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Antimicrobial resistance has become a worldwide problem. Each year in the United States, at least 2 million people acquire an infection with bacteria that is resistant to one or more antibiotics designed to treat such an infection. Of those, at least 23,000 people die as a direct result.
Antimicrobial resistance not only puts physical strain on patients, it puts enormous economical pressure on the healthcare system. Treatment for antimicrobial-resistant infections is a prolonged and costlier treatment, extended hospital stays, more doctor visits, and greater disability and death compared to those infections easily treated with antibiotics. Although it has been difficult to track the specific economic harms of antimicrobial resistance, some estimates suggest at least $20 billion of excess direct healthcare costs, with an additional $35 billion a year for lost productivity.
Overall, according to the Centers for Disease Control and Prevention (CDC), up to 50 percent of all antibiotics prescribed for people are not needed or are not optimally effective as prescribed. Furthermore, the CDC states that at least 30 percent of outpatient antibiotic prescriptions in the U.S. are unnecessary, 40-75 percent of antibiotics prescribed in nursing homes may be unnecessary or inappropriate, and 20-50 percent of all antibiotics in U.S. acute care hospitals are either unnecessary or inappropriate.
Healthcare-associated infections (HAIs) are among the leading cause of preventable harm and death in the United States. One in 31 hospitalized patients has at least one HAI at any given time. Annually that means 687,000 patients will contract an HAI with nearly 72,000 dying as a result. An increasing number of these infections are untreatable due to resistance to our current arsenal of antibiotics. Without immediate intervention, antibiotic resistance can make minor infections become life-threatening and put our ability to perform surgical procedures at risk.
Since before 1997, The Society for Healthcare Epidemiology of America (SHEA) has advocated for prioritizing preventing the spread of antimicrobial resistance through a variety of evidence-based practice and clinical interventions. SHEA strongly believes that antibiotic stewardship programs are a key component in preventing the spread of antibiotic resistance in all healthcare facilities in the US and across the world. Antibiotic stewardship programs optimize antibiotic use to achieve the best clinical outcomes while minimizing adverse events and limiting selective pressures that drive the emergence of resistance and may also reduce excessive costs attributable to suboptimal antibiotic use.
SHEA supports robust investments in the research, development, and implementation of stewardship programs in all healthcare settings. We are asking for $200 million for the Antibiotic Resistance Solutions Initiative in FY 2020, a 19 percent increase over FY 2019 funding levels. We are also seeking increases in investments in FY 2020 for the Combating Antibiotic Resistant Bacteria (CARB) Initiative, funded through efforts at the National Institutes of Health (NIH) and the Agency for Healthcare Research and Quality (AHRQ). SHEA applauds the Centers for Medicare & Medicaid Services in finalizing a rule that requires all acute inpatient healthcare facilities to adopt antibiotic stewardship programs as a condition of participation.
SHEA has and will continue to urge policymakers and interested stakeholders to support policies that incentivize the adoption of antibiotic stewardship programs across the U.S. and the world. SHEA will also work with other stakeholders to further understand the benefits of antibiotic stewardship for hospital epidemiologists, infection preventionists, healthcare facilities and the patients they serve. To date SHEA has undertaken the following initiatives related to antibiotic resistance:
SHEA will continue standing with others from the healthcare community to address antimicrobial resistance. SHEA will also monitor current legislation and regulative efforts in addressing this global problem.
SHEA understands and appreciates your desire to stay informed and to get directly involved in SHEA’s next steps. To receive regular updates and to receive instructions on how to get involved, join SHEA’s Grassroots Network by texting PREVENTION to 52886 or sending an email firstname.lastname@example.org with the subject line “Subscribe.”
To become involved on social media, use the hashtag #AntibioticResistance.