US aims to follow Britain's lead in fighting superbugs (Update)

by Kerry Sheridan

Some $30 million proposed by President Barack Obama could help hospitals fight the growing problem of antibiotic resistance much the way Britain has, US health authorities said Tuesday.

The extra funds for fiscal year 2015, if approved by Congress, would double the amount spent on efforts to cut back on overprescribing of antibiotics, a widespread trend that experts agree is contributing to dangerous superbugs and untreatable infections worldwide.

The money would help "establish a robust infrastructure that can detect antibiotic resistance threats and protect patients and communities," said Tom Frieden, chief of the US Centers for Disease Control and Prevention.

The goal is to reduce deadly infections that are often picked up by patients in hospital and long-term care settings by half in five years, he said.

Frieden also spoke to reporters about a new CDC Vital Signs report that found more than one third of antibiotics prescribed in hospitals might be unnecessary and could be fueling drug resistance.

Since prescribing practices vary widely by hospital, improved stewardship programs could help streamline practice and cut back on potential errors and excess in prescribing, he said.

"Practices that are not optimal are putting patients at unnecessary risk of future drug resistant infections," said Frieden.

"This is about hospitals getting together, agreeing on protocols and then implementing those protocols," he said.

In some hospitals, doctors prescribed three times as many antibiotics as others, even when patients were being cared for in similar areas.

"This kind of wide difference does provide a warning bell," said Frieden.

The Vital Signs report was based on data from 183 US hospitals in 2011.

More than half (55.7 percent) of the 11,282 hospital patients studied received an antibiotic to treat an active infection, it said.

"Antibiotic use could potentially have been improved" in 37 percent of cases, said the report.

The most common possible errors were doling out antibiotics without proper testing and prescribing them for too long.

Not just a theory

Cutting back on certain antibiotics could help reduce cases of potentially deadly diarrhea caused by a bacterium called Clostridium difficile, sometimes called C. diff or CDI, the report added.

A 30 percent drop in use of broad spectrum antibiotics could lead to 26 percent fewer C. difficile infections, according to CDC modeling estimates.

Infections from C. difficile are usually acquired during medical care and are linked to 14,000 US deaths annually.

If funded at $30 million per year over the next five years, Frieden said the new US initiative would aim to cut infections of C. diff and Carbapenem-resistant Enterobacteriaceae (CRE) by half over that time span.

"This isn't just a theory. We have seen systems, we have seen countries do this. And I am very confident that if we invest, we will be able to do it here."

Lead author of the Vital Signs report, Arjun Srinivasan of the US National Center for Emerging and Zoonotic Infectious Diseases, said Britain was an example for the United States to follow in this realm.

"Over the past seven years the UK has engaged in a robust effort throughout the country to reduce the use of antibiotics that are most associated with Clostridium difficile," Srinivasan said.

"What they have seen is a more than 50 percent reduction in the use of those targeted agents and they have a seen a roughly 70 percent reduction in Clostridium difficile," he said, describing the results as "very dramatic."

The Infectious Diseases Society of America applauded the proposal to boost CDC funds, but warned that years of belt-tightening have taken a toll.

"On behalf of the millions of patients who suffer from resistant infections, IDSA has long called for increased federal leadership to address this public health crisis," the group said in a statement.

"This budget request is an important step forward, and we urge Congress to fully fund it."

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