agency’s Center for Drug Evaluation and Research is exploring ways to enhance available approaches for the development of new antibiotics. Such activities include fostering early communication between the FDA and pharmaceutical companies, using the agency’s product labeling system to help educate physicians and other health care workers about antimicrobial resistance, and exploring methods for using data collected in clinical trials to make reliable inferences about a drug’s potential to trigger antimicrobial resistance.

The CDC is implementing a variety of surveillance efforts and prevention and control activities, and is both undertaking and supporting applied research. In one effort, the agency has initiated the Campaign to Prevent Antimicrobial Resistance in Healthcare Settings, a nationwide program that targets clinicians, patient care partners, health care organizations, purchasers, and patients. The campaign centers around four basic strategies that front-line clinicians can use to prevent antimicrobial resistance. These strategies include preventing infections so as to directly reduce the need for antimicrobial exposure and the emergence and selection of resistant strains; diagnosing and treating infection properly, which will benefit patients and decrease the opportunity for development and selection of resistant microbes; using antimicrobials wisely, since optimal use will ensure proper patient care while avoiding overuse of broad-spectrum antimicrobials and unnecessary treatment; and preventing transmission of resistant organisms from one person to another.

At the international level, the World Health Organization (WHO) in 2001 issued the WHO Global Strategy for Containment of Antimicrobial Resistance. The plan details a comprehensive framework of interventions designed to reduce the disease burden and the spread of infection, improve access to and improve use of appropriate antimicrobial agents, strengthen health systems and their surveillance capabilities, introduce and enforce regulations and legislation, and encourage the development of new drugs and vaccines. In implementing the plan, special priority will be given to educating the distributors, prescribers, and consumers of antimicrobial agents; to infection control measures aimed at preventing the dissemination of resistant strains; to quality assurance programs for antibiotics and other medicines; and to the establishment of functional and sustainable laboratories for antibiotic resistance surveillance.

Much of the responsibility for implementing the WHO plan will fall on individual countries, and some of them—especially in the developing world—will need assistance. Toward this end, the Rational Pharmaceutical Management Plus Program, based at a nongovernmental organization, is helping to develop a systematic approach to designing national-level efforts to contain antimicrobial resistance. This approach will provide a framework by which various stakeholders, working with technical consultants



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