U.S. surveillance plan among top action items

Eleven priorities of equal importance unveiled

A draft plan recently issued by a multiagency federal task force to combat antibiotic resistance lists 11 top priorities for action. The items, which have equal priority regardless of order, are summarized as follows:

Surveillance:

1. Design and implement a national antibiotic resistance surveillance plan that defines national, regional, state, and local surveillance activities and the roles of clinical, reference, public health, and veterinary laboratories, and is consistent with local and national surveillance methodology and infrastructure that currently exist or are being developed.

2. Develop and implement procedures for monitoring patterns of antimicrobial drug use in human medicine, in agriculture, and in consumer products.

Prevention and Control:

3. Develop and implement a public health education campaign to promote judicious antimicrobial use as a national health priority.

4. In collaboration with professional societies and other stakeholders, develop, disseminate, and evaluate clinical guidelines that address judicious antimicrobial use.

5. In consultation with stakeholders, refine and implement the proposed Food and Drug Administration framework for approving new antimicrobial drugs for use in food-animal production and, when appropriate, for re-evaluating currently approved veterinary antimicrobial drugs.

6. Support demonstration projects to evaluate comprehensive strategies that use multiple interventions to promote judicious drug use and reduce infection rates, in order to assess how interventions found effective in research studies can be applied effectively on a routine basis and on a large scale and how this application can be done most cost-effectively.

Research:

7. Provide to the research community genomics and other powerful technologies to identify targets in critical areas for the development of new rapid diagnostics methodologies, novel therapeutics, and interventions to prevent the emergence and spread of resistant pathogens.

8. Develop a human clinical trials network involving medical research and health care institutions to coordinate and conduct clinical trials addressing antibiotic resistance issues that are difficult to resolve in industry-sponsored studies (e.g., novel therapies, new treatment regimens, and other products and practices).

9. Identify, develop, test, and evaluate the impact of new rapid diagnostic methods (e.g., tests for resistance genes including nonculture specimens, point of care diagnostics for patients with respiratory infections and syndromes, and diagnostics for drug resistance in microbial pathogens).

Product Development:

10. Create an interagency antibiotic resistance product development working group to identify and publicize priority public health needs for new antibiotic resistance products (e.g., innovative drugs, targeted spectrum antibiotics, point-of-care diagnostics, vaccines, anti-infective medical devices, and biologics).

11. In consultation with stakeholders, economic consultants, and the aforementioned working group, identify ways (e.g., financial and/or other incentives or investments) to promote the development and/or judicious use of priority products for which market incentives are inadequate.