Researcher joins nationwide effort to monitor resistance to antibiotics

Because infectious microorganisms are becoming increasingly resistant to antibiotics, a Wayne State University researcher has joined a nationwide effort to monitor that resistance while optimizing the use of existing drugs.

Michael Rybak, Pharm.D., M.P.H., professor of pharmacy and medicine and director of the Anti-Infective Research Laboratory in the Eugene Applebaum College of Pharmacy and Health Sciences, recently received $223,000 for six months from the Michigan Department of Community Health (MDCH) to create a mechanism to enable better stewardship of antimicrobials and reduce resistance to them.

In recent years pharmaceutical companies have produced fewer antibiotics, which are used to treat microbial infections. That is because they offer smaller returns on investment than drugs used to treat chronic diseases such as diabetes, arthritis or hypertension and because of the difficulty of getting new anti-infectives approved by the Food and Drug Administration. A decade ago, Rybak said, companies were producing up to 20 new antibiotics a year, but now are down to maybe one or two - and in some years, none.

"We can't continue the way we are," he said. "We're going to get to the stage where there are patients with serious infections but no effective antibiotics to treat them. We are simply not keeping pace with the development of bacterial resistance to antibiotics."

To minimize the development of drug resistance, the Centers for Disease Control and Prevention (CDC) recently made available a pool of money as part of the Affordable Care Act for which state health departments could apply; MDCH is among the first nationally to do receive such a grant.

Rybak's project, "Improving Hospital-based Antimicrobial Prescribing Towards Reducing Antimicrobial-Resistant Hospital-Acquired Infections," will involve working with medical support vendors to develop reporting software that can merge information with data already being collected by the National Healthcare Safety Network (NHSN). The network enables health care providers to report epidemiology and infection data to the CDC.

Previously, researchers could look only at resistance patterns and compare them to hospital purchases of antimicrobials, but Rybak said such data yields only a rough estimate at best on how antibiotics are being prescribed.

"Just because somebody purchases drugs doesn't mean they're using them," he said.

Rybak's project is a surveillance attempt to determine how antibiotics are being prescribed. By allowing additions to the NHSN report, his grant will help researchers validate which patients receive a particular antibiotic in a specific unit in a given hospital.

The new module will derive data from bar coding systems in use at the Detroit Medical Center and the University of Michigan Health System and soon to be adopted by the Henry Ford and Beaumont health systems that document patient administration of antibiotics. It will enable researchers to trace resistance patterns to regions, states, cities and even hospital systems.

"This will vastly enhance our ability to discourage the development of antibiotic resistance," Rybak said. "Stewardship of antimicrobials including antibiotics means trying to steer the appropriate use of antimicrobials at the most optimized dose so resistance doesn't develop so quickly that we can't keep pace with it.

"We're not producing a lot of anti-infectives, so we really have to preserve the ones we have. Because unfortunately, antibiotic resistance continues to increase worldwide.

"Microbes are very quick and very smart, and they'll be here long after we're gone."

Source: Wayne State University - Office of the Vice President for Research