Zerbaxa's benefit in 5 Years

A New Alternative to Reducing Antibiotic Resistance

MSD superantibiotic Zerbaxa's benefit applied from October

After five years of domestic approval, the MSD super antibiotic "Zerbaxa (Ceftolozane/Tazobactam)" was registered.

 

It is expected to help reduce the recent surge in carbapenem antibiotic resistance.

 

MSD Korea held a press conference at the Koreana Hotel in Jung-gu, Seoul on the 27th to commemorate the registration of Zerbaxa, a multidrug-resistant antifungal antibiotic.

 

Zerbaxa is a combination of new cephalosporin-based antibiotics Ceftolozane and beta-lactam degrading enzyme inhibitors Tazobactam.

 

In response to the main resistance mechanism of pseudomonas aeruginosa, it has proven its activity in multidrug-resistant pseudomonas aeruginosa and ESBL-producing intestinal bacteria.

 

ESCMID and IDSA recommend Zerbaxa as the first treatment in severely infected patients who are difficult to treat due to carbapenem-resistant pseudomonas aeruginosa.

 

Antibiotic resistance has been an issue that has emerged worldwide for many years.

 

In 2016, the British government predicted that 700,000 people worldwide die of antibiotic-resistant bacteria every year and that the death would reach 10 million by 2050 unless special measures were taken.

 

In response, the World Health Organization (WHO) proposed an "Action Plan" in 2015 to prevent the occurrence and spread of resistant bacteria across borders and urged national countermeasures and international cooperation.

 

Korea is also not free from antibiotic resistance.

 

As the use of carbapenem, a wide range of antibiotics increased, the number of strain infections resistant to carbapenem antibiotics increased.

 

According to the Korea Centers for Disease Control and Prevention, 23,311 CRE infections were classified as second-class infectious diseases last year, up 28.7% from the previous year.

 

This year, 24,009 cases of infection were reported by October, already exceeding the number of infected people last year.

 

In particular, it is analyzed that the use of antibiotics increased during the COVID-19 epidemic, which did not have adequate treatments, encouraging resistance.

 

Choo Eun-joo, an infectious medicine professor at Soonchunhyang University Bucheon Hospital, who attended the meeting, said, "In the early 2000s, I didn't think much about carbapenem resistance.

 

However, resistance has increased to more than 80% in eight years, he said.

 

"In Korea, the problem of antibiotic resistance is likely to become more serious due to the rapid aging and the expansion of long-term care facilities." "Antibiotic resistance causes serious problems in that it limits the treatment options that can be selected," he explained.

 

Carbapenem is an antibiotic that was considered the last alternative in severely infected patients.

 

Before the Zerbaxa license, there was no antibiotic that could be replaced if carbapenem resistance occurred in Korea.

 

The American Society of Infectious Diseases presented various new antibiotics as alternative drugs, but Zerbaxa was the only drug in Korea that was approved and released.

 

However, Zerbaxa has been in a state of non-reimbursement for five years due to difficulties in economic evaluation.

 

This is because Zerbaxa was considered to be cost-effective because other antibiotics selected as alternative drugs were so inexpensive.

 

Usually, patients were not convinced that antibiotics were used as non-reimbursement, so Zerbaxa was rarely used in the field for five years.

 

During that period, the number of cases of CRE infection more than quadrupled from 5,717 to 24,000.

 

Professor Choo said, "Even if the effect of Zerbaxa was twice as high as before, the cost was more than 10 times different, so I had no choice but to use colistin, which came out 40 years ago, and this drug was less effective than a new antibiotic and had poor kidney function." Dramatically, as the government included antibacterial agents in the PE exemption list, there was an opportunity to register Zerbaxa's reimbursement.

 

Since October, Zerbaxa has been reimbursed in cases where carbapenem antibiotics have failed to treat complex intra-abdominal infections, complex urinary tract infections, and in-house infectious pneumonia, or if multidrug-resistant rust bacteria have been proven.

 

Professor Choo predicted that Zerbaxa's benefits will help reduce carbapenem resistance.

 

Choo said, "It is difficult to see a dramatic effect in a short period of time, but it will generally reduce cases of infection with Zerbaxa." Of course, Zerbaxa also poses a risk of developing resistant bacteria in the future if its usage increases.

 

No matter how severe a patient is, antibiotics should be used properly to create fewer resistant bacteria and receive other new treatments," Choo said.

 

"In particular, long-term care facilities increase, and antibiotics are frequently used without knowing what resistant bacteria are present.

 

The best way to reduce resistance is to use antibiotics well, Choo explained.