TY - JOUR
T1 - The epidemic of antibiotic-resistant infections
T2 - A call to action for the medical community from the infectious diseases society of America
AU - Spellberg, Brad
AU - Guidos, Robert
AU - Gilbert, David
AU - Bradley, John
AU - Boucher, Helen W.
AU - Scheld, W. Michael
AU - Bartlett, John G.
AU - Edwards, John
N1 - Funding Information:
Potential conflicts of interest. B.S. has received consulting fees from Pfizer; has received research support from Astellas, Gilead, Elan, Enzon, Novartis, Merck, and Pfizer; and is on the speakers’ bureaus for Merck, Pfizer, and Astellas. D.G. serves on the speakers’ bureau of Abbott Laboratories, Bayer, GlaxoSmithKline, Lilly, Merck, Pfizer, Roche, Schering-Plough, and Wyeth. J.B.’s employer has received research grants from AstraZeneca, Elan, Glaxo SmithKline, Johnson & Johnson, and Novartis and reimbursement for J.B.’s role in consulting for Johnson & Johnson, Trius Therapeutics, Cerexa, and Wyeth. H.W.B. serves as an advisor/consultant to Cubist, Johnson & Johnson, Pfizer, Schering-Plough, and Tar-ganta; serves as a speaker for Cubist, Pfizer, and Schering-Plough; and owns or has owned shares of Pfizer and Cubist. W.M.S. serves on advisory boards for Pfizer, Cubist, and GlaxoSmithKline and serves on speakers’ bureaus of these same companies, plus those of Schering-Plough and Bristol-Myers Squibb. J.G.B. serves on the HIV advisory boards for Bristol-Myers Squibb, Abbott Laboratories, and GlaxoSmithKline. J.E.E. serves on the scientific advisory boards of Pfizer, Merck, and Gilead; has participated in educational programs regarding fungal infections funded by Pfizer, Merck, and Astellas; has received research laboratory support from Pfizer, Merck, and Gilead; and has participated in the Bristol-Myers Squibb Freedom to Discovery research program. R.G.: no conflicts. These funding sources played no role in the preparation of this manuscript. The Antimicrobial Availability Task Force receives no financial support from outside sources for any of its activities, and the authors received no financial support for preparation of this manuscript.
PY - 2008/1/15
Y1 - 2008/1/15
N2 - The ongoing explosion of antibiotic-resistant infections continues to plague global and US health care. Meanwhile, an equally alarming decline has occurred in the research and development of new antibiotics to deal with the threat. In response to this microbial "perfect storm," in 2001, the federal Interagency Task Force on Antimicrobial Resistance released the "Action Plan to Combat Antimicrobial Resistance; Part 1: Domestic" to strengthen the response in the United States. The Infectious Diseases Society of America (IDSA) followed in 2004 with its own report, "Bad Bugs, No Drugs: As Antibiotic Discovery Stagnates, A Public Health Crisis Brews," which proposed incentives to reinvigorate pharmaceutical investment in antibiotic research and development. The IDSA's subsequent lobbying efforts led to the introduction of promising legislation in the 109th US Congress (January 2005-December 2006). Unfortunately, the legislation was not enacted. During the 110th Congress, the IDSA has continued to work with congressional leaders on promising legislation to address antibiotic-resistant infection. Nevertheless, despite intensive public relations and lobbying efforts, it remains unclear whether sufficiently robust legislation will be enacted. In the meantime, microbes continue to become more resistant, the antibiotic pipeline continues to diminish, and the majority of the public remains unaware of this critical situation. The result of insufficient federal funding; insufficient surveillance, prevention, and control; insufficient research and development activities; misguided regulation of antibiotics in agriculture and, in particular, for food animals; and insufficient overall coordination of US (and international) efforts could mean a literal return to the preantibiotic era for many types of infections. If we are to address the antimicrobial resistance crisis, a concerted, grassroots effort led by the medical community will be required.
AB - The ongoing explosion of antibiotic-resistant infections continues to plague global and US health care. Meanwhile, an equally alarming decline has occurred in the research and development of new antibiotics to deal with the threat. In response to this microbial "perfect storm," in 2001, the federal Interagency Task Force on Antimicrobial Resistance released the "Action Plan to Combat Antimicrobial Resistance; Part 1: Domestic" to strengthen the response in the United States. The Infectious Diseases Society of America (IDSA) followed in 2004 with its own report, "Bad Bugs, No Drugs: As Antibiotic Discovery Stagnates, A Public Health Crisis Brews," which proposed incentives to reinvigorate pharmaceutical investment in antibiotic research and development. The IDSA's subsequent lobbying efforts led to the introduction of promising legislation in the 109th US Congress (January 2005-December 2006). Unfortunately, the legislation was not enacted. During the 110th Congress, the IDSA has continued to work with congressional leaders on promising legislation to address antibiotic-resistant infection. Nevertheless, despite intensive public relations and lobbying efforts, it remains unclear whether sufficiently robust legislation will be enacted. In the meantime, microbes continue to become more resistant, the antibiotic pipeline continues to diminish, and the majority of the public remains unaware of this critical situation. The result of insufficient federal funding; insufficient surveillance, prevention, and control; insufficient research and development activities; misguided regulation of antibiotics in agriculture and, in particular, for food animals; and insufficient overall coordination of US (and international) efforts could mean a literal return to the preantibiotic era for many types of infections. If we are to address the antimicrobial resistance crisis, a concerted, grassroots effort led by the medical community will be required.
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U2 - 10.1086/524891
DO - 10.1086/524891
M3 - Review article
C2 - 18171244
AN - SCOPUS:39449103059
VL - 46
SP - 155
EP - 164
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 2
ER -