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Action Plan — Table of Contents

  • Executive Summary
  • Top Priority Action Items
  • Introduction and Overview
  • The Focus Areas
    • I. Surveillance
      • A. Issue: The United States lacks a coordinated national...
      • B. Issue: Implementation of the national plan for AR surveillance will...
      • C. Issue: Monitoring AR in agricultural settings is essential to ensure animal and plant health and a safe food supply.
    • II. Prevention and Control
      • A. Issue: Appropriate use of antimicrobial drugs can offer great benefits to patients, but overuse and misuse of these drugs can hasten the development of resistance and shorten the drug’s useful life.
      • B. Issue: Improved diagnostic practices can enhance antimicrobial use and patient care.
      • C. Issue: Preventing infection transmission through improved infection control, behaviors that prevent infection (e.g., safe sexual practices), and use of vaccines can help prevent the spread of antimicrobial resistance.
      • D. Issue: Prevention and control of drug resistance in agriculture and veterinary medicine is important to promoting animal and plant health, as well as in preventing AR transmission to humans through the food supply or through contact with infected animals or the environment.
      • E. Issue: Efforts to prevent and control AR emergence and spread must be comprehensive and multifaceted, involve a wide variety of nonfederal partners and the public, and become a part of routine practice nationwide.
    • III. Research
      • A. Issue: Specific scientific gaps remain in the understanding of microbial physiology, ecology, genetics and mechanisms of resistance.
      • B. Issue: The existing research infrastructure needs to ensure a critical mass of researchers in AR and related fields.
      • C. Issue: Special efforts are needed to translate research findings into medically useful products for human and agricultural/veterinary use, such as novel antimicrobial therapeutics, diagnostic tests, vaccines and other tools for preventing AR emergence and spread.
    • IV. Product Development
      • A. Issue: Researchers and drug manufacturers need to be better informed of current and projected gaps in the arsenal of antimicrobial drugs, vaccines, and diagnostics and of potential markets for these products.
      • B. Issue: Existing market incentives and regulatory processes may be insufficient to stimulate the development of certain priority AR products while fostering their appropriate use.
      • C. Issue: The development and use of antimicrobial drugs and related products in agriculture and veterinary medicine should be optimized to reduce the development and transfer of resistance to pathogens that can infect humans.
  • References
  • Index to the Action Items
  1. In this document, the term "antimicrobial" is used inclusively to refer to any agent (including an antibiotic) used to kill or inhibit the growth of microorganisms (bacteria, viruses, fungi, or parasites). This term applies whether the agent is intended for human, veterinary, or agricultural applications.
  2. Implementation of this Action Plan requires working with a wide variety of partners, e.g., state and local health agencies, universities, professional societies, pharmaceutical and biotechnology companies, healthcare delivery organizations, insurers, agricultural producers, consumer groups, and the public. A wide variety of expertise is needed, e.g., from clinicians, consumers, pharmacists, microbiologists, epidemiologists, behavioral and social scientists, economists, health policy researchers, and others. Partners and expertise needed will vary with different action items.
  3. In this Action Plan, appropriate antimicrobial drug use is defined as use that maximizes therapeutic impact while minimizing toxicity and the development of resistance. In practice, this means prescribing antimicrobial therapy when and only when beneficial to a patient; targeting therapy to the desired pathogens; and using the appropriate drug, dose, and duration.
  4. Except where specified, these issues, goals, and action items apply to human AR issues and not to nonhuman (e.g., agricultural) issues. Agricultural issues refer to the production of animals and plants, as well as fish and other species (aquaculture).
  5. Public health surveillance is the ongoing, systematic collection, analysis, and interpretation of data for use in the planning, implementation, and evaluation of public health practice. Desirable qualities of any system include simplicity, flexibility, acceptability, sensitivity, and representativeness. A surveillance system also includes the timely dissemination of these data to persons who can undertake effective prevention and control activities, including clinicians, researchers, laboratorians, and public health personnel. (MMWR, Guidelines for Evaluating Surveillance Systems, May 6, 1988/37(S5);118.)
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