Antibiotic resistance. Rhode Island’s next health emergency? – Kerry LaPlante, Pharm.D.

by Kerry LaPlante, Pharm.D., F.C.C.P., F.I.D.S.A

Last week, I met with Rhode Island congressional staffers as part of The Pew Charitable Trusts’ Stand Up to Superbugs initiative. Together with dozens of health care professionals, scientists, farmers, superbug survivors, and others from across the country, I urged our policymakers to prioritize efforts to combat a looming global health threat that threatens the future of modern medicine: antibiotic-resistant bacteria.

As the COVID-19 pandemic rages on, Rhode Islanders have seen the importance of strengthening public health infrastructure before a disaster hits. I know this all too well from my work as chairperson of the Rhode Island Department of Health Antimicrobial Stewardship and Environmental Cleaning Task Force. In that group, we work to bring an interdisciplinary approach in providing resources to healthcare facilities to create and implement antimicrobial stewardship programs and improve infection control practices throughout the state of Rhode Island.

Antibiotic resistance happens when bacteria evolve to evade the drugs used to treat them. The result is increasingly hard-to-defeat “superbugs,” which not only threaten individual patients, but modern medicine as we know it. The Centers for Disease Control and Prevention (CDC) estimates about 3 million antibiotic-resistant infections occur each year in the U.S. and tens of thousands of people die from them. In Rhode Island, CDC has reported the presence of carbapenem-resistant Enterobacteriaceae, commonly referred to as the “nightmare bacteria” because of its resistance to nearly all available antibiotics and difficulty to treat.

I have always felt that the small geographic size of Rhode Island offers advantages in managing infectious disease control, namely, it enables clear communication and personalized outreach to a relatively centralized healthcare network. It’s also noteworthy that Rhode Island is home to nationally and internationally-recognized experts in the treatment, control, and prevention of multi-drug resistant pathogens.

Among the expert community, there’s consensus that the world is on the cusp of a post-antibiotic era, in which even simple infections could become deadly, and medical procedures like surgery, chemotherapy and dialysis too dangerous. Further, this problem is likely escalating during the pandemic with so many COVID-19 patients receiving antibiotics.

Unfortunately, the U.S. overall is not prepared to meet this threat. The antibiotics market is broken and the innovation needed to fight superbugs is at a standstill. The last new class of antibiotics was discovered more than 35 years ago. And, to make things worse, large companies making antibiotics are exiting the market. The drug companies behind five of the 15 new antibiotics approved since 2010 have collapsed, unable to maintain their investments in these drugs. Without increased federal attention to antibiotic resistance, the antibiotics market will be unable to meet the need for new, effective drugs and superbugs will become harder to treat.

The good news is that there is clear action Congress can take to ensure the U.S. is not caught flat-footed when new, dangerous superbugs emerge. Last week I asked policymakers to take two key steps:

1.  Congress needs to shore up resources for public health agencies on the front lines of the fight against antibiotic resistance. Agencies like the CDC, the Food and Drug Administration, the National Institutes of Health, the Biomedical Advanced Research and Development Authority, and the U.S. Department of Agriculture require sustained and significant investment to strengthen public health infrastructure and fight superbugs.

Supporting these agencies would help expand U.S. efforts to collect data to track resistant bacteria, advance prescriber and health system stewardship programs, and fund essential medical and veterinary research on antibiotic use and resistance. This bipartisan commitment would ensure that scientists and policymakers have the tools they need to respond effectively to superbugs.

2. In addition to federal funding, Congress should move quickly to pass legislation to stimulate the antibiotics market, like the bipartisan PASTEUR Act. The PASTEUR Act, first introduced in the House and Senate in 2020, would jump-start the development of urgently needed new antibiotics by changing the way the U.S. government pays for them, while also helping to protect the drugs we need for medical treatments today. This is a key step to make sure patients have sustainable access to new antibiotics when they need them.

The COVID-19 pandemic made it clear that the best time to take action to protect Rhode Islanders is before a disaster strikes. Rhode Island members have shown leadership on these issues in the past—join me and take action here to urge Rhode Island’s congressional officials to defend our state against antibiotic resistance.

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Bio: Kerry LaPlante, Pharm.D., F.C.C.P., F.I.D.S.A., is department chairperson and a tenured professor of pharmacy at the University of Rhode Island, an adjunct professor of medicine at Brown University, and director of the antimicrobial stewardship clinical research program and fellowship at the Veterans Affairs Medical Center in Providence, Rhode Island. She is a member of the Rhode Island COVID-19 Vaccine Subcommittee, the immediate past president of the Society of Infectious Diseases Pharmacists, Vice President of Making a Difference in Infectious Diseases (MAD-ID), chairperson of the Rhode Island Department of Health’s Antimicrobial Stewardship and Environmental Cleaning Task Force, and technical expert for the Joint Commission’s Leading Practices in Antimicrobial Stewardship panel.