December 12, 2019
This week’s Study Break highlights work of our faculty to address the global crisis of antimicrobial resistance. Efforts at UTHealth and McGovern Medical School are led by Dr. Luis Ostrosky-Zeichner, professor of internal medicine, Division of Infectious Diseases, and Dr. Cesar Arias, professor of internal medicine, Division of Infectious Diseases, and director of the Center for Antimicrobial Resistance and Microbial Genomics.
Can you imagine a time when potentially untreatable infections that are resistant to all antibiotics will limit our ability to safely perform lifesaving procedures, including major surgery, C-sections, transplants, or to give chemotherapy to cancer patients or to use immunomodulators for patients with rheumatic or gastrointestinal diseases? Can you imagine a time when we will care for patients with untreatable infections?
Physicians and scientists are calling this the “post-antibiotic era,” and the bad news is that this is not something theoretical or in our imagination … it’s already happening. In the recently released Antimicrobial Threat Report by the Centers for Disease Control and Prevention, it is estimated that more than 2.8 million antibiotic-resistant infections occur in the United States each year, and as a result, more than 35,000 people die. A global report also suggests that the antimicrobial resistance crisis may kill more people than cancer by the year 2050. We are living in the midst of a true public health crisis, with urgency to address the problem. We all need to carefully assess what we do every day to avoid creating further antimicrobial resistance in our community.
The CDC sponsors Antibiotic Awareness Week to highlight steps that can be taken to improve antibiotic prescribing and use. Among them are critical time periods for antibiotic decision-making. These 4 moments of antibiotic prescribing are a framework for carefully considering the need for and use of antibiotics: 1) Does my patient have an infection that requires antibiotics? 2) Have I ordered the appropriate cultures or tests before starting empirical antibiotics? 3) Can I stop, “de-escalate,” or step down to oral antibiotics? and 4) What duration of antibiotics is needed?
Our faculty are working to address this global threat. Led by Dr. Arias, CARMiG, is a world-class center dedicated to the study of antimicrobial resistance. The annual meeting of CARMiG will take place Jan. 22-24, 2020, with talks by experts in the field. The antimicrobial stewardship program at Memorial Hermann-Texas Medical Center, led by Dr. Ostrosky and Dr. Michael Chang, assistant professor of pediatrics, has been recognized nationally by the Infectious Diseases Society of America as a Center of Excellence. The antimicrobial stewardship program at Harris Health’s Lyndon B. Johnson Hospital, led by Dr. Charles Ericsson, professor of internal medicine/infectious diseases, has made strides in terms of both antimicrobial resistance and cost containment. Dr. Karen Vigil, associate professor of internal medicine/infectious diseases, is pioneering an outpatient antimicrobial stewardship program at our UT Physicians clinics.
Together we can safeguard our fragile antimicrobial pipeline and ensure that future generations benefit from needed and life-saving antimicrobials.
Please join me in thanking Drs. Arias, Ostrosky-Zeichner, Chang, Ericsson, and Vigil for their leadership and dedication to this important worldwide problem.
P.S. Attached please find a list of current legislative issues and congressional leadership for your contact that are involved in key legislation this month affecting medical schools and their teaching hospitals.
P.P.S. Earlier this week we celebrated Human Rights Day, a reminder of the Universal Declaration of Human Rights.