New US strategy on antimicrobial resistance launched

22 September 2014

America is making official moves to take action against the rising threat of antibiotic resistance.

A Presidential Executive Order states that the Federal Government will work nationally and internationally to implement measure ‘that reduce the emergence and spread of antibiotic-resistant bacteria and help ensure the continued availability of effective therapeutics for the treatment of bacterial infections’. The order is accompanied by a new National Strategy for Combating Antibiotic Resistant Bacteria, which is built around five goals:

  1. Slow the emergence of resistant bacteria and prevent the spread of resistant infections.
  2. Strengthen national ‘one-health’ surveillance efforts to combat resistance across medical and veterinary public health including food and environmental surveillance.
  3. Advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria.
  4. Accelerate basic and applied research and development for new antibiotics, other therapeutics, and vaccines.
  5. Improve international collaboration and capacities for antibiotic resistance prevention, surveillance, control, and antibiotic research and development.

The new order and strategy accompany a new report from the President’s Council of Advisors on Science and Technology (PCAST); Combating Antibiotic Resistance delivers a stern warning on the perils of antibiotic resistance, citing an estimated domestic impact of antibiotic-resistant infections of $20 billion in direct health care costs alone. The report notes that many modern medical procedures including including surgery and cancer chemotherapy rely heavily on effective antibiotics for safety and calls for urgent actions to improve stewardship (maximising the length of time for which current antibiotics will continue to be effective) alongside efforts to develop novel antibiotics and vaccines. Stewardship includes the careful use of existing antibiotics and prompt recognition and control of the spread of resistance.

Chillingly, but accurately, the report observes that ‘no permanent victory is possible’ since pathogens will evolve novel resistance mechanisms against new control measures: as new treatments are developed, organisms will evolve new ways to become resistant.

America’s new official stance is in line with that of the UK, for whom tackling antibiotic resistance is a major health service (and funding) priority, and of the World Health Organization who are in the process of developing a global action plan on the issue.

Genomics is an important element in the fight against antibiotic resistance, most recently demonstrated by the emerging capacity for rapid and precise identification of resistant bacterial strains, as well as understanding genomic features that support resistance and could be targeted by drugs. There has also been news that analysis of the human microbiome can lead to the discovery of new antibiotics.

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