What gives you hope that we can tackle the problem?

At Salem Hospital we are rolling out two new treatments this fiscal year in our ED (emergency department) population. Single-dose gentamicin for the treatment of acute cystitis (bladder infections). Some benefits include increased patient compliance, fewer patient call backs for therapy changes and decreased antibiotics. The other treatment is dalbavancin in order to treat moderate SSTIs (skin and soft tissue infections) benefits of this include decreased hospitalization, decreased patient and hospital cost and increased patient compliance.

- Danielle Britt, PharmD, MA, Infectious Diseases Pharmacist, Salem Health Hospital

I am particularly intrigued by the recent rise of artificial intelligence (AI) technologies. We are in early stages, but I foresee that AI will play many critical roles for the many complex challenges involved with antibiotic resistance.

- Zintars Beldavs, Acute and Communicable Disease Prevention Manager at Oregon Health Authority

I strongly believe that improvements anywhere can lead to impacts everywhere. Resistance is a problem that clinicians recognize and day to day they are mindful that overuse of antibiotics has downstream consequences. Collectively, we want to ensure that these vital medications remain effective and to take the best care of our patients. Additionally, COVID-19 showed the tenacity and ferocity the world has to generate new evidence and create novel therapies and vaccines. I know the global community will continue to innovate ways to fight back against resistance.

- Jeremy Tigh, PharmD, BCIDP, Antimicrobial Stewardship Pharmacist, Samaritan Health Services

One progressive step in the healthcare setting has been de-labeling people previously labeled as “penicillin-allergic." Studies have shown that most people labeled as “penicillin-allergic" in their hospital record are not in fact allergic. Using an oral challenge with a low-dose of penicillin is relatively safe and can lead to a majority of these patients being de-labeled. This is also a very cost-effective approach. Also, the recognition that beta-lactam allergies are almost always related to the side chains. So even someone truly allergic, for example, to ceftazidime, can safely be given cefazolin – because the two drugs don't share side chains.

- Paul R. Cieslak, MD, Infectious Disease Physician, Medical Director of Communicable Diseases and Immunizations at Oregon Health Authority

There are many important global, national, state, and local efforts to address this issue, ranging from innovative programs to promote new drug development all the way to massive efforts to reduce unnecessary antibiotic prescribing.  Political leaders, industries, doctors, and patients will need to work together to bend the curve on this issue.

- Christopher Pfeiffer, MD, MHS.  Section Chief and Hospital Epidemiologist, VA Portland Health Care System, Medical Director of the Oregon's “DROP-CRE" Network