Mortality rates for difficult-to-treat resistant infections have not improved, even with newer antibiotics, a large US study found. These infections, resistant to key first-line drugs, are associated with significantly higher mortality.
The study analyzed over 8 million hospital encounters from 2016 to 2023. While the use of newer, resistant-pathogen-active antibiotics rose, 84% of patients in 2023 still received initial therapy not active against the infection. This treatment mismatch is a key concern, as delays worsen outcomes.
Researchers found no meaningful change in mortality over time for most resistant Gram-negative infections, including Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii. An exception was a modest decline in mortality for bloodstream infections caused by Pseudomonas aeruginosa, though this finding is based on a small number of cases.
The findings underscore a critical gap between antibiotic availability and effective use. Rapid pathogen and resistance identification, alongside improved diagnostic turnaround times and antimicrobial stewardship, may be as crucial as new drug development in reducing deaths.