Drug Resistance Scan for Jun 30, 2014

Drug-resistance joint statement
FDA and animal antibiotics
AMA animal antibiotic policy
Resistant pneumonia

Health and ag ministers issue joint antibiotic resistance statement

Health and agriculture ministers from more than 20 countries issued a joint statement calling for stepped-up political efforts to battle antibiotic resistance, the World Health Organization (WHO) Regional Office for Europe said today. The call for action came out of a meeting at The Hague on Jun 25 and Jun 26.

The joint statement highlights the links between antibiotic use in animals and the threat of antimicrobial resistance (AR) in humans, along with the need to fight all sources of the problem. The group's statement strongly supports the development of a global action plan, which was called for by the World Health Assembly in May.

Dr Zsuzsanna Jakab, the WHO's regional director for Europe, said in the statement that AR can spread not just from human to human, but also through the food chain and the environment. "Thus, tackling it requires multifaceted approaches. Intersectoral and interdisciplinary collaboration and information sharing are crucial."

The joint statement said reducing AR demands a One Health approach that cuts across many sectors, including health, agriculture, and aquaculture. The group also called for a United Nations high-level meeting in 2016 to enable follow-up on the global action plan.

It also detailed several issues that came up at the meeting, including improving public awareness at all levels and improving the quality and voicing particular concerns about the rise in drug-resistant bacteria. The statement also listed priorities, led by the need to develop and set national and global standards for preventing infections and curbing the antimicrobial use in human and veterinary settings.
Jun 30 WHO statement
Joint statement text


FDA notes progress on judicious drug use in food animals

The US Food and Drug Administration (FDA) today issued the first of its planned semiannual progress reports on promoting the judicious use of antimicrobials in food animals, saying drug companies are on board.

The FDA said all 26 drug manufacturers affected by the agency's plan to combat drug overuse in animals as a means of curtailing antimicrobial resistance (AR), called Guidance for Industry (GFI) #213, "have now agreed to fully engage in the strategy by phasing out the use of medically important antimicrobials in food-producing animals for food production purposes and phasing in the oversight of a veterinarian for the remaining therapeutic uses of such drugs."

And, although drug companies have until December 2016 to complete recommended changes to their antimicrobials, some have already begun to implement them, the FDA said.

Of 283 products that fall under GFI #213, 31 have been withdrawn from the market completely and will no longer be available in the United States, while partial label changes have been completed for 2 and are pending for 1, the report states.

In an FDAVoice blog post today, David G. White, PhD, chief science officer and research director in the FDA's Office of Foods and Veterinary Medicine, wrote, "While these changes are significant steps forward, the strategy is still in its early stages. The changes are just one part of FDA’s overall strategy for monitoring and reducing antimicrobial resistance."
Jun 30 FDA report
Jun 30 FDAVoice
blog post
Full text of GFI #213


AMA toughens stance on animal antibiotics

The American Medical Association (AMA) is pressing federal officials to take steps to ban antibiotic use in food animals for growth promotion to help slow the development of antibiotic-resistant bacteria, according to a report today from Food Safety News (FSN).

The group adopted a resolution at its annual meeting earlier this month in Chicago that urges its members to support regulatory and legislative measure to require animal antibiotic prescriptions to be overseen by a veterinarian and for the FDA to expand its surveillance and data collection regarding agriculture antibiotic uses.

The new AMA policy is seen as a more stringent step that replaces the group's previous stance, which opposed antimicrobials at nontherapeutic levels in agriculture and pushed for them to be stopped or phased out, according to FSN.

In a statement today, Keep Antibiotics Working, a Chicago-based coalition of health, consumer, and advocacy groups, applauded the AMA for taking a tough stance on reducing antibiotic use in food animals.

Dave Wallinga, MD, a physician on the group's steering committee, said in the statement, "Timely implementation of this policy will help stave off a future where antibiotics no longer work. Such a future would mean greater suffering and death for children, cancer patients, transplant recipients, and other patients who need them."
Jun 30 FSN report
Jun 30 Keep Antibiotics Working statement


Study: Timing of antibiotic use may predict resistant pneumonia

Time since the last exposure to antibiotics is the most important factor in predicting AR in pneumococcal disease, according to a study in Clinical Infectious Diseases.

Researchers with the Toronto Invasive Bacterial Diseases Network analyzed data on patients in that city from 2002 through 2011, using broth microdilution to measure antimicrobial susceptibility. They collected data on 4,062 episodes of AR in pneumococcal disease, 1,193 (29%), of which involved antibiotic treatment in the previous 3 months.

They found that the time elapsed since the most recent antibiotic course was inversely relatedly to resistance and varied by antibiotic class. The investigators also found that the risk of resistance after exposure declined fastest for fluoroquinolones and penicillins and reached baseline in 2 to 3 months with those drug classes.

The decline in resistance was slowest for macrolides, particularly for azithromycin. The researchers found no significant link between duration of therapy and resistance for any antibiotic class.
Jun 27 Clin Infect Dis study

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