U.S. Updates Antibiotic Resistance Plan: Here's What's New

On October 9, the U.S. government released an update to its National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), which aims to combat antibiotic-resistant bacteria and subsequent infections. There are more than 2.8 million antibiotic-resistant infections—and 35,000 deaths—in the U.S. each year.

The report updates the original plan, released in 2015.

The plan aims to:

1. Slow the growth of resistant bacteria and prevent infections from spreading
2. Strengthen surveillance efforts
3. Advance development and use of rapid diagnostic tests
4. Accelerate the development of new antibiotics, vaccines, and alternative therapies
5. Boost global collaboration on antibiotic-resistant prevention and control

Helen Boucher, MD, chief of geographic medicine and infectious diseases at Tufts Medical Center in Massachusetts, who was not involved with the plan, tells Verywell more people need to understand the gravity of antibiotic-resistant infections in order to curb the threat.

Boucher calls the updates ambitious, but “very welcome.”

What is Antibiotic Resistance?

Antibiotics, also known as antimicrobial medicines, are used to destroy bacteria. Resistance occurs when germs such as bacteria and fungi develop the ability to survive the drugs designed to kill them.

“Antibiotic resistance will always be a problem,” Brian Luna, PhD, an assistant professor of molecular microbiology and immunology at the Keck School of Medicine of USC in California, tells Verywell. “The numbers of bacteria and their diversity is really what makes antibiotic-resistance such a difficult problem."

Antibiotic resistance can affect people at any stage of life. Infections caused by resistant germs are difficult—sometimes impossible—to treat, according to the Centers for Disease Control and Prevention (CDC).

“In nature, bacteria produce antibiotics and develop resistance mechanisms as competitive strategies to survive,” Luna says. “As a society, we can mitigate the problem by adhering to best practices for the use of antibiotics, however, it seems unlikely that we can ‘eliminate’ the problem of antibiotic resistance."

About The Plan

The Federal Task Force for Combating Antibiotic-Resistant Bacteria created the new plan. The task force is a group of federal departments including the U.S. Department of Health and Human Services (HHS), the U.S. Department of Agriculture, (UDSA) the Department of Defense, and the agencies within them, including the CDC and the Food and Drug Administration (FDA).

The updates make a better attempt at integrating efforts across multiple departments within the government, Boucher says.

The report acknowledges a decrease in deaths due to antibiotic-resistant infections, but urges more progress. While infections have declined, other threats have emerged—such as pollution contributing to antibiotic resistance. Treatments for people with antibiotic-resistant infections remain limited.

The COVID-19 pandemic may complicate the issue as well. The report states antibiotic-resistant infections can complicate the response to public health emergencies such as the pandemic. While the consequences of antibiotic resistance are not yet known for COVID-19 treatment, increasing the use of antibiotics could exacerbate infections.

Goals for Battling Bacteria

Beyond its five overarching goals, the plan outlines several objectives or targets. For instance, by 2025, the CDC is tasked with lowering healthcare-associated antibiotic-resistant infections by 20% and community-acquired antibiotic-resistant infections by 10%.

The plan also calls the development of 10 novel therapeutics by 2022. Making new diagnostic tools readily available, however, will be a challenge. The way payment works within healthcare systems, Boucher says, may make it difficult for everyone to access testing.

“Those are hard targets, but it’s good to have hard targets and concrete goals,” Boucher says.

The plan hopes to promote the economic sustainability of the antibiotics market through collaboration with the private sector. Part of this goal includes creating a network of clinical trial sites in order to reduce barriers for research.

Departments and agencies will provide an annual report to mark progress on their assigned objectives. “There’s greater accountability, which I think is excellent,” Boucher adds.

Identifying Threats

Last fall, the CDC released its 2019 AR Threats Report, an update to the 2013 report, listing 18 germs posing the largest threats of antibiotic resistance. The report defines these germs as urgent threats:

• Carbapenem-resistant Acinetobacter
• Candida auris (C. auris)
• Clostridioides difficile (C. difficile)
• Carbapenem-resistant Enterobacteriaceae (CRE)
• Drug-resistant Neisseria gonorrhoeae (N. gonorrhoeae)

The topic of antibiotic resistance emerged on the global stage between 2014 and 2016, though researchers have known about it much longer. Over time, there's been a growth in awareness about the issue and what can be done to curb it, but Boucher hopes this is just the start.

Protecting Yourself

Because antibiotic resistance affects everyone, all of us need to be aware of the issue and make sure we’re not needlessly taking antibiotics, Boucher says.

Education needs to go beyond teaching medical professionals how to prevent contamination and treat antibiotic-resistant infections. All people, including children, need to understand the danger of antibiotic-resistant infections and make sure they only take antibiotics when necessary, she says.

People need to question their doctors when offered antibiotics, Boucher says. You should talk to your doctor, and vice versa, to discern when common cold or flu symptoms are caused by a virus, therefore not warranting antibiotics. According to Boucher, it's important we refrain from taking antibiotics when our body doesn’t need them to eliminate the risk of building up a tolerance.