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Drug-Resistant Infections Rise and Antibiotics Decline

Ernie Shannon's picture

Drug-resistant infections are growing worldwide faster than medical laboratories can create new drugs to combat them, according to several organizations dedicated to beating infectious diseases. These organizations are calling for stepped up efforts to protect existing antibiotic drugs and the few under laboratory development at this time.

The Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society have combined their expertise in a new position paper calling on health care systems and policymakers to safeguard available antibiotics. The paper appears in the April issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

“Antibiotic stewardship is a critical component of providing quality care in any health setting,” said Dr. Neil Fishman, past president of SHEA and the position paper’s author. “Effective stewardship will improve, conserve limited resources and limit emergence of resistance.”

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The emergence of drug-resistant infections is of great concern to the medical community worldwide. In response, antimicrobial stewardship programs and interventions have been designed to help prescribers know when antibiotics are needed and what the best treatment choices are for a particular patient to help improve the use of drugs. For too long, researchers say, physicians have prescribed antibiotics at the slightest evidence of infection and over such a broad swath of the population that some infectious diseases have developed a resistance to the drugs.

For instance, just last week, scientists in Australia revealed that a strain of whooping cough is successfully evading a last-ditch drug used to treat patients and leaving children and adolescents at great risk. Consequently, cases of whooping in Australia and deaths from the infection are increasing.

“With few antibiotics in the pharmaceutical pipeline, we must take the necessary measures to preserve our current supply of antibiotics, and ensure that our children have access to these lifesaving medications,” said Christopher J. Harrison, chair of the Pediatric Infectious Diseases Society’s Clinical Affairs Committee.

In the face of these challenges, the paper outlines five steps the medical community can take to preserve the usefulness of antibiotics:
1) Incorporate antimicrobial resistance and antibiotic stewardship into the curriculum for healthcare professionals to ensure that practicing providers are knowledgeable in these areas.
2) Collect data on antimicrobial use in both inpatient and outpatient settings. These data are critical to monitor antibiotic use and its relationship to antibiotic resistance.
3) Monitor AS initiatives in ambulatory and outpatient healthcare settings. SHEA, IDSA and PIDS encourage federal agencies to fund pilot projects designed to develop and implement AS programs in these settings, including expanded use of electronic health records.
4) Require health settings to implement AS programs through regulatory mechanisms. The authors recommend that the Centers for Medicare and Medicaid (CMS) require participating healthcare institutions to develop and implement AS programs to help optimize the use of antibiotics.
5) Fill the knowledge gaps in our understanding of antibiotics resistance to increase our understanding of the transmission of resistance and assessing the impacting of clinical interventions.



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