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FOR IMMEDIATE RELEASE CONTACT: GAARD Study Finds Early Signs of Resistance to Quinolone Antibiotics in Treating Respiratory Tract Infections -- APUA says early warning provides time to take action -- CHICAGO - December 16, 2001 - A study presented today at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) issued an early warning alert that Haemophilus influenzae (HI), a major respiratory tract infection, is developing resistance to fluoroquinolones, including Cipro. The announcement is the first alert resulting from the surveillance efforts of the Global Advisory on Antibiotic Resistance Data (GAARD), a public-private partnership among the Alliance for the Prudent Use of Antibiotics (APUA), a non-profit organization, and four multinational companies. The global collaboration founded by APUA includes Bristol-Myers Squibb, GlaxoSmithKline, AstraZeneca and Focus Technologies. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have been participating as advisors to GAARD. Haemophilus influenzae strains from the United States, Canada and Europe were screened, and a small but increasing number of isolates (less than one percent) showed reduced susceptibility to the fluoroquinolones -- ciprofloxacin (Cipro) and ofloxacin. This study confirms findings from individual surveillance programs. Once an antibiotic demonstrates reduced susceptibility, it has the potential to become fully resistant. "This is an alert. The problem of antibiotic resistance threatens our ability to cure bacterial infections," said Dr. Stuart B. Levy, president of APUA, which spearheaded the GAARD study. Thus, these findings, albeit small compared to the higher resistance rates of HI to some other antibiotics, are even more compelling. The good news is that the GAARD surveillance data provide early detection and allow us to determine if the frequency of HI fully resistant to quinolones continues to rise." While vaccination has reduced the impact of invasive, life-threatening Haemophilus influenzae in the United States, the organism remains an important health threat in the developing world; according to the CDC, Haemophilus influenzae is the second leading cause of bacterial pneumonia deaths in children in developing countries. According to WHO, the major causes of antibiotic resistance are the under use of antibiotics in developing countries and the overuse, including inappropriate and unnecessary use, of antibiotics in industrialized countries. "The wiser use of drugs is critical so that resistance is minimized and effective treatments can continue to be used for generations to come," said David Heymann, M.D., executive director for communicable diseases for WHO, which released a comprehensive strategy in September 2001 for containing the spread of drug resistance. The GAARD study indicates that Haemophilus influenzae organisms had emerged with reduced susceptibility to fluoroquinolones even before the recent increase in the use of Cipro due to the threat of anthrax. "The anthrax scare, and the resulting stockpiling of Cipro, further compounds the problem. Overuse and misuse of antibiotics such as this could very well push organisms closer to full-blown resistance," Levy said. Levy said that hospitals and clinical laboratories should conduct their own careful surveillance to look for trends that might indicate an evolving resistance problem. Physicians should also be vigilant about only prescribing fluoroquinolones for appropriate indications. Levy said that the public should act now and can play an important role in limiting inappropriate use of antibiotics in the way that they communicate with their physicians. "This winter when people get sick with viral illnesses, like the flu or colds, they need to understand that viral infections do not respond to antibiotics. Patients often pressure their doctors into prescribing antibiotics. This does not help their current illness and in the long run could cause antibiotics not to work effectively against bacteria causing infections later," Levy said. "The GAARD project is a historic effort at a critical time when countries need to join together if we are to face antibiotic resistance while there is still time to effectively control it. GAARD mines large sets of international data, representing the world's largest collaboration of antibiotic resistance surveillance systems. The statistical power of these data makes GAARD the world's best resource for detecting and tracking newly emerging infectious diseases and providing early warnings of antibiotic resistance" Levy said. GAARD is part of APUA's ongoing public health program to provide objective information on resistance and educate the public about appropriate antibiotic use.
CONTACT: GAARD: Brain Trust Formed to Curtail the Increasing Threat of Antibiotic Resistance Worldwide TORONTO -- September 16, 2000 -- Antibiotic resistance is a global problem requiring immediate action in order to avoid a public health catastrophe. The recognized need for a global cooperative effort to address the problem has now achieved its first step. This global effort was announced by Dr. Stuart Levy, President of the Alliance for the Prudent Use of Antibiotics (APUA), at Global Resistance Day on Sept. 16, 2000, part of the 40th Interscience Conference on Antimicrobial Agents and Chemotherapy. The conference, sponsored by the American Society for Microbiology, was held at the Metro Toronto Convention Centre. Recognizing the urgency of the problem and seeking to build public awareness, three multinational enterprises - Bristol-Myers Squibb, SmithKline Beecham, and an infectious diseases services company called MRL - have joined forces with APUA to spearhead a global partnership on antibiotic resistance. As members of the project steering committee, they will lead a broad coalition called GAARD (Global Advisory on Antibiotic Resistance Data). The GAARD project was initiated and will be coordinated by APUA, the only independent international organization exclusively dedicated to curbing antibiotic resistance. Dr. Levy stated that a global, public-private brain trust like this is urgently needed because "resistant bacteria and their respective genes do not need passports in order to cross country borders. They can quickly circumnavigate the globe, carried along as stowaways in humans, animals, and food products. The GAARD project is a historic effort at a critical time when countries need to join together if we are to face antibiotic resistance while there is still time to effectively control it." According to the World Health Organization (WHO), almost all major infectious diseases are slowly - but surely - becoming resistant to existing medicines. The underuse of drugs in developing countries and the overuse - inappropriate and unnecessary use of drugs - in industrialized countries encourage the development of resistance. A recently released WHO report titled "Overcoming Antimicrobial Resistance" states: "The most effective strategy against antimicrobial resistance is to get the job done right the first time-to unequivocally destroy microbes-thereby defeating resistance before it starts." WHO also notes that the challenge is to get the right treatment to the patient, each and every time. If the world fails to mount a more serious effort to fight infectious diseases, antimicrobial resistance will increasingly send the world back to a pre-antibiotic era. The GAARD project will collaborate with other public health authorities such as WHO to promote optimal antibiotic use and to slow or reverse antibiotic resistance. Every recent report on the problem calls for more surveillance data and GAARD hopes to help fulfill this urgent public health gap. GAARD will serve as an international advisory group whose functions are:
GAARD leadership is developing an action plan and will be inviting collaboration with additional antibiotic resistance study groups to contribute to the data, conduct research, and share containment strategies and training expertise. For more information on GAARD or to find out how to join the advisory group's efforts, please contact Dr. Barbara Souder or call (617) 636-0966.
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