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HICprevent

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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Obama orders federal agencies of all stripes to combat rising antibiotic-resistant infections

March 18th, 2015

In what could be a prelude to future federal regulations, President Obama has issued an executive order to reduce the threat of antibiotic resistant bacteria and protect what remains of the nation’s endangered drug formulary.

The September 18 executive order includes establishing a task force that doesn’t quite look like the proverbial blue ribbon panel. Homeland Security has a seat at the table and one of the three co-chairs is the Secretary of Defense. The other two chairs in this triumvirate are the Secretary of the Department of Health and Human Services and the Secretary of Agriculture.

The task force mission is to “identify actions that will provide for the facilitation and monitoring of implementation of this order and the National Strategy for Combating Antibiotic-Resistant Bacteria. … By February 15, 2015, the Task Force shall submit a 5-year National Action Plan to the President that outlines specific actions to be taken to implement the Strategy. The Action Plan shall include goals, milestones, and metrics for measuring progress, as well as associated timelines for implementation.”

After years of warnings and pleas to use antibiotics judiciously, this is what we’ve come to: a crisis big enough to stir the full mechanization of federal power. It’s not an overreaction. There are now infections resistant to all available antibiotics, as vanishing drug efficacy and a “post-antibiotic” era are no longer theoretical threats. At this year’s conference of the Association for Professionals in Infection Control and Epidemiology there were gram negative infections described that were even resistant to colistin, a bottom-of-the-barrel antibiotic that has maintained its efficacy primarily because it’s typically worse for the patient than anything they are infected with.

In addition to pushing for new drug development and reaching out to international partners facing a similar, global problem, the executive order calls for a more aggressive role in "actively identifying and responding to antibiotic-resistant outbreaks; preventing outbreaks and transmission of antibiotic-resistant infections in healthcare, community, and agricultural settings through early detection and tracking of resistant organisms; and identifying and evaluating additional strategies in the healthcare and community settings for the effective prevention and control of antibiotic-resistant infections. .... DoD, HHS, and the VA shall review and, as appropriate, update their hospital and long-term care infectious disease protocols for identifying, isolating, and treating antibiotic-resistant bacterial infection cases."