US Antibiotic Resistance Solutions Initiative Emphasizes Infection Prevention

As antibiotic-resistant bacteria continue to endanger public health, greater attention from health officials and new US federal funding aimed at fighting superbugs signal a new urgency in this battle.

In late 2015, Congress approved a spending bill for 2016 which included a $160 million budget to support the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB) and the Antibiotic Resistance Solutions Initiative. The funding backs the Centers for Disease Control and Prevention’s (CDC) efforts with officials in the state, local, academic, healthcare, and veterinary sectors to combat antibiotic resistance. Now, the trick for these health agencies is coming up with solutions to fight superbugs faster than the pathogens can develop new drug resistance. Beth Bell, MD, MPH, director of the Center for Disease Control and Prevention’s National Center for Emerging and Zoonotic Infectious Diseases, recently appeared on CNBC’s “On the Money” to discuss the growing health crisis. “The superbugs are always changing and the more they change and the more antibiotics we use, the more dangerous the situation is,” explained Dr. Bell, noting the rise of hard-to-treat forms of Malaria, tuberculosis, HIV, pneumonia, and gonorrhea. “In other parts of the world, there are bacteria that are resistant to all known antibiotics, so this is really a frightening situation, and seriously one of the most infectious disease threats of our time.”

With the new funding from Congress, the CDC plans to distribute money to support health departments from all 50 states, the six largest local health departments, and Puerto Rico. The funds will help public health officials to better detect and respond to threats of superbugs in healthcare settings as well as communities, thus saving lives. According to the CDC, at least 2 million individuals in the United States battle antibiotic-resistant infections each year, and as a result more than 23,000 of these individuals die.

In the CNBC interview, Dr. Bell noted the integral role that antibiotics have played for patients going through chemotherapy, organ transplants, joint replacement, and C-sections. Stressing the importance of antibiotics, Dr. Bell stated, “The success of all of these sorts of innovations is really based on our ability to treat infections, so antibiotic resistance and the rise of superbugs really does put modern medicine at risk.” With an additional funding of $40 million toward fighting superbugs proposed for the 2017 fiscal year, Congress has shown its support for the long fight ahead to protect Americans and respond at all levels.

Key steps in the CARB plan include slowing the development and preventing the spread of drug-resistant bacteria, strengthening national surveillance efforts, advancing the development and use of rapid diagnostic tests to identify bacteria, accelerating research for new antibiotics, and improving international collaboration in the fight against antibiotic resistance. While better tracking, rapid detection, faster outbreak response, and improved patient care will prove key in the effort against superbugs, Dr. Bell noted that some 47 million unnecessary antibiotic prescriptions are given every year in the United States, a number that shows just how manmade this health crisis is. “Infection prevention is really at the foundation of preventing antibiotic resistance,” explained Dr. Bell. “Overuse and misuse of antibiotics, whether it be in healthcare with doctors or on the farm with animals, is the major driver of antibiotic resistance, and there are many strategies that we’re using in healthcare to improve antibiotic use, by making sure that doctors are prescribing antibiotics for the right conditions.”

Improving the use of antibiotic drugs through antibiotic stewardship will prove key to the success of the Antibiotic Resistance Solutions Initiative. Goals include cutting inappropriate prescribing practices by 50% in doctors’ offices and by 20% in hospitals, improving data on antibiotic use and trends to help us understand current prescribing practices, and implementing stewardship programs using CDC recommendations in hospitals, doctors’ offices, and nursing homes. With few new antibiotic drugs in the pipeline, along with the understanding that an aggressive offensive against superbugs would only fuel new resistance capabilities, Dr. Bell and health officials worldwide emphasized the role of prevention as the best line of defense against these dangerous infections.