National Strategy for Combating Antibiotic Resistant Bacteria.

This National Strategy for Combating Antibiotic Resistant Bacteria is a cross-sectoral policy document. The National Strategy outlines five interrelated goals for action by the United States Government in collaboration with partners in healthcare, public health, veterinary medicine, agriculture, food safety, and academic, Federal, and industrial research. The goals include: 1. Slow the emergence of resistant bacteria and prevent the spread of resistant infections; 2. Strengthen national One-Health surveillance efforts to combat resistance; 3. Advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria; 4. Accelerate basic and applied research and development for new antibiotics, other therapeutics, and vaccines; and 5. Improve international collaboration and capacities for antibiotic-resistance prevention, surveillance, control, and antibiotic research and development.
Under the Goal 1, three objectives are set up: 1.1 Implement public health programs and reporting policies that advance antibiotic resistance prevention and foster antibiotic stewardship in healthcare settings and the community. 1.2 Eliminate the use of medically important antibiotics for growth promotion in animals and bring other in-feed uses of antibiotics, for treatment and disease control and prevention of disease, under veterinary oversight. 1.3 Identify and implement measures to foster stewardship of antibiotics in animals. Four objectives are developed under Goal 2: 2.1 Create a regional laboratory network to strengthen national capacity to detect resistant bacterial strains and a specimen repository to facilitate development and evaluation of diagnostic tests and treatments. 2.2 Expand and strengthen the national infrastructure for public health surveillance and data reporting, and provide incentives for timely reporting of antibiotic resistance and antibiotic use in all healthcare settings. 2.3 Develop, expand, and maintain capacity in State and Federal veterinary and food safety laboratories to conduct standardized antibiotic susceptibility testing and characterize select zoonotic and animal pathogens. 2.4 Enhance monitoring of antibiotic-resistance patterns, as well as antibiotic sales, usage, and management practices, at multiple points in the production chain from food-animals on-farm, through processing, and retail meat. Under Goal 3, the objectives are 3.1 Develop and approve new diagnostics, including tests that rapidly distinguish between viral and bacterial pathogens and tests that detect antibiotic resistance that can be implemented easily in a wide range of settings. 3.2 Expand availability and use of diagnostics to improve treatment of antibiotic resistant infections, enhance infection control, and facilitate outbreak detection and response in healthcare and community settings. The main objectives under Goal 4 include: 4.1 Conduct research to enhance understanding of environmental factors that facilitate the development of antibiotic resistance and the spread of resistance genes that are common to animals and humans; Increase research focused on understanding the nature of microbial communities, how antibiotics affect them, and how they can be harnessed to prevent disease. 4.3 Intensify research and development of new therapeutics and vaccines, first-inclass drugs, and new combination therapies for treatment of bacterial infections. 4.4 Develop non-traditional therapeutics and innovative strategies to minimize outbreaks caused by resistant bacteria in human and animal populations; etc. Under the Goal 5, the key objectives include: Promote laboratory capability to identify at least three of the seven WHO priority AMR pathogens using standardized, reliable detection assays; Develop a mechanism for international communication of critical events that may signify new resistance trends with global public and animal health implications; Establish and promote international collaboration and public-private partnerships to incentivize development of new therapeutics to counter antibiotic resistance including new, next-generation, and other alternatives to antibiotics; vaccines; and affordable, rapidly deployable, point-of-need diagnostics; Support countries to develop and implement national plans to combat antibiotic resistance and strategies to enhance antimicrobial stewardship; Partner with other nations to promote quality, safety, and efficacy of antibiotics and strengthen their pharmaceutical supply chains; etc.