Stakeholder Opinions: Skin and soft tissue infections
| Product Code | DAT15189 |
| Publication Date | July 2009 |
| Publisher | Datamonitor |
| Product Type | Report |
| Pages | 94 |
| ISBN Number | not applicable |
Stakeholder Opinions: Skin and soft tissue infections
Introduction
Treatment of skin and skin structure infections often requires systemic antibacterial therapy. Two trends are concerning physicians: the spread of methicillin-resistant Staphylococcus aureus (MRSA), particularly community-acquired strains (CA-MRSA) have become the most important pathogen in the US; and a slow but measurably declining susceptibility to vancomycin by these bacteria.
Scope
- Epidemiological trends and economic impact of key pathogens
- Overview of diagnosis and referral patterns
- Analysis of present and future unmet needs with outline of key drugs in development for SSTIs
- Outline of drivers of treatment choice in both the hospital and the community setting
Highlights
Guideline adoption for skin and soft tissue infections (SSTIs) among specialists is fairly strong, but less so among primary care physicians (PCPs). PCPs treat mild-to-moderate forms of disease, representing an estimated 70% of SSTI patients, while specialists treat severe SSTI sufferers (30%).
Resistance is the single most important factor affecting the SSTI drug market, in both the community and hospital settings. Vancomycin has traditionally been viewed as the most effective treatment option for SSTIs caused by MRSA, although bacterial resistance to the drug is emerging and it is becoming less effective for the treatment of SSTIs.
A highly valuable new SSTI drug should possess a number of important characteristics, including strong bactericidal activity against MRSA, VISA, and H-VISA strains, a good toxicity and side effect profile, cost-effectiveness, good tissue penetration for systemic use, superior efficacy versus vancomycin, and broad spectrum coverage.
Reasons to Purchase
- Identify key opportunities that will impact the use and uptake of new and existing products
- Understand the critical issues that drive prescription choice in skin and soft tissue infections
- Learn about the difference between key antibacterial drug attributes relevant to hospital and community-based physicians
Contents
- ABOUT DATAMONITOR HEALTHCARE
- About the Infectious Diseases and Respiratory pharmaceutical analysis team
- CHAPTER 1 EXECUTIVE SUMMARY
- Scope of the analysis
- Datamonitor insight into the skin and soft tissue infections market
- Contributing experts
- Related reports
- Upcoming related reports
- CHAPTER 2 EPIDEMIOLOGY AND DISEASE BACKGROUND
- Etiology and symptoms
- Types of skin and soft tissue infections
- Cellulitis
- Erysipelas
- Erythrasma
- Folliculitis and skin abscesses
- Impetigo
- Furunculosis
- Lymphadenitis
- Lymphangitis
- Necrotizing skin infections
- Staphylococcal scalded skin syndrome
- Complicated and uncomplicated skin and soft tissue infections
- Recurrent skin and soft tissue infections
- Pathogens
- Staphylococcus and Streptococcus bacterial species are the main SSTI pathogens in both the community and hospital settings
- Staphylococcus aureus
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Risk groups
- General risk factors for SSTIs
- Epidemiological trends
- SSTIs are a major driver for ambulatory care utilization
- US
- Increasing incidence of SSTIs in the US may be driven by CA-MRSA
- Incidence of MRSA is lower in Japan compared to the US and Europe
- Europe
- Economic burden of skin and soft tissue infections
- CHAPTER 3 PRESENTATION, DIAGNOSIS AND REFERRAL OPTIONS
- Overview
- Presentation
- Diagnosis
- Diagnosis of skin and soft tissue infections is commonly based purely on clinical impression
- Guidelines for the diagnosis and management of skin and soft tissues infections are sparse across the seven major markets
- Laboratory tests used in the diagnosis of skin and soft tissue infections
- Tissue swab with bacterial culture
- Blood cultures
- Needle aspiration
- X-rays and ultrasound
- Computed tomography (CT) and magnetic resonance imaging (MRI) scans
- Gram stain
- Referral
- Primary care physicians treat most skin and soft tissue infections, although a referral may be made in more severe cases
- Reasons for hospital admission for SSTIs
- Mild-to-moderate nosocomial skin and soft tissue infections are treated by the attending physician
- Unmet needs and future developments in the diagnosis of skin and soft tissue infections
- Cepheid has developed a rapid molecular diagnostic test for SSTIs caused by MRSA and methicillin-susceptible S. aureus
- CHAPTER 4 CURRENT TREATMENT OPTIONS AND TRENDS
- Market overview
- Treatment guidelines
- Guideline adherence for SSTIs is strong among specialists, but poor among primary care physicians
- Treatment options
- Current skin and soft tissue infection therapies
- Levofloxacin
- Ciprofloxacin
- Moxifloxacin
- Imipenem and cilastatin
- Clindamycin
- Daptomycin
- Linezolid
- Tigecycline
- Cefazolin
- Cefalexin
- Vancomycin
- Piperacillin/tazobactam
- Quinupristin/dalfopristin
- Resistance issues for skin and soft tissue infections
- Resistance issues are growing for bacterial skin and soft tissue infections caused by staphylococci and streptococci
- Studies and key opinion leaders acknowledge that vancomycin is becoming less effective at treating SSTIs caused by MRSA
- Emerging pathogens
- Community-acquired methicillin-resistant Staphylococcus aureus is the most dangerous emerging pathogen for skin and soft tissue infections
- Treatment choice
- Efficacy against pathogens is highly influential in treatment choice for skin and soft tissue infections, although safety and cost also play a role
- CHAPTER 5 UNMET NEEDS AND NEW DEVELOPMENTS
- Unmet needs and future developments
- Gaining regulatory approval represents a significant challenge for pharmaceutical companies developing drugs for the treatment of skin and soft tissue infections
- The different characteristics of therapies can all contribute to the uptake of new antibacterial drugs for SSTIs
- Treatment satisfaction
- Variation in resistance patterns may be highly influential in the levels of skin and soft tissue infection treatment satisfaction expressed by physicians
- Unmet needs in the treatment of skin and soft tissue infections
- Despite the availability of efficacious therapies and a busy pipeline, increasing resistance highlights the need for novel skin and soft tissue infection drugs
- Key pipeline drugs in development for skin and soft tissue infections
- Telavancin
- Ceftobiprole
- Oritavancin
- Ceftaroline
- Iclaprim
- Torezolid
- Dalbavancin
- Radezolid (RX-1741)
- Delafloxacin (RX-331)
- Razupenem (PZ-601)
- BIBLIOGRAPHY
- Journal papers
- Websites
- APPENDIX A
- Contributing experts
- APPENDIX B
- About Datamonitor
- About Datamonitor Healthcare
- About the Infectious Diseases and Respiratory pharmaceutical analysis team
- Disclaimer
- Table 1: Occurrence of pathogens causing skin and soft tissue infections in North America, Europe, Latin America, and Asia-Pacific region, 1999-2004
- Table 2: Occurrence of pathogens responsible for causing skin and soft tissue infections in the US and Canada, 1997-2000
- Table 3: Etiologic risk factors for skin and soft tissue infections and their associated bacterial causes
- Table 4: Drug susceptibilities of methicillin-susceptible Staphylococcus aureus isolated from SSTI outpatients across the US, France, Germany, Italy, and Spain, 2001
- Table 5: Drug susceptibilities of methicillin-resistant Staphylococcus aureus isolated from SSTI outpatients across the US, France, Germany, Italy, and Spain, 2001
- Table 6: Drug susceptibilities of methicillin-susceptible Staphylococcus aureus isolated from SSTI inpatients and intensive care unit patients across the US, France, Germany, Italy, and Spain, 2001
- Table 7: Drug susceptibilities of methicillin-resistant Staphylococcus aureus isolated from SSTI inpatients and intensive care unit patients across the US, France, Germany, Italy, and Spain, 2001
- Table 8: Drug susceptibilities of Streptococcus pyogenes isolated from SSTI inpatients and intensive care unit patients across the US, France, Germany, Italy, and Spain, 2001
- Table 9: Vancomycin susceptibility results for Staphylococcus aureus isolates across the five major EU markets, 2001-06
- Table 10: Importance of different characteristics of drugs in treatment choice in both the community and hospital settings