The White House unveiled a five-year, $1.2 billion plan Friday to contain outbreaks of infections that are resistant to drugs and can be deadly to humans.
The initiative ties into a wider effort that was announced by the White House Wednesday, in which the government and health care providers will be taking proactive measures toward a health care delivery and payment system that rewards providers for the quality of care they provide rather than the quantity.
Preventing the spread of bacteria in hospitals and other health care facilities – thereby removing the threat of illness and readmissions – is a key component to lowering costs. The Centers for Disease Control and Prevention estimates that each year in the U.S. drug-resistant bacteria cause 2 million illnesses and about 23,000 deaths.
Issues with antibiotic-resistant bacteria have come to the forefront of national conversation after a recent spread of a "superbug" by a medical device used in hospitals caused several deaths and many illnesses.
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The White House plan, the National Action Plan for Combating Antibiotic-Resistant Bacteria, extends to veterinary medicine, agriculture, food safety, and research and manufacturing. It pulls from numerous agencies – including the Centers for Medicare and Medicaid Services, the Department of Veterans Affairs, and the Department of Agriculture – to set strict goals and guidelines for the use and tracking of antibiotics. Part of the funding – requested by President Barack Obama, which nearly doubles the U.S. investment, he said in a WebMD article published Friday – will go toward researching new technologies for testing, treatment and vaccinations. The plan outlines specific ways to monitor and block the spread of harmful diseases.
Drug-resistant bacteria occur when someone has repeated exposure to antibiotics. A bacteria then mutates or takes on new genes, making an antibiotic unable to kill it or inhibit its growth. According to the Association for Professionals in Infection Control and Epidemiology, more than half of hospital patients are prescribed antibiotics because they become vulnerable to bacterial infections after surgery, for procedures ranging from hip replacements to organ transplants. Studies by the CDC have shown, however, that 30 percent to 50 percent of antibiotics prescribed in hospitals are unnecessary or incorrect.
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Obama said in the WebMD interview that over-prescribing antibiotics is a serious problem. "Studies have consistently shown that a lot of America's antibiotic use is unnecessary," he said. The action plan includes a 2020 goal to reduce inappropriate antibiotic use by 50 percent in outpatient settings and by 20 percent in inpatient settings.
The initiative will target specific infections, such as carbapenem-resistant Enterobacteriaceae (CRE), methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile.
C-diff, in particular, has become the most common microbial cause of health care-associated infections in the U.S., costing hospitals about $4.8 billion each year in excess costs, according to the Association for Professionals in Infection Control and Epidemiology. A CDC study in February found that nearly twice as many people are infected by the bacteria than previously thought.
The deadly diarrheal infection mostly affects people who take antibiotics. The CDC estimates that the infection caused almost half a million infections in 2011, and that 29,000 U.S. patients died within 30 days of their diagnosis.
Patients who have the infection are twice as likely to be readmitted to the hospital as patients without it, according to a study published in the April issue of the American Journal of Infection Control, the publication of the Association for Professionals in Infection Control and Epidemiology.
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By 2020, the U.S. aims to reduce the incidence of the disease by 50 percent compared to 2011 estimates. The same goal is set for MRSA, and it plans to reduce incidences of CRE by 60 percent.
The plan also will create a system to show real-time rates of antibiotic use and where cases of drug resistance are being reported. "If we can see where these drugs are being over-prescribed, we can target our interventions where they're needed most," Obama said in his WebMD interview.
The hospital industry praised the initiative. “We applaud the administration’s efforts and agree with the importance of this issue," Dr. John Combes, chief medical officer for the American Hospital Association, said in a statement. "Hospitals are reviewing the use of antibiotics to ensure they are used only when necessary so that we can deter the development of new antibiotic-resistant bugs ... we will continue to encourage hospitals to use antibiotics appropriately.”
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