The epidemic of antibiotic-resistant infections: A call to action for the medical community from the Infectious Diseases Society of America
The epidemic of antibiotic-resistant infections: A call to action for the medical community from the Infectious Diseases Society of America
复制标题
DOI：
10.1086/524891
复制
发表时间：
2008-01-15
影响因子：
11.8
通讯作者：
Edwards, John, Jr.
中科院分区：
文献类型：
--
作者：
Spellberg, Brad;Guidos, Robert;Edwards, John, Jr.
抗药性感染的持续爆发继续困扰着全球和美国的医疗保健。与此同时，为应对这一威胁而研发的新抗生素也出现了同样令人担忧的下降。为了应对这场微生物“完美风暴”，2001年，联邦抗菌素耐药性跨部门工作组发布了“抗击抗菌素耐药性行动计划;第1部分：国内”，以加强美国的应对措施。美国传染病协会（IDSA）在2004年发表了自己的报告，“Bad Bugs，No Drugs：As Antibiotic Discovery Stagnates，A Public Health Crisis Brews”，其中提出了激励措施，以重振抗生素研究和开发的制药投资。IDSA随后的游说努力导致在第109届美国国会（2005年1月至2006年12月）引入了有希望的立法。不幸的是，这项立法没有颁布。在第110届国会期间，IDSA继续与国会领导人合作，制定有希望的立法，以解决抗药性感染问题。然而，尽管进行了密集的公关和游说努力，但仍不清楚是否会颁布足够有力的立法。与此同时，微生物继续变得更具耐药性，抗生素管道继续减少，大多数公众仍然没有意识到这一严重情况。联邦资金不足;监测、预防和控制不足;研发活动不足;农业中抗生素的错误监管，特别是对食用动物的监管;以及美国（和国际）努力的整体协调不足，这些都可能意味着许多类型的感染实际上回到了抗生素出现前的时代。如果我们要解决抗生素耐药性危机，将需要由医学界领导的协调一致的基层努力。
The ongoing explosion of antibiotic-resistant infections continues to plague global and US health care. Meanwhile, an equally alarming decline has occurred in the research and development of new antibiotics to deal with the threat. In response to this microbial "perfect storm," in 2001, the federal Interagency Task Force on Antimicrobial Resistance released the " Action Plan to Combat Antimicrobial Resistance; Part 1: Domestic" to strengthen the response in the United States. The Infectious Diseases Society of America (IDSA) followed in 2004 with its own report, " Bad Bugs, No Drugs: As Antibiotic Discovery Stagnates, A Public Health Crisis Brews," which proposed incentives to reinvigorate pharmaceutical investment in antibiotic research and development. The IDSA's subsequent lobbying efforts led to the introduction of promising legislation in the 109th US Congress ( January 2005-December 2006). Unfortunately, the legislation was not enacted. During the 110th Congress, the IDSA has continued to work with congressional leaders on promising legislation to address antibiotic-resistant infection. Nevertheless, despite intensive public relations and lobbying efforts, it remains unclear whether sufficiently robust legislation will be enacted. In the meantime, microbes continue to become more resistant, the antibiotic pipeline continues to diminish, and the majority of the public remains unaware of this critical situation. The result of insufficient federal funding; insufficient surveillance, prevention, and control; insufficient research and development activities; misguided regulation of antibiotics in agriculture and, in particular, for food animals; and insufficient overall coordination of US ( and international) efforts could mean a literal return to the preantibiotic era for many types of infections. If we are to address the antimicrobial resistance crisis, a concerted, grassroots effort led by the medical community will be required.