By Jonathan Springston, Editor, Relias Media

The National Institutes of Health (NIH) has announced it will allocate more than $100 million in funding to the Antibacterial Resistance Leadership Group (ARLG), an arm of the NIH that conducts scientific investigations into antibiotic resistance, for the next seven years.

“Overuse and misuse of antibiotics drives the spread of antibacterial resistance, and there is an urgent need for novel strategies to combat these serious infections,” National Institute of Allergy and Infectious Diseases Director Anthony S. Fauci, MD, said in a statement. “The Antibacterial Resistance Leadership Group oversees a unique clinical research network that has made significant contributions to improving the prevention, diagnosis, and treatment of antibacterial-resistant infections, and we are pleased to continue our support.”

The CDC notes more than 2 million Americans contract an antibiotic-resistant infection every year, which leads to more than 35,000 deaths. Since 2013, the ARLG has conducted more than 40 clinical research studies around the globe about antibiotic stewardship and how to reduce antibiotic resistance.

The subject of antibiotic resistance is one taken more seriously with each passing year. The Centers for Medicare & Medicaid Services (CMS) recently finalized new requirements for hospitals to establish antibiotic stewardship programs as part of their infection control efforts, as detailed in this article in the December 2019 issue of ED Management. The primary goal of stewardship programs is to ensure that antimicrobials are used only when they are necessary and right for each specific case. They also are designed to mitigate or decrease the incidence of resistant organisms in hospitals.

Further, CMS is finalizing an alternative new technology add-on payment pathway for antimicrobial products designated by the FDA as Qualified Infectious Disease Products (QIDPs), as reported in this article in the January 2020 issue of Hospital Case Management. “Similar to the alternative pathway for certain breakthrough devices, under this policy, a QIDP will be considered new and will not need to demonstrate that it meets the substantial clinical improvement criterion; it will only need to meet the cost criterion,” author Jeanie Davis wrote. “CMS also is increasing the new technology add-on payment to 75% for an antimicrobial designated by the FDA as a QIDP.”

Andrew Morris, MD, the lead author of a white paper published by the Society for Healthcare Epidemiology of America, was blunt in his assessment in the December 2019 issue of Hospital Infection Control & Prevention: “We should be treating antibiotics like narcotics. For every single antibiotic, [report] who is getting it, and when and how are they getting it.”

When thinking about antibiotic resistance, one may look at common infections such as Clostridioides difficile. However, antibiotic resistance has become so widespread that even STDs are in the picture. For example, the CDC recently reported antibiotic-resistant gonorrhea is an urgent threat. As reported in the January 2020 issue of Contraceptive Technology Update, there are 550,000 estimated drug-resistant cases of gonorrhea each year, with 1.14 million total new infections each year. However, gonorrhea has quickly developed resistance to all but one class of antibiotics, and half of all infections are resistant to at least one antibiotic.

“While a number of new antibiotic agents are in development to treat gonorrhea, drug development has been slow, prompting the need for creative strategies to better use the drugs we already have,” Christopher Hall, MD, San Francisco AIDS Foundation’s vice president of medical affairs, said.

For more incisive commentary and clinical abstracts on current issues in infectious diseases, check out the latest issues of Infectious Disease Alert.