Our voices have power: Driving change to address antimicrobial resistance

As an infectious diseases physician and antibiotic steward, I work every day to ensure that patients with hard-to-treat bacterial and fungal infections receive optimal therapy that maximizes cure and minimizes toxicity and the emergence of antimicrobial resistance. Last month, I had the opportunity to impact AMR at a national level by joining patients and other AMR experts to talk with policymakers in Washington, D.C., about the PASTEUR Act — a bipartisan bill in Congress that would strengthen our antibiotic pipeline and provide new funding for antibiotic stewardship programs. 

I met individually with staff for several congressional representatives who worked in health care before serving in Congress. Given their background, these representatives often have a particular interest in health care issues and can be especially effective in persuading their peers in Congress to support health care proposals. 

I shared my daily realities to paint a picture for congressional staff about the need for federal action on AMR. I spoke about patients at my hospital, often young adults, who after months and sometimes years of ill health and painful treatments successfully undergo organ or bone marrow transplants only to succumb to infections with resistant organisms. With our meager antibiotic options, we are forced to debate when to give a new agent, knowing that a patient may only have one shot at treatment before resistance develops ― and the patient, family and health care providers face the heartbreak of running out of therapeutic options entirely.  

I also spoke about the powerful impact of antibiotic stewardship programs on patient outcomes and AMR, as well as the greater impact we could have with more resources, particularly in smaller hospitals, long-term care facilities and more rural areas that are all eager for access to more ID and stewardship expertise. I experienced firsthand the need for access to antibiotic stewardship and ID expertise across all types and sizes of facilities across the United States when working with hospitals, nursing homes and ambulatory practices to implement the Agency for Healthcare Research and Quality’s Safety Program for Improving Antibiotic Use, an intervention that aimed to develop and enhance stewardship infrastructure and train frontline clinicians to be “self-stewards.”  

Repeatedly, participating sites noted the value and necessity of access to stewardship and ID experts provided by the program; many had had no previous access to these resources, especially since nearly 80% of counties in the U.S. do not have a single ID physician. Unfortunately, funding for the project is ending, and participating sites have lost their access to this expertise, although all materials from the AHRQ Safety Program are publicly available as toolkits.  

In the afternoon, I participated in a panel discussion featuring patients and advocates and attended by members of Congress and their staff. Each of us had unique backgrounds — a patient with cystic fibrosis, a woman who lost her daughter to a multidrug-resistant infection, a woman who nearly lost her leg to a MRSA infection acquired in the college athletic setting, a lawyer who now advocates for solutions to fix the antibiotic pipeline and a health policy expert — but we shared a common passion to enact the PASTEUR Act to ensure the availability and optimal use of antibiotics for patients who need them. 

As ID physicians, we routinely use our voices to help our patients and to lead our hospitals’ antibiotic stewardship and infection prevention and control programs. Our voices also have the power to drive change at a national level. While our specialty is in the national spotlight, we have the opportunity to focus the country’s attention on other major ID threats like AMR.    

You can urge your senators and representatives to combat antimicrobial resistance by cosponsoring the PASTEUR Act. Want to get involved in additional efforts to drive change to address AMR and other key issues? Visit the IDSA/HIVMA Action Center today.