WASHINGTON – More than 90,000 Americans die every year after contracting a bacterial infection in a hospital.
Nearly 70 percent of those infections are resistant to at least one antibiotic. A House subcommittee held the second of three hearings Wednesday about how to combat the problem.
“Rather than ‘use it or lose it,' with antibiotics it's ‘use it and lose it.' And ‘lose it,' we are,” said Rep. Henry Waxman,D- Calif.,who chairs the Energy and Commerce Committee.
Dr. Brad Spellburg said he recognized a need for federal involvement after seeing 23 patients in one month who were resistant to all antibiotics.
“Everyone is at risk for these infections,including healthy Americans from all different communities,” Spellburg told the health subcommittee during the 3½ hour hearing.
An assistant professor of medicine at the University of California,Los Angeles,and a member of the Infectious Diseases Society of America and its Antimicrobial Availability Task Force,Spellburg said,”The time for debate has passed. The time for action is now.”
According to testimony prepared by IDSA,common antibiotic-resistant infections have increased at least 30 percent over the past 20 years.
The number of new antibacterial drugs has decreased from 16 between 1983 and 1987,to one over the past two years. In April,the IDSA launched the “10 x '20” campaign as a global initiative to approve 10 new antibiotics by 2020,posing a potential solution to antimicrobial resistance. These drugs would treat a broader range of illnesses than bacterial infections.
Rep. Jim Matheson,D-Utah,introduced the Strategies to Address Antimicrobial Resistance Act,H.R. 2400,in May 2009.
Matheson said there are four necessary measures to combat the increase in resistance to common antibiotics: creating an antimicrobial task force that would report to the Department of Health and Human Services,developing research and surveillance plans,collecting global data and encouraging public education about overuse and inappropriate use of antibiotics.
“Our committee has a critical role in establishing the foundation of work in this issue,” Matheson said. “I look forward to doing whatever we can to help move this legislation forward.”
But Janet Woodcock,director of the Food and Drug Administration's Center for Drug Evaluation and Research,said the problem cannot be solved by spending more money,decreasing the public's daily demand for antibiotics or increasing general awareness.
“Everybody has noted that it is important that we use antibiotics pertinently,but pertinent use alone is not enough,” Woodcock said.
Woodcock said the FDA is working as quickly as possible to create guidelines for pharmaceutical companies to follow when developing new drugs,but a conflict arises with the lack of primary scientific research needed for testing.
She said market and government failures are partly to blame. Woodcock and committee members pointed out that antibiotics are relatively cheap and that drug companies are focusing their research on more costly drugs to treat chronic illnesses.
Rep. Frank Pallone,D-N.J.,the subcommittee chair,and other committee members chastised Woodcock for not being clear about what the agency needs to solve the problem.
Rep. Marsha Blackburn,R-Tenn.,questioned how much authority the FDA has and noted how ambiguous Woodcock's testimony was about developing new drugs.
“We appreciate the work that you are doing,but we are concerned with the uncertainties of the FDA and the disincentives,” she said.
The first hearing May 5 outlined the problem,and the third hearing will deal with antibiotic use in animals.
Rep. Tim Murphy,R- Pa.,presented a more simple approach to the overuse of today's common drugs.
“The solutions don't require great science or approval of the FDA. The most effective antibiotic is the one you don't have to prescribe,” he said.