Final plan makes ICP a priority position

But will that translate to program $upport?

Concerned with both preserving old antibiotics and encouraging new drug development, a federal task force did not forget to make one critical observation: Neither will be needed in patients who do not become infected.

As previously reported, infection control has been elevated to among the 13 top priorities for action and support in the federal task force plan to combat antibiotic resistance. (See Hospital Infection Control, January 2001, under archives at HIConline.com.)

The original draft had 11 priorities, but in addition to infection control, vaccine issues were added to the top items for action. Since part of the plan is essentially prioritizing how federal money should be sent to address antibiotic resistance, being one of the top priorities should help the infection control professional.

"This document is going to be useful in setting funding priorities," says David Bell, MD, co-chairman of the federal task force and assistant to the director at the Centers for Disease Control and Prevention center for infectious diseases. "It really
is a road map to ensure the problem is addressed through specific actions."

For example, one of the plan’s action items is "facilitate and support the activities of infection control programs in health care settings as a component of medical care." Bell reminds that among the agencies signing on to the plan — and specifically highlighted as coordinators of that action item — are the Department of Veterans Affairs and the Health Care Financing Administration.

"The second part of that [action item is] to promote infection control education at all stages of training and practice for health care workers who have contact with patients,’" he points out.

"Just having that stated in a document and having the big government agencies with big medical care systems sign on to agree that they will do it, is also noteworthy," Bell says.

Also included among the action items related to infection control are some intriguing but yet undefined items, such as "evaluate the effectiveness including cost effectiveness of current and novel infection control practices." Though there is no specific plan yet of how that will be done, the idea of updating data on the cost effectiveness of infection prevention has been much discussed in recent years.

While ICPs would welcome any supportive data in that area, it is well to remember that the task force made infection control one of the top priorities — period.

"That implies that it needs to be done," Bell says. "Some things that need to be done aren’t always cost-effective. They just need to be done. But when it comes to specific practices, sometimes you can make progress if you show that some are more cost-effective than others.

"There is recognition that infection control
is a top priority item and that infection control personnel, practitioners, and epidemiologists will play a critical role in containing drug resistances in the health care delivery system," he adds.

One of the key questions regarding the federal task force plan to combat antibiotic resistance was whether it would result in any changes in health care or be yet another warning taken on advisement by hospital administrators and clinicians.

"This is not just another document that sits on the shelf," Bell emphasizes.

"I don’t mean to disparage it. Previous documents produced by expert commissions have been helpful in describing the problem and outlining directions to proceed," he continues. "This document represents the next step of specifying which agencies are going to take what steps with some approximate time frame so that the federal government actually makes progress in a coordinated manner."

Implementation of the plan ultimately is dependent on federal funding for the agencies themselves, and Bell sees encouraging signs that that will happen.

"It is an ambitious plan, and I think, realistically, we will have to implement it incrementally because the funding necessary will most likely be provided incrementally," he says.

"I’m optimistic. There has strong bipartisan support in Congress for efforts to combat antimicrobial resistance," Bell adds.