National Action Plan Developed for Combating Antibiotic-Resistant Bacteria
Amesh A. Adalja, MD, FACP, FACEP, April 3, 2015
In an attempt to address the rising tide of antimicrobial resistance, the Obama administration released a national strategy and action plan to address what has become increasingly viewed as an ominous threat to human health. In the multifaceted program outlined, special attention is given to hospital-based initiatives, since hospitals are major sites of injudicious antibiotic use and drug-resistant nosocomial infections.
Stewardship Activities, Coalitions, Quantification
One overarching aim of the plan, primarily directed toward healthcare facilities, is to prevent antibiotic resistance by fostering better stewardship of antibiotics. As part of this objective, the plan calls for a review of existing regulations regarding antibiotic stewardship and possible proposal of new regulations in this area; the establishment of the National Healthcare Safety Network (NHSN) to track the number of facilities with stewardship programs; and the modification of conditions of participation in Medicare and Medicaid to include antimicrobial stewardship. These activities would be coupled with an education program designed to explain the benefits of stewardship to providers.
Recognizing that antibiotic-resistant organisms in a region affect multiple healthcare facilities, the strategy calls for expanding collaborative efforts among healthcare facilities to limit the spread of these organisms.
The plan also calls for developing the capacity to quantify both inpatient and outpatient antibiotic prescriptions with public reporting of state and regional data. Such data would provide a platform for targeted efforts.
The plan has many other aspects, including specific targets for rates of infection for several epidemiologically important microorganisms such as Clostridium difficile; pathways for development of new therapeutics, vaccines, and diagnostic devices; methods to improve international collaboration; and an emphasis on a “One-Health” approach that integrates human and animal infection data.
Taken as a whole, the national plan recognizes that the threat of antibiotic resistance is real and requires a multipronged approach if it is to be reversed. The portions of the plan directed toward healthcare facilities are particularly important, as these facilities have come to realize through experience that antibiotic resistance can literally shutter units, cancel surgeries, and substantially increase costs. Stewardship activities are an important means of optimizing antibiotic use, making sure that patients are getting the right drug, at the right dose, for the right duration. As the specific components of the plan are implemented in the years ahead, it is hoped that the rewards of stewardship—as well as developing regional collaborations between healthcare facilities on these issues—will become apparent.
The White House. National Action Plan for Combating Antibiotic-Resistant Bacteria. 2015. https://obamawhitehouse.archives.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf Accessed March 30, 2015.