ANTIMICROBIAL RESISTANCE IN CYSTIC FIBROSIS
International Task force
The prevalence of antimicrobial resistance (AMR) among microbial pathogens is increasing and is a high priority worldwide for interventions from antibiotic stewardship to new antibiotic development (http://www.who.int/antimicrobial-resistance/en/). Increasing AMR prevalence is driven by the widespread use of antibiotics.
AMR is commonly encountered in bacteria and fungi isolated from the airways of people with cystic fibrosis (CF). This is an expected finding given the high use of antibiotics in CF patients. The increasing survival of people with CF will result in greater lifetime exposure to antibiotics.
There is a lack of full understanding for stakeholders including people with CF, clinicians, the pharmaceutical industry, and (drug approving) regulatory bodies, about the relevance of AMR and how this should influence drug development and usage in the treatment of CF lung disease.
The Taskforce will develop guidelines on the interpretation of AMR for clinical care in CF. The Taskforce will also provide guidance on the role of AMR in clinical trials with new antimicrobial agents. The Taskforce that will have international and multidisciplinary representation will address the following objectives:
- Understand how chronic infections differ from acute infections with respect to the microbiological assumptions regarding AMR.
- Describe current and developing methodologies for determining antimicrobial resistance.
- Assess the value of current susceptibility testing including the frequency and timing of testing.
- Offer guidance for the use of antimicrobial resistance testing in the conduct of clinical trials by the pharmaceutical industry and regulatory agencies.
- Set key research priorities for the development of appropriate future application of AMR diagnostics to improve patient outcomes.
- Explore how monitoring antibiotic usage impacts on AMR in people with CF.
Australia/New Zealand Representatives
- Cass Byrnes, CF pediatrician
- Jason Roberts, pharmacist
- Tim Kidd, microbiologist
- Scott Bell, adult CF physician
Update from Scott Bell, February 2018
Thanks again to CFA for their support of this international working group. The working group met at the North American CF Conference and had approximately 50 to 60 participants.
Five groups have been established:
- Antimicrobial resistance definitions
- Literature review and development of current evidence
- Antimicrobial stewardship
- Education for clinicians, patients, families and participants
Since that meeting, the Steering Committee Group have had a teleconference to report the update. All four groups are demonstrating rapid progression. The aim is to meet again in Artimino in September 2018 in order to finalise the recommendations of the working group for antimicrobial resistance in cystic fibrosis.
Findings of the groups are anticipated to be presented in a symposium of the North American CF Conference in Denver in October 2018 and again in the European CF Conference in Liverpool in June 2019.
At least three publications are likely to be generated by the working group but importantly will provide the clinician, research and patient community with an update on AMR in cystic fibrosis.