By Jonathan Springston, Editor, Relias Media

The U.S. Department of Health and Human Services (HHS), in conjunction with several other federal agencies, has published the National Action Plan for Combating Antibiotic-Resistant Bacteria 2020-2025, which builds on the first national plan from 2015.

The five-point strategy remains the same, but the tactics have improved to help execute the goals. For example, the new plan includes details about stronger and more evidence-based activities that have reduced antibiotic resistance, such as optimizing the use of antibiotics in human and animal health settings, that public health officials can lean on to drive progress.

“This plan continues to prioritize infection prevention and control to slow the spread of resistant infections and reduce the need for antibiotic use. To ensure that patients receive the right antibiotic care, the plan supports innovative approaches to developing and deploying diagnostic tests and treatment strategies,” the plan authors wrote. “A One Health approach, which recognizes the relationships between the health of humans, animals, plants, and the environment, is integrated throughout the plan, with an expanded effort to understand antibiotic resistance in the environment. The plan also focuses on collecting and using data to better understand where resistance is occurring, support the development of new diagnostics and treatment options, and advance international coordination.”

This is a plan to guide U.S. government activity on the subject, but public health officials and healthcare providers can use the guidance to steer their own initiatives. That notion is reflected in a progress report from the United States Task Force for Combating Antibiotic-Resistant Bacteria, published in October 2017, about steps forward since the 2015 plan was published. For instance, the progress report indicated the percentage of all U.S. hospitals administering antibiotic stewardship programs that meet all of CDC’s Core Elements rose to 46% in 2015 and to 64% in 2016.

The Infectious Diseases Society of America (IDSA) issued a statement of general praise for the next-generation action plan, calling it "an important, sustained federal commitment to addressing the crisis of antibiotic resistance, which threatens modern medical advances and complicates our responses to public health emergencies, including the COVID-19 pandemic.”

IDSA underlined the new plan’s support for additional investigators to bolster research capacity. “[This] reflects a crucial understanding that a highly skilled workforce is necessary to effectively combat antibiotic resistance,” the group wrote.

The plan’s authoring committee admitted there are ongoing challenges, including proper resource allocation, obstacles to gathering and sharing data, and uncertainty about industry and research partner participation. The IDSA concurred, arguing failure or success will boil down to funding.

“While the objectives and activities described in the plan all represent important steps, they are unlikely on their own to meet current and future patient needs for new antibiotic development,” the IDSA wrote. “A new financing mechanism that provides a meaningful, predictable return on investment for the most critically needed antibiotics and that is delinked from the sales and use of those antibiotics is essential.”

Antibiotic resistance and stewardship are topics of frequent conversation in Relias Media publications. Most recently, there was this detailed exploration of stewardship in critical care and a report on the progress against antibiotic-resistant infections in pediatric patients.

For more on the national action plan and other related topics, be sure to read upcoming issues of Hospital Infection Control & Prevention and Infectious Disease Alert.