapies and drugs in development for urinary tract
infections
- New drug approvals for uncomplicated urinary tract infections have been
sparse over the past 5 years as the impact of generics grows
- Pipeline drugs in late-stage development
- Unmet needs and future developments
- Treatment satisfaction
- Unmet needs in the diagnosis of urinary tract infections
- Unmet needs in the treatment of urinary tract infections
- Future developments
- Researchers at UCLA are developing point-of-care technology for the
detection of urinary tract bacterial pathogens
- US researchers have recently suggested strategies for developing new
virulence-targeted urinary tract infection therapies
BIBLIOGRAPHY
- Journal papers
- Websites
- Other
APPENDIX A
APPENDIX B
TABLES
- Table: Pathogens responsible for urinary tract infections in the community
and hospital setting
- Table: Pathogens isolated most frequently among community outpatients with
a urinary tract infection in Brescia, Italy, 2002 - 05
- Table: Pathogens isolated from urine of patients with a
catheter-associated urinary tract infection in Brescia, Italy, 2002 - 05
- Table: Pathogens most frequently isolated among hospital inpatients with a
urinary tract infection in Brescia, Italy
- Table: Estimated number of visits to physicians for UTI in the US, 2000
- Table: Number of physician visits for urinary tract infection (site not
specified) in the US, 1995 - 2006
- Table: Number of physician visits for cystitis and other disorders of the
bladder in the US, 1995 - 2006
- Table: Number of physician visits for urinary tract infection (site not
specified) and cystitis and other bladder disorders in the US, 1995 - 2006
- Table: Annual incidence of urinary tract infection in the UK
- Table: US expenditure on urinary tract infection, 1994 - 2000
- Table: Expenditure on female and male urinary tract infection in the US
and share of costs by site of service, 2000
- Table: Average annual spending and use of outpatient prescription drugs
for treatment of UTI (male and female), 1996 - 98
- Table: Volume sales (standard units, 000s) for drugs used to treat urinary
tract infections (UTIs) in the US and five major EU markets, 2007
- Table: Value sales ($000s) for drugs used to treat urinary tract
infections (UTIs) in the US and five major EU markets, 2007
- Table: Aminopenicillin susceptibility results for Escherichia coli
isolates in the five major EU markets, 2002 - 07
- Table: Fluoroquinolone susceptibility results for Escherichia coli
isolates in the five major EU markets, 2002 - 07
- Table: Third generation cephalosporin susceptibility results for E. coli
isolates in the five major EU markets, 2002 - 07
- Table: Resistance rates of outpatient Escherichia coli isolates to urinary
tract infection drugs in the US and Canada, April 2003 - June 2004
- Table: Antimicrobial resistance of Escherichia coli isolates from women
with community and hospital acquired urinary tract infections in Rennes, France
- Table: Antimicrobial susceptibility of Escherichia coli in 15 laboratories
across nine regions in Spain, March - July 2002
- Table: Antimicrobial resistance rates of Escherichia coli isolates in 15
laboratories across nine regions in Spain, February - June 2006
FIGURES
- Figure: US expenditure on urinary tract infection (UTI), 1994 - 2000
- Figure: Volume sales (standard units, 000s) for drugs used to treat
urinary tract infections (UTIs) in the US and five major EU markets, 2007
- Figure: Value sales ($000s) for drugs used to treat urinary tract
infections (UTIs) in the US and five major EU markets, 2007
- Figure: Aminopenicillin susceptibility results for Escherichia coli
isolates in the five major EU markets, 2002 - 07
- Figure: Fluoroquinolone susceptibility results for Escherichia coli
isolates in the five major EU markets, 2002 - 07
- Figure: Third generation cephalosporin susceptibility results for E. coli
isolates in the five major EU markets, 2002 - 07
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