Table Of ContentPHARMACOLOGY - RESEARCH, SAFETY TESTING AND REGULATION
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OMBATING NTIBIOTIC
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EPORT TO THE RESIDENT AND
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ATIONAL TRATEGY
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PHARMACOLOGY - RESEARCH, SAFETY TESTING AND REGULATION
C A
OMBATING NTIBIOTIC
R
ESISTANCE
R P
EPORT TO THE RESIDENT AND
N S
ATIONAL TRATEGY
ELIJAH POOLE
EDITOR
New York
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CONTENTS
Preface vii
Chapter 1 Report to the President on Combating
Antibiotic Resistance 1
President’s Council of Advisors
on Science and Technology
Chapter 2 National Strategy for Combating Antibiotic-
Resistant Bacteria 83
President's Council of Advisors on Science
and Technology
Index 123
PREFACE
For an American in the 21st century, it is hard to imagine the world before
antibiotics. At the beginning of the 20th century, as many as nine women out
of every 1,000 who gave birth died, 40 percent from sepsis. In some cities as
many as 30 percent of children died before their first birthday. One of every
nine people who developed a serious skin infection died, even from something
as simple as a scrape or an insect bite. Pneumonia killed 30 percent of those
who contracted it; meningitis killed 70 percent. Ear infections caused
deafness; sore throats were not infrequently followed by rheumatic fever and
heart failure. Surgical procedures were associated with high morbidity and
mortality due to infection. This picture changed dramatically with three major
developments: improvements in public health, vaccines, and antibiotics. Over
the course of the 20th century, deaths from infectious diseases declined
markedly and contributed to a substantial increase in life expectancy.
Antibiotics, in particular, have saved millions of lives. This book discusses
combating antibiotic resistance and provides reports to the presidents and
national strategies.
Chapter 1 – Bacteria and other microbes evolve in response to their
environment and inevitably develop mechanisms to resist being killed by
antibiotics. For many decades, the problem was manageable as the growth of
resistance was slow and the pharmaceutical industry continued to create new
antibiotics. Over the past decade, however, this brewing problem has become a
crisis. The evolution of antibiotic resistance is now occurring at an alarming
rate and is outpacing the development of new countermeasures capable of
thwarting infections in humans. This situation threatens patient care, economic
growth, public health, agriculture, economic security, and national security.
viii Elijah Poole
Developed in consultation with a working group of experts in antibiotic
resistance, this report identifies areas that require urgent attention and offers
practical recommendations to the Federal government for strengthening the
Nation‘s ability to combat the rise in antibiotic-resistant bacteria.
Chapter 2 – The discovery of antibiotics in the early 20th century
fundamentally transformed human and veterinary medicine. Antibiotics now
save millions of lives each year. The rise of antibiotic-resistant bacterial
strains, however, represents a serious threat to public health and the economy.
The Centers for Disease Control and Prevention (CDC) estimates that
annually, at least two million illnesses and 23,000 deaths are caused by
antibiotic-resistant bacteria in the United States alone. If the effectiveness of
antibiotics (drugs that kill or inhibit the growth of bacteria) is lost, we will no
longer be able to reliably and rapidly treat bacterial infections, including
bacterial pneumonias, foodborne illnesses, and health care associated
infections. As more strains of bacteria become resistant to an ever-larger
number of antibiotics, our drug choices have become increasingly limited and
more expensive and, in some cases, nonexistent.
The National Strategy for Combating Antibiotic Resistant Bacteria
identifies priorities and coordinates investments: to prevent, detect, and control
outbreaks of resistant pathogens recognized by CDC as urgent or serious
threats; to ensure continued availability of effective therapies for the treatment
of bacterial infections; and to detect and control newly resistant bacteria that
emerge in humans or animals.
Description:For an American in the 21st century, it is hard to imagine the world before antibiotics. At the beginning of the 20th century, as many as nine women out of every 1,000 who gave birth died, 40 percent from sepsis. In some cities as many as 30 percent of children died before their first birthday. One
