Obama plan to fight antibiotic resistance may limit treatment for Lyme disease

President Barack Obama signed an Executive Order on Thursday, September 18th which creates a task force to address concerns over the spread of drug-resistant bacteria due to an overuse of antibiotics.

The task force by Executive Order must submit an action plan by February 15, 2015, outlining specific steps on how to implement a national strategy to combat antibiotic resistance and accelerate research and development on new antibiotics by 2020.

obama_speakingThe task force will be led by the secretaries of Health and Human Services, the Department of Defense and the Department of Agriculture. A Presidential Advisory Council will also include nongovernmental experts to provide advice and guidance on strengthening surveillance of infections, researching new treatments and developing alternatives to using antibiotics in agriculture.

President’s Council of Advisors on Science and Technology (PCAST) recently released a report finding that bacteria are growing resistant to antibiotics, in part, due to individuals overusing antibiotics. The report also points out that significant amounts of antibiotics are being used in raising farm animals for human consumption and that this is a “matter of serious concern.”

I applaud the President for taking on the fight against antibiotic resistance. And while it’s important to acknowledge the lives lost due to infections not responding to antimicrobial treatment, it’s equally important to keep in mind all the patients who benefit from antibiotic treatments, particularly those suffering from Lyme disease and other tick-borne infections. These patients often have no alternative treatment options, and long-term antibiotics have been found through evidence-based studies to improve their quality of life, restoring them to pain-free, productive lives.

The Obama Executive Order did not include protections to ensure that individuals with other conditions have access to the antibiotics they need. Individuals with Lyme and related tick-borne diseases require antibiotics to prevent serious long-term illness. The International Lyme and Associated Diseases Society (ILADS) 2014 evidence-based treatment guidelines concluded that the benefits of antibiotics can outweigh risks in Lyme disease despite concerns regarding emerging antibiotic resistance.

The ILADS guidelines concluded, “Clinicians should discuss antibiotic retreatment with all patients who have persistent manifestations of Lyme disease. These discussions should provide patient-specific risk–benefit assessments for each treatment option and include information regarding C. difficile infection and the preventative effect of probiotics (although none of the subjects in the retreatment trials developed C. difficile infection).”

According to the CDC, there are at least 300,000 reported cases of Lyme disease (not including other tick-borne infections) each year in the United States. Given that Lyme disease has become a national public health crisis and that the only treatment option involves the use of antibiotics, it’s critical that researchers and physicians experienced in treating Lyme and tick-borne diseases are included in the discussions to ensure that these patients will have access to antibiotics when the benefits outweigh the risks.

 


2 Replies to "Obama plan to fight antibiotic resistance may limit treatment for Lyme disease"

  • Sara Culler
    09/23/2014 (1:53 am)
    Reply

    To try to see his side – Super bugs/antibiotic resistant bugs are one of, if the not biggest, threat to mankind (other than ignorance) and therefore IS the presidents issue as it is political. Like you said – Our agriculture industry is to thank and I think that is where we should direct the focus of all our politicians. This is not a Democrat VS Republican issue as many republicans high up have interests in that particular industry and also the pharmaceutical industry. We can thank our FDA and USDA for when it comes to allowing antibiotic use in our foods since many, many years back. Meat industry as well as produce even organics – Apples and pears on the top usage of antibiotics when it comes to organic fruit.
    http://www.motherjones.com/tom-philpott/2013/02/meat-industry-still-gorging-antibiotics

  • JOANNE DRAYSON
    09/23/2014 (1:10 pm)
    Reply

    Thank you Dr Cameron, the same push for reducing antibiotic use is happening here in UK but then Lyme patients rarely get much in the way of treatment anyway.

    Whilst antibiotic resistance is a concern the biggest problems would seem to stem from antibiotic persistence – very little attention is given to persister cells found in other bacterial infections not just Borrelia but TB, MRSA, E Coli and Pseudomonas it was good to hear of the work of Prof Kim Lewis in finding a compound to treat persister cells in MRSA this is one of three excellent presentation Prof Lewis has done https://www.youtube.com/watch?v=qXTPiJWhtDg

    Borrelia aside why is there seemingly so little attention given to persister cells in other illnesses – why do most doctors think one course of antibiotics is cure all for such as ear infection, urine infection, pneumonia etc when time and again it is shown not to be adequate.

    When penicillin was first being produced in UK after the end of the war it was recognised that it did not eradicate the infection but persister cells remained and it was down to the immune system to deal with the persisters. Do doctors not understand that basic concept?


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