August 20, 2019
Antibiotics Report Highlights Stewardship, Workforce, Research Needs
The U.S. Centers for Disease Control and Prevention report on the use of antibiotics in health care settings across the United States in 2018 tell us that while progress has been made to promote appropriate use of infection-fighting drugs, strengthened and continued efforts and greater resources are needed to protect some of the most valuable medicines we have and prevent the accelerating development of illness-causing bacteria that are resistant to treatment.
With evidence that about 30 percent of all antibiotic courses annually are prescribed unnecessarily, the report, Antibiotic Use in the United States: Progress and Opportunities, describes strides in antibiotic stewardship and surveillance in recent years, but also persisting challenges in ensuring that the leadership, expertise and education necessary to stewardship programs meets ongoing needs. In addition, highlighting the value of existing and growing numbers of antibiotic stewardship programs, the report underscores the need for policies requiring the programs at all health facilities.
The report also highlights critical leadership on the part of CDC in supporting the development of stewardship programs. Increased funding will be essential to the expansion of the agency’s efforts, particularly at smaller facilities with fewer resources including rural hospitals and critical access hospitals.
As an organization of more than 11,000 infectious diseases specialists, the Infectious Disease Society of America knows the pivotal role of antibiotic stewardship in ensuring the continued effectiveness of existing medicines, and developed the Antimicrobial Stewardship Centers of Excellence Program to identify institutions that demonstrate commitment to combating antimicrobial resistance by aligning with evidence-based guidelines.
We urge the passage of the DISARM -- Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms – Act, legislation that will require hospitals to establish stewardship programs, raise reimbursement for new antibiotics and require hospitals to report antibiotic use and resistance data to CDC.
While strengthened stewardship is vital to stemming the threat of resistant infections, we recognize that a comprehensive response to antimicrobial resistance is essential. In addition to stewardship programs at all health settings and a “One Health” approach to limiting the impacts to humans and animals of excessive antibiotic exposure, this response must include policies, the allocation of the resources necessary to ensure infection prevention and surveillance, the development of new vaccines, diagnostics, and antibiotics, and investments in the necessary infectious diseases physician workforce.