Advisory council outlines progress, persisting issues in antibiotic resistance efforts

Issue: May 2016

Despite numerous recent accomplishments against antibiotic resistance in the United States, further focused efforts from government agencies are needed to achieve goals set in the National Action Plan, according to a report from the President’s Advisory Council on Combating Antibiotic-Resistant Bacteria.

“Recognizing the challenges facing agencies and departments, we applaud their ability to implement so much in such little time,” the President’s Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) wrote in a draft of its working March 2016 report. “However, as noted frequently, much has yet to be accomplished and we hope that the six overarching themes identified in the executive summary, in addition to the specific recommendations outlined in the body of the report, provide a framework for a successful path forward.”

Established through an executive order from President Barack Obama and appointed by Department of Health and Human Services Secretary Sylvia M. Burwell, PACCARB was formed to gauge implementation of the National Action Plan (NAP) for CARB. In addition, the council was tasked with designing recommendations on how best to invest government resources and incentivize new advances against resistance.

The council’s first progress report, which was discussed and unanimously accepted during an open meeting on March 30-31, commended several government departments and agencies on their swift progress toward NAP goals. Independent and collaborative actions highlighted included:

CMS’ requirement for inpatient and long-term care settings to establish antibiotic stewardship programs;
establishment of the CARB Biopharmaceutical Accelerator public-private partnership;
the launch of the Defense Department’s Multidrug-Resistant Organism Repository and Surveillance Network; and
the FDA’s final ruling of the Veterinary Feed Directive.

Despite these advances, the council wrote that additional work is necessary. PACCARB advocated increased government action after these six broad recommendations:

fully embrace a One Health approach;
appoint a strong federal champion to lead efforts across agencies;
increase federal response coordination;
improve resource allocation;
develop critical partnerships with state and local agencies, private-sector organizations; and
advance economic incentives for developing new diagnostic, preventive and therapeutic tools.

“The PACCARB presents these six themes for leadership to consider as they move toward achieving new milestones,” they wrote. “During the next several months, PACCARB will continue to gather relevant information about [government] activities and progress, as well as the evidence-base that underpins these efforts.”

These analyses and recommendations were applauded by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The organizations said the suggested areas of focus would improve patient health and limit antibiotic resistance.

Louise M. Dembry

“I am pleased to see national progress that will drive lasting change on all the different facets of antibiotic resistance,” Louise M. Dembry, MD, MS, MBA, professor of medicine and epidemiology at Yale School of Medicine and president of SHEA, said in a press release. “The President’s Advisory Council provides a roadmap for SHEA and other stakeholders to help fill the gaps to support and build on these efforts in order to operationalize actions that reach front-line health care providers and make the aspirational goals of stewardship a reality in every setting.” – by Dave Muoio

Reference:

HHS.gov. Draft Report 1: Initial Assessments of the National Action Plan for Combating Antibiotic-Resistant Bacteria. http://www.hhs.gov/ash/carb/march3031meeting/paccarb-draft-report1-march-2016.pdf. Accessed March 31, 2016.

Disclosures: Burwell and Dembry report no relevant financial disclosures.