More Education on AMR Legislation is Needed, Sepsis Alliance Survey Shows
January 17, 2023
In 2019, the World Health Organization listed antimicrobial resistance (AMR) among the top threats to global health. AMR, which occurs when infectious germs adapt to avoid the antimicrobial medicines designed to combat them, dangerously threatens our treatment of sepsis. As more germs become resistant to antimicrobials, infections are more likely to progress into sepsis, and sepsis cases will become increasingly difficult to treat.
According to Cindy Hou, DO, an infectious diseases specialist and Sepsis Alliance’s Chief Medical Officer, AMR is caused by a mix of factors. “Antimicrobial resistance is driven by inappropriate antibiotic use, the lack of new antimicrobials, the lack of complete uptake of vaccinations, and partial completion of antibiotics by patients,” Dr. Hou said. “These factors are important contributors to AMR and need to be considered when discussing AMR and necessary interventions.”
In September 2022, Sepsis Alliance heralded a survey conducted by Radius Global Market Research of among more than 150 infectious disease (ID) physicians and pharmacists who have practiced medicine for at least one year to determine their knowledge of AMR, their institutions’ AMR education, and their views on what might help lessen the global burden of AMR. The findings show that 90% of ID physicians and pharmacists consider antimicrobial resistance to be a “major problem” and that there is broad consensus about important actions clinicians themselves can take to improve AMR. However, the data show that there is less of an understanding among ID physicians and pharmacists of larger-scale solutions to AMR – including legislative solutions currently being considered in Congress, like the PASTEUR Act.
ID Physicians and Pharmacists Know What They Can Do
The ID physicians and pharmacists surveyed were asked about what they, themselves, can do to improve AMR. According to the findings, 90% of ID physicians and pharmacists consider AMR to be a “major problem,” and 96% assume personal responsibility for solving AMR. There is, similarly, a strong consensus among this group about what measures they can take to solve the problem.
97% believe that analyzing antibiotic use data is a key AMR improvement strategy, while 93% consider institutional antibiotic use guidelines to be an important piece of the solution. 94% see decreasing inappropriate utilization and prescription of broad-spectrum antibiotics at the facility level to be a leading opportunity to improve AMR.
“Overall, the majority of ID physicians and pharmacists are working in facilities that have an antimicrobial stewardship program or prioritize AMR in some way,” said Claudia Orth, BSN, RN, Director of Provider Education and Training at Sepsis Alliance. “Among those providing direct clinical care, we see wide familiarity with the CDC Core Elements of Hospital Antimicrobial Stewardship Programs and a strong sense of personal responsibility for solving this growing problem. All of this is key for making progress on AMR.”
What’s more, 81% of this group see lack of development of new drugs to treat infection to be a major problem. This piece of the AMR puzzle requires a larger-scale solution.
In addition to these clinical solutions, there are also legislative solutions to AMR currently being considered in Congress. One of these is the PASTEUR Act, which seeks to combat the problem of superbugs adapting to avoid antimicrobial drugs in two ways:
- First, by establishing a model of subscription-style payments between the federal government and drug manufacturers, the PASTEUR Act would encourage the development of new antimicrobials – ones that no germs have become resistant to yet.
- Second, the PASTEUR Act would create a grant support pathway for the protection of drugs we already have, to keep them working effectively.
“The PASTEUR Act will create a pull incentive that will ensure a robust pipeline of novel treatments in years to come,” said Kristin DeVries, Director of Policy and Advocacy at Sepsis Alliance. “This bill, along with Lulu’s Law – which would curate and connect disparate data on sepsis and its association to AMR – has the potential to change the treatment landscape for common infections that can spiral into sepsis.”
Lulu’s Law, a bill that would expand the collection of data relating to sepsis and the infectious, often drug-resistant, germs that can cause it, has been introduced in both the House of Representatives and the Senate. More thorough data would help us better understand and manage these public health threats (learn more about how to support Lulu’s Law here).
Legislation: Less Understood
Among ID physicians and pharmacists, there is a lower level of understanding of legislative solutions to AMR than there is of clinical or personal solutions. According to Sepsis Alliance’s survey, only 36% report that they are “very” or “somewhat” familiar with the PASTEUR Act, with pharmacists demonstrating slightly more familiarity (41%, as compared to only 33% of ID physicians). Numbers were similarly low for other proposed legislative solutions to AMR, such as only 28% familiarity with the DISARM Act.
Of those familiar with PASTEUR, only 31% of ID physicians and pharmacists believe the legislation would help promote responsible and appropriate antimicrobial stewardship, despite funding for stewardship programs being a key portion of the bill.
Going forward, it will be important to increase clinicians’ familiarity with legislative solutions like the PASTEUR Act, and to ensure that ID physicians and pharmacists understand the implications of these AMR-related bills to their own facilities and practices. Clinicians can be encouraged to become vocal supporters of these legislative solutions, using their valuable perspectives on AMR to emphasize the benefit of legislative intervention on patient wellbeing and on the health of the populations they serve. “We need to do more to educate physicians and pharmacists on real-life legislative interventions to the burgeoning AMR crisis,” said Kristin DeVries. “Educational efforts will help clinicians understand the options available and champion these life-saving efforts, before the next individual reaches those ER doors.”
“Legislative solutions to this global threat are critically important because they can be large-scale and multi-disciplinary,” said Tom Heymann, President and CEO of Sepsis Alliance. “When we’re thinking about tackling AMR, we want to bring together clinical stewardship work with therapeutic innovation, new research, better data collection, and patient education.”
More work also needs to be done at the grassroots level to help gain additional Congressional support. Members of the Sepsis Alliance community can get involved by encouraging their Congressional representatives to support the life-saving PASTEUR Act. Do so in just a few clicks here!
Looking for more ways to get involved? Visit EndSuperbugs.org to discover AMR resources, including downloadable information guides, stories of personal experiences with AMR, and more. You can also discover more advocacy actions to take today at SepsisVoices.org.
Funding for this survey was provided through a grant from PhRMA.