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U.S. task force unveils coordinated government plan to combat antimicrobial resistance

An interagency task force has mapped the government's response to the rising threat of antimicrobial resistance (AR), including implementation of "appropriate" antibiotic use policies. "Unless AR problems are detected as they emerge—and actions are taken quickly to contain them—the world may be soon faced with previously treatable diseases that have again become untreatable, as in the pre-antibiotic era," said the federal panel in releasing a 44-page public health action plan.

That pre-antibiotic era ended in the 1940s with the widespread availability of penicillin and the discovery of streptomycin. But scientists and clinicians fear it may be returning with several microbes rapidly becoming drug-resistant, such as those that cause pneumonia, ear infections, and meningitis (e.g., Streptococcus pneumoniae); skin, bone, lung, and bloodstream infections (e.g., Staphylococcus aureus); food-borne infections (e.g., Escherichia coli); and infections transmitted in health-care settings (e.g., enterococci and Klebsiella).

The four major components of the plan—surveillance, prevention and control, research, and product development—are broken down into 84 action items. Thirteen considered "essential" to addressing the problem were assigned the highest priority. The plan will be implemented incrementally as resources become available. The overall goal is to:

• Develop and implement a coordinated national plan for AR surveillance

• Ensure availability of reliable drug susceptibility data for surveillance

• Monitor patterns of antimicrobial drug use

• Monitor AR in agricultural settings to ensure a safe food supply

Concerning appropriate prescription drug use, the task force plans a public health education program as a national priority. Inappropriate prescribing will be targeted by developing clinical guidelines and computer-assisted decision support. The hope is to extend the useful life of antimicrobial Rxs. Research is needed to determine if variations in regimens foster or reduce AR emergence and spread, the report said. The relationship between prescribing behavior and marketing practices for specific antibiotics also will be evaluated.

"Infection control in health settings will be enhanced by developing new interventions based on rapid diagnosis, improved understanding of factors that promote cross-infection, and modified medical devices or procedures that reduce the risk of infection," the report continued. New classes of antibiotics are needed to kill resistant organisms, and so are new vaccines and anti-infective devices. The report said financial or investment incentives may be needed to spur development of the new products.

Michael F. Conlan

 

Mike Conlan. U.S. task force unveils government plan to combat antimicrobial resistance. Drug Topics 2001;3:16.