GAO urges tighter antibiotic resistance checks

The federal government should step up monitoring of antibiotic use and antibiotic resistance to help stem overuse of the drugs, which is rendering them ineffective, says a report by the U.S. Government Accountability Office.

The GAO is calling on the Centers for Disease Control and Prevention to better track human antibiotic use and antimicrobial-resistant infections in inpatient health care facilities.

"Without more comprehensive information about the occurrence of cases of antibiotic resistant infections and the use of antibiotics, the agency's ability to understand the overall scope of the public health problem, detect emerging trends, and plan and implement prevention activities is impeded," said the June report (link).

The Dept. of Health and Human Services responded with a letter detailing several initiatives, including a survey of acute care hospitals and enhancements to surveillance systems such as the CDC's National Antimicrobial Monitoring System.

"We believe that when these many activities come to fruition, they will provide a complete and accurate national picture of the public health impact of antimicrobial resistance," said Steve Solomon, MD, director of CDC's Office of Antimicrobial Resistance.

The federal government has the scope and authority to combat the problem, and the report shows at least one agency recognizes the issue's importance, said James R. Johnson, MD, a member of the Infectious Diseases Society of America's Antimicrobial Resistance Work Group and professor at the University of Minnesota Medical School. "It's a step in the right direction. The antibiotic resistance problem is huge, and we don't have a good handle on what's driving it."

William Schaffner, MD, professor and chair of preventive medicine at Vanderbilt University School of Medicine in Nashville, Tenn., said the CDC has done a lot to promote appropriate antibiotic use, and resources would be better invested at the state and local levels. "We know that some antibiotic use is appropriate and some is inappropriate, but you can't determine that from 30,000 feet," he said.