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Although U.S. regulators approved several new antibiotics for combating hard-to-treat bacteria during a recent five-year period, hospital doctors instead gave older, generic remedies to more than 40% of patients battling those stubborn pathogens, according to a new analysis.

Moreover, 80% of the time these older antibiotics were already known to be highly toxic or ineffective, according to the analysis. And one-third of the hospitals where data were collected never used any of the new antibiotics. Notably, those hospitals tended to be smaller institutions located in rural areas or in urban settings where there was a low rate of antibiotic resistance. And cost may also be an issue.

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“There is an urgent need to understand why clinicians at hospitals with access to newer agents do not always prefer newer agents,” the researchers wrote in the Annals of Internal Medicine. They examined data spanning January 2016 through June 2021 at 619 U.S. hospitals and then tracked usage of seven antibiotics that were approved by the Food and Drug Administration between 2014 and 2019.

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