IC top priority in new federal drug plan

Recognizing ICP role in resistance fight

Infection control has been elevated to a top priority in a sweeping federal task force plan on antibiotic resistance, the Centers for Disease Control and Prevention reports. The plan was expected to be finalized in the near future, as this issue went to press.

The plan is essentially a blueprint for future interaction by the CDC, the Food and Drug Administration, the National Institutes of Health, and several other federal agencies. It calls for a national system for antibiotic resistance surveillance that would include drug susceptibility data and patterns of antimicrobial use.

The draft plan calls for prevention and control of drug-resistant infections by promoting the prudent use of antimicrobial drugs, improving diagnostic testing, and increasing vaccine use. (See Hospital Infection Control, August 2000, p. 108-110; archives at HIConline.com.)

While the plan addressed infection control issues in health care, the final version will list it among the 13 top priorities for action and support, according to David Bell, MD, co-chairman of the federal task force that developed the draft and assistant to the director at the CDC center for infectious diseases.

"It certainly was the intent of the task force to emphasize that infection control was one of the top priorities," Bell told HIC. "It stands to reason that the experts in infection control have a major role in implementing this. [The plan emphasizes] evaluating current and novel measures to prevent infection transmission in health care settings, extended care settings, and in the community" (See related story, below.)

Bell credited the change to advice and input from CDC advisors, particularly the CDC Healthcare Infection Control Practices Advisory Committee (HICPAC).

"I will tell you, as a result of [HICPAC] comments, the task force decided to make infection control one of the top priority action items," he told the committee at a recent meeting in Atlanta.

"[It] was a painful choice out of 87 action items to identify 13 top priorities. I think the principal value of this document is its comprehensiveness and the fact that so many different agencies have endorsed it. It will definitely guide future activity," he explained.

The original draft has 11 priorities, but in addition to infection control, vaccine issues were added to the top items for action. Bipartisan support is already emerging for the plan in Congress, so there is growing sentiment that this will be more than a wish list or another toothless guideline. The extent of regulatory enforcement, most likely by the FDA, remains to be detailed in the final version.

Bell said several recommendations has to be worded with such verbs as "explore" or "consider" because regulatory agencies must go through an established process before changing requirements.

"The plans, of course, are contingent on resources, but we are getting positive vibrations that those resources will come to some extent," he said.

(Editor’ s note: The federal draft guidelines have been posted at www.cdc.gov/drugresistance/action plan. The final version will be posted at that site as well.)