5 Things to Know About Antimicrobial Resistance

Antibiotic resistance is one of the most urgent threats to public health. According to the CDC, 2 million people develop serious infections caused by bacteria resistant to antibacterial drugs, and at least 23,000 people die.

Here are 5 things to know about antimicrobial resistance (AMR):

1. Drug development to create new antibiotics is running thin, but the FDA hopes to change that.

Last month, the FDA announced a new, 4-pronged approach to the growing problem of antimicrobial resistance (AMR), as regulators unveiled a 2019 strategic plan that envisions innovative payment strategies in an effort to spur pharmaceutical companies to develop new antibiotics. The plan has 4 goals: facilitate product development; support antibiotic stewardship; increase surveillance of antimicrobial use; and enhancing regulatory science.

2. AMR is an issue in oncology care.

The benefits of common surgical procedures and cancer chemotherapy are at risk when compromised by AMR, noted a study published a few years ago. Patients with blood cancers like acute myeloid leukemia can be in danger from conditions such as neutropenia, which causes their immune system to become vulnerable to life-threatening infections.

3. Providers have new tools at their disposal, to make more informed antibiotic choices.

Last year, the FDA released a website tool to provide information about when bacterial or fungal infections are likely to respond to a specific drug. Physicians can use antimicrobial susceptibility test results to help choose an appropriate antibacterial or antifungal drug to treat a patient’s infection. These tests rely on criteria—called susceptibility test interpretive criteria or “breakpoints”—that help determine whether a specific bacteria or fungi are susceptible to antibacterial or antifungal drugs. Bacteria and fungi change over time, which may result in decreased susceptibility to some drugs. When this occurs, breakpoints may need to be updated.

4. It is not always necessary for a provider to write a prescription in order to satisfy a patient.

Part of good antibiotic stewardship is steering clear of prescribing antibiotics for common viral illnesses. An article published last year in The American Journal of Managed Care® found that while patient satisfaction scores are slightly lower when antibiotics are not prescribed for acute sinusitis, 75% of those encounters still received favorable satisfaction scores.

5. Provider interventions can be effective at reducing unnecessary prescriptions.

ID Week is an annual conference focused on many different infectious disease topics, and research presented at the meeting this week showcased some work being down to reduce antibiotic prescribing for respiratory infections in facilities run by the Department of Veterans Affairs. Approaches like an audit feedback intervention (used to help providers translate evidence into behavior change) as well as a national campaign that tracked various metrics were all useful at reducing the rate of antibiotic prescribing.