The Last Line of Defense: New Solutions in the Fight Against AMR

We are today, as the earliest warnings predicted, at the cusp of a post-antibiotic era.  However, technologies that radically alter our understanding of the epidemiologic, microbiologic, economic, social and behavioral complexities of the antibiotic resistance crisis offer an opportunity to effectively address this urgent global public health problem.  From the bedside in the clinic to intergovernmental global public health collaborations, and spanning the continuum of developing to highly developed economies, significant changes in the way data and information are obtained, managed, transmitted, translated and communicated can overcome existing barriers to combating the spread of antibiotic resistance.    These innovations can improve the timeliness, the quality and the utility of information to make decisions vital to preventing and treating antibiotic resistant infections and designing and successfully implementing appropriate public health policies locally, nationally and globally. 

This presentation will review opportunities to use existing and emerging technologies to generate and employ information to address antibiotic resistance and consider the necessary steps to make such progress a reality.  Rapid diagnostics to identify etiologies and genetic markers of resistance combined with electronic patient data can transform the availability and usefulness of data from the laboratory and the clinic.   Application of new knowledge of bacterial and human genomes and the human microbiome can suggest prevention and treatment strategies that may reduce the need for antibiotics.  Innovative analytic approaches can transform these data into actionable information that can lead to more accurate clinical decision-making and near real-time public health surveillance to improve prescribing, make infection control more effective, and assure early warning of newly emerging resistance problems while those problems can still be contained.    Long-distance training using digital platforms and technical assistance can leverage significant quality improvement in laboratory and public health response capacity in developing and developed economic environments.   Extensive electronic data on bacteriology, clinical infections and antibiotic use and prescribing may offer researchers, clinicians and public health authorities the potential to develop evidence-based approaches  for priority setting, intervention design and evaluation, and targeting the highest-risk threats while making optimal use of limited prevention and control resources.     The use of communication technologies and health marketing strategies, informed by data derived from internet searches and social media, can profoundly change our understanding of the behavioral economics of how health professionals and consumers think about antibiotics and antibiotic resistance and help alter the widely-held but false perception that antibiotics are a virtually no-risk solution to a variety of health and economic problems.