The pace of new drug develop-
ment is — at best — slow, and most of the newer agents belong to the exist- ing classes of antimicrobials. Current studies indicate modest benefits of the recently approved drugs over old- er ones, and increasing resistance to these agents is likely over the next few years. To accelerate research, develop- ment, and approval of new pharmaco- logical agents, several policies aimed at addressing this issue have been implemented, including the Orphan Drug Act of 1983 and several Food and Drug Administration initiatives. Spe- cific to antibiotic development is the Generating Antibiotic Incentives Now, or GAIN, Act of 2012. Most infectious disease practitio-
ners have little or no influence on the process of developing new drugs or di- agnostics, but the one thing we all can and should excel at is antimicrobial stewardship. We may be most effec- tive in dealing with the entire gamut of drug resistance by developing and implementing stewardship policies at all levels. Creating a successful infection
prevention and antimicrobial stew- ardship policy requires expertise at many levels, including infectious dis- ease physicians, pharmacists, micro- biologists, epidemiologists, infection preventionists, and data managers. Considering our current steward- ship practices have not adequately addressed the core challenge of drug resistance, there is opportunity for in- novation in this field. Q
OLADAPO A. ABODUNDE, MD, is a 2016
graduate of the Infectious Diseases Fellowship Program at The University of Texas Southwest- ern Medical School.
PAUL SOUTHERN, MD, is an infectious diseases clinician and professor at UT-South-
western. He is program director of the Infectious Diseases Fellowship Program.
JAMES P. LUBY, MD, is an infectious diseas-
es clinician and professor at UT-Southwestern. His research interests include clinical virology and the epidemiology of infectious diseases.
18 TEXAS MEDICINE February 2017
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