The White House announced an aggressive plan Friday to combat antibiotic-resistant bacteria, a mounting problem that causes an estimated 2 million illnesses and 23,000 deaths every year in the United States.
The plan lists specific goals to fight the spread of antibiotic-resistant microbes over the next five years. It outlines steps to prevent and contain antibiotic-resistant infections through better surveillance of "superbugs," to maintain the effectiveness of current and new drugs, and to develop next-generation therapeutics. The much-anticipated plan is part of the Obama administration's efforts to nearly double the amount of federal spending dedicated to combating antibiotic-resistant bacteria. Obama's budget request calls for more than $1.2 billion to combat and prevent antibiotic resistance.
Scientists, doctors and other public health officials have increasingly warned that if antibiotic resistance were to continue at the current rate, routine infections could become life-threatening. Common modern surgeries and treatments, such as knee replacements, organ transplants and cancer treatments, could again become dangerous because of hard-to-treat infections. Vulnerable hospital patients and nursing home residents could be at particularly high risk for contracting deadly infections.
In an interview with WebMD, President Obama said effective antibiotics are vital to the country's national security.
"They save the lives of service members wounded in battle. They prevent infections in one community from spreading far and wide. They’re also a critical defense against bio-terrorism. They are, quite simply, essential to the health of our people and people everywhere. So we should do everything in our power to ensure that antibiotics remain effective," the president said. "These vital drugs have saved countless lives over the past century. It’s up to us to make sure they keep saving lives for years to come."
The action plan sets specific targets to reduce the incidence of some of the most serious and common infections.
Under the plan, the Centers for Disease Control and Prevention will aim to cut Clostridium difficile infections by 50 percent, reduce carbapenem-resistant Enterobacteriaceae (CRE) infections acquired during hospitalization by 60 percent and lower Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections by at least 50 percent.
CRE infections typically strike patients in medical facilities and have become resistant to nearly all existing antibiotics.
Details of the plan became known Thursday, and some groups immediately criticized the document as weak in addressing antibiotic use in animals. Administration officials call for the reduction and eventual elimination of "medically-important antibiotics" for growth promotion in animals raised for human consumption. But the plan does not set specific targets.
The Natural Resources Defense Council said in a statement that although the White House is acknowledging the dangerous public health threat posed by the misuse of antibiotics in human medicine and the livestock industry, “the Obama Administration needs to do more to reduce antibiotic use in animals that are not sick. The plan continues to allow the routine feeding of antibiotics to animals that live in the crowded conditions endemic to industrial farms."
Among the companies that have most recently taken action to work with their suppliers are fast-food giant McDonald’s and retailer Costco, which have taken steps to eliminate or sharply curtail the use of antibiotics in chicken.
In a briefing with reporters Friday, an administration official who was not authorized to speak on the record said: "We recognize this is an area where we need to have better data." He said officials are hoping to collect more "species-specific" data and evidence "to allow us to target the areas that are most critical."
Officials from the U.S. Department of Agriculture and the Food and Drug Administration are organizing a meeting with industry officials, planned for late spring or early summer, he said.
Rep. Louise Slaughter, (D-NY), the only microbiologist in Congress, said the administration’s plan was “woefully short of taking meaningful action to curb the overuse of antibiotics in healthy food animals.” In a statement, she said meaningful solutions must begin with limits on the farm. “Trusting a voluntary policy that lets industry police itself will not bring about real change,” she said. She noted that antibiotic resistance will become a major trade issue when foreign counterparts stop accepting U.S. meat raised with medically-important antibiotics.
The budget request calls for a quadrupling of USDA's budget to help better understand the emergence of antibiotic resistance in food production, and to develop alternatives to antibiotics in farm animals, another official pointed out. Antibiotics used in farm animals account for the vast majority of antibiotics sold each year in the United States.
Hospitals will also be required to put in place programs to improve infection control, such as hand-washing and the judicious use of prescribing antibiotics for patients. The overuse of drugs is the strongest factor contributing to antibiotic resistance around the globe, health experts have said. The more a particular germ is exposed to antibiotics, the more rapidly it can develop resistance.
By 2020, the plan calls for establishment of such programs in all of the country's acute care hospitals; a 50 percent reduction in inappropriate antibiotic use in all outpatient settings; and establishment of antibiotic resistance prevention programs in all 50 states to monitor multidrug-resistant organisms and to provide feedback and technical assistance to health care facilities.
A key focus will be better tracking of these deadly microbes. By 2020, officials hope to create a national database of resistant pathogens; conduct routine testing of pathogens for antibiotic susceptibility at a network of labs; and require nearly all doctors working with the government's Medicare and Medicaid health plans, the Defense Department and Veterans Affairs facilities to report their prescribing patterns for antibiotics.