The rising rates of antimicrobial resistance have created an urgent need for antibiotics with activity against drug-resistant gram-negative pathogens (GNPs). Antibiotics such as carbapenems, which have historically been reserved for later lines of therapy, are being used earlier in treatment, placing additional pressure on the already-limited gram-negative infection (GNI) armamentarium. Despite the launch of antibiotics, such as Avycaz / Zavicefta, Zerbaxa, Vabomere, Xerava, and Zemdri, unmet need remains for additional effective treatments. Although the recent launches of Recarbrio and Fetroja will partially address this unmet need, commercial opportunities still exist for emerging therapies with efficacy in patients with drug-resistant infections, especially those infections that are associated with high rates of mortality. However, the market is heavily genericized, and cost-containment measures may limit commercial success.


  • What are the drivers and constraints in the hospital-treated (HT)-GNI therapy market, and how will the market evolve over the forecast period? How will rising antibiotic resistance rates and the entry of new generics shape the market?
  • How large are the different GNI indications? What are the resistance rates to different classes of antibiotics across several pathogen species?
  • How will different emerging therapies address current unmet needs? What emerging therapies do infectious disease specialists consider most promising, and where will these therapies be used?
  • On what attributes will emerging therapies need to improve to compete with currently marketed products? What challenges will they face?

Geographies: United States, France, Germany, Italy, Spain, United Kingdom, Japan

Primary Research: More than 20 country-specific interviews with thought-leading infectious disease specialists supported by survey data collected for this and other DRG research.

Epidemiology: Diagnosed events of GNIs segmented by key indications (nosocomial pneumonia, complicated skin and skin structure infections / surgical site infections, bloodstream infections, complicated intra-abdominal infections, urinary tract infections), pathogens (E.coli, Pseudomonas, Acinetobacter, Klebsiella), resistance, and country.

FORECAST: Ten-year, annualized, drug-level sales and patient share of key GNI therapies through 2029, segmented by brands / generics, geography, and five key indications.

Emerging Therapies: Phase III/PR: 7 drugs; Phase I/Phase II: 15 drugs; coverage of select preclinical products


Disease Landscape & Forecast provides comprehensive market intelligence with world-class epidemiology, keen insight into current treatment paradigms, in-depth pipeline assessments, and drug forecasts supported by detailed primary and secondary market research.

Table of contents

  • Hospital-Treated Gram-Negative Infections - Landscape & Forecast - Disease Landscape & Forecast

Author(s): Archita Kukreja; Joseph Granato, MPH

Archita is a member of Decision Resources Group’s Infectious, Niche, and Rare Diseases (INRD) team. In this role she works on a range of antibacterial and antiviral indications as well as numerous niche and rare diseases.

Archita holds a Masters in Science degree in biotechnology from Jamia Millia Islamia, New Delhi and has completed her MBA from Amity University, Noida.

Joseph Granato joined Decision Resources Group in 2012 and previously worked on both Market Access and Global Market Access products.  Joseph is currently responsible for forecasting the prevalence and incidence of disease populations throughout the world.  He is also tasked with identifying at risk populations and developing new epidemiological methods used to predict overall population health.

He received his M.P.H. from Des Moines University where he worked on several population health projects including the delivery of continuing medical education on tick-borne diseases.  He also holds a B.S. in Animal Science from the University of Tennessee.  Prior to his time with DRG Joseph worked with the Monroe County Health Department on the surveillance of reportable diseases including Dengue Fever.