Federal health agencies must urgently tackle key measures of a plan to curb the rising threat of antibiotic-resistant organisms, according to new testimony released by the Government Accountability Office Thursday.
The global burden of antibiotic resistance, which may leave clinicians with no antibiotic treatment options for severe infections, has continued to grow. Examples are plentiful. Just this week, reports covered the tragic spate of four deaths and 31 infections from a Klebsiella outbreak in a Seattle hospital. An earlier study found a 15% spike in deaths tied to antibiotic-resistant superbugs during the COVID-19 pandemic. And U.S. physicians are having more trouble finding effective first-line antibiotics for common urinary tract infections, a 2021 study found.
The GAO’s testimony, addressed to a Congressional subcommittee, covers the results of recent federal efforts to combat antibiotic resistance. In 2020, HHS agreed on seven out of eight federal actions recommended by the GAO.
HHS and the Centers for Disease Control and Prevention have taken steps to address the problem but haven’t gone far enough, the published testimony states. Challenges remain in collecting surveillance data from healthcare systems; diagnostic testing to ensure appropriate choice and use of the correct antibiotics; and support for the development of new antibiotics, the GAO said.
“An adequate response will require action on many fronts — ensuring surveillance and testing are in place to identify the threat, reducing the overuse and misuse of antibiotics, and ensuring a sufficient pipeline of new treatments,” the authors wrote.
And much more work remains to be done, they added.
“Continued attention to this issue will be critical to ensuring that we are able to slow the development of antibiotic resistance and maintain an effective array of lifesaving drugs.”
Stewardship success in nursing homes
In March, a panel convened by the GAO also identified infection prevention and control actions in nursing homes that it recommended the HHS either continue, enhance or discontinue.
HHS should continue requiring data reporting to the National Healthcare Safety Network, prioritize nursing homes for resources and consider granting federal flexibilities in future emergencies, the panel concluded. It also recommended strengthening technical assistance for infection prevention and control and enhancing staffing solutions.
U.S. nursing homes and hospitals have been required since 2017 by the Centers for Medicare & Medicare Services to implement antibiotic stewardship programs. In fact, antibiotic stewardship uptake jumped 28% from 2016 to 2019, according to a CDC study published in 2021.
Another study published in 2022 found that among more than 439 nursing facilities that completed an antibiotic stewardship program, all significantly shrank the number of antibiotic treatment courses started and the length of drug therapies using fluoroquinolones and other oral antibiotics.