Posted on April 3, 2015
Last week, the White House released the National Action Plan for Combating Antibiotic-Resistant Bacteria, designed to mobilize the nation to fight the emergence of “superbugs” and protect many of the gains in medical practice and treatments made since the discovery of penicillin in 1928. The rapidly increasing prevalence of these multidrug-resistant organisms (MDROs) impairs our ability to treat bacterial infections and threatens patients undergoing procedures such as surgery, dialysis, organ transplantation and chemotherapy.
According to the Centers for Disease Control and Prevention, superbug infections affect two million Americans each year and cause 23,000 deaths annually.1 They also cost U.S. hospitals $20-35 million each year and account for an additional $35 million in lost wages.2
The new plan addresses the policy recommendations made by the President’s Council of Advisors on Science and Technology in their report issued last September3 and sets five goals for the next five years:4
Slow the emergence of resistant bacteria and prevent the spread of resistant infections.
Strengthen national One-Health surveillance efforts to combat resistance.
Advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria.
Accelerate basic and applied research and development for new antibiotics, other therapeutics, and vaccines.
Improve international collaboration and capacities for antibiotic-resistance prevention, surveillance, control, and antibiotic research and development.
For hospitals, the first goal is likely to have the greatest direct impact. Effectively preventing superbug infections and extending the life of current antibiotics requires the judicious use of antimicrobials in healthcare settings, including reducing the inappropriate use of antibiotics. The Action Plan sets a target of a 50% reduction in inappropriate use in outpatient settings and a 20% reduction in hospitals over the next five years. The CDC currently estimates that up to 50% of antibiotic use in hospitals is unnecessary or otherwise inappropriate.
The Plan calls for the establishment of antimicrobial stewardship programs in all acute care hospitals and improved antimicrobial stewardship across all healthcare environments by 2020. In addition to improved prescribing practices, healthcare organizations are expected to take action to prevent the spread of MDROs and superbug infections within their facilities and communities.
State Antibiotic Resistance Prevention Programs will be established in all 50 states to monitor the emergence and spread of MDROs and support hospitals in development of plans to control them and reduce infections. Byy 2020, nearly all Medicare-eligible hospitals will be expected to report antibiotic use and resistance data to the National Health Safety Network, as will federal healthcare facilities operated by the Department of Defense and the Department of Veterans Affairs.
Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013.
Fishman N. Antimicrobial Stewardship 2014: National and regional trends. University of Pennsylvania Perelman School of Medicine. September 30, 2014.
President’s Council of Advisors on Science and Technology. Report to the President on Combating Antibiotic Resistance. September 2014.
The White House. National Action Plan for Combating Antibiotic-Resistant Bacteria. March 2015.