Activities to address antimicrobial resistance in the United States

Antimicrobials are essential for the prevention and treatment of bacterial infections in humans and animals. Subtherapeutic antimicrobials have been used as growth promoters for >40 years. The subject of antimicrobial resistance is not new but has gained increasing attention due to public-health concerns about multi-resistant pathogenic organisms. Numerous United States' activities do exist to address antimicrobial resistance. A surveillance system (the National Antimicrobial Resistance Monitoring System) was established in 1996 to monitor changes over time in resistance for 17 antibiotics in humans and animals. Educational campaigns have been created to promote the judicious therapeutic use of antimicrobials. Producer groups are developing guidelines for judicious therapeutic antimicrobial use for their prospective species. Basic and applied research programs are being expanded to answer many of the unsolved questions regarding development, persistence, and transmission of antimicrobial resistance. This paper focuses on a federal inter-agency public-health action plan to combat antimicrobial resistance; the plan was released for public comment in 2000. This plan addresses goals and actions to combat antimicrobial resistance in humans and agriculture in four areas: surveillance; research; prevention and control; product development.