Following the recent publication of the GRAM report, it is now beyond dispute that antibiotic resistance is one of the world’s leading causes of death, responsible for at least 1.2 million deaths worldwide each year. It is also increasingly apparent that the current market does not adequately incentivise companies to make essential drugs.

Dr David Jenkins, President of the British Society for Antimicrobial Chemotherapy, said: “Gram negative bacteria already has caused outbreaks across a number of UK hospitals where, in many cases, ceftazidime-avibactam and cefiderocol are the only effective treatments.

“BSAC, therefore, welcomes the NHS de-linkage scheme, while hoping it will operate across the UK, not just England.

“Having been involved in the economic modelling for this scheme, BSAC also recognises the difficulty of predicting how new antibiotics will be used in clinical practice.

“The phase three trials required by regulatory authorities focus on only a small range of infections. But in practice, antibiotics are used for a wide range of infections even though evidence of effectiveness in these conditions is lacking.

“To better understand the range of conditions in which these drugs are likely to provide patient benefit, BSAC has commissioned the University of Aberdeen to host a registry (United Kingdom Antimicrobial Registry – UKAR) to record the use of recently licenced antimicrobials, including ceftazidime-avibactam and cefiderocol.

“UKAR will support the evaluation of the de-linkage scheme and provide a basis for considering extension of the scheme to other antimicrobials.

“In addition, we must remember that while the de-linkage scheme represents important progress, pulling through new antibiotics is only one solution to a complex problem.

“We also need rapid diagnostic tests to ensure antibiotics are only prescribed when necessary, as well as innovative hospital designs that support good infection prevention practice to limit the spread of resistant bacteria. These sections of the national AMR strategy must also be supported with appropriate levels of funding.”

See the NICE draft guidance for Ceftazidime with avibactam & Cefiderocol