ANTIMICROBIAL RESISTANCE SOLUTIONS
WITH DR. JOHN H. REX
Latest Newsletters
Dear All (wonkish alert ... lots of details here ... take your time and absorb it all!),I've written several times about the concept of DTR, or Difficult-to-Treat resistance, that was proposed in 2018 by Kadri et al. Today we will consider an important update from Kadri and colleagues in which the idea of DTR is adjusted to consider the implications of limited antibiotic access.We will take the conversation in 3 parts: (1) What is DTR?, (2) What adjustments to the definition of DTR were found to be needed?, and (3) What does the new idea of DTR Index teach us? Off we go!First stop: What is DTR?The original idea of DTR was developed for Gram-negative bacteria and was built on ideas that are the basis for the definitions of MDR, XDR, and PDR (Multi-drug resistance, eXtensive-Drug Resistance, Pan-Drug Resistance):Carbapenem resistance (CR): Resistance to any one of imipenem, meropenem doripenem, or ertapenemExtended-spectrum cephalosporin resistance (ECR): Resistance to any one of ceftazidime, cefepime, ceftriaxone, or cefotaximeFluoroquinolone resistance (FR): Resistance to any one of ciprofloxacin, levofloxacin, or moxifloxacinReference: Magiorakos 2012. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. CMI 2012;18:268-81.With these ideas in your head, DTR for Gram-negatives is CR plus ECR plus FRNote carefully: The definition does NOT...
Dear All,No one is safe...
Dear All,If you represent a...
Latest Government Action
Dear All,If you represent a US-based organization with an interest in AMR, there is an opportunity to sign a letter advocating for AMR-related funding in the FY2026 US Government (USG) budget.Founded in 2014, IDSA's S-FAR (Stakeholder Forum on Antimicrobial Resistance) has been steadily coordinating messages to the USG from professional groups with an interest in AMR. Today, there is an opportunity to be a part of the process for FY2026 by signing this draft letter. As a signatory, you would be joining the Association for Professionals in Infection Control and Epidemiology (APIC), American Society of Microbiology (ASM), Society for Healthcare Epidemiology of America (SHEA), AdvaMed Dx, BIO, Food and Animal Concerns Trust (FACT), and Infectious Diseases Society of America (IDSA) in supporting a request for FY 2026 funding for domestic and global antimicrobial resistance (AMR) programs. The letter is similar in structure to a letter sent last year in providing recommendations for funding of AMR-related work across all parts of USG (CDC, ASPR (including BARDA and CARB-X), NIAID, FDA, etc.)You can sign this year's letter here: https://forms.gle/2ppBt83LUEvXWU557. Please note that signatories should be US-based organizations. The deadline for signatures is 9 May 2025.Many thanks to our colleagues at IDSA for organizing this effort! All best...
Dear All, Sadly, I must...
Dear All (and with thanks...
Dear All, The Global Leaders Group on Antimicrobial...
Dear All,BARDA has released a...
R&D Insight
Dear All (and with thanks...
Dear All: EU's IMI (Innovative...
Dear All: I've written a...
This newsletter is part of...
Dear All,Our colleagues at FDA...
Dear All: As recently summarized...
Can you help?
Dear All,I have just learned that Lifeline, the musical formerly known as The Mould that Changed the World, is seeking scientists, medics, and healthcare professionals to be part of the cast for a portion of a planned 5-week off-Broadway run of the show around the time of the High-Level Meeting (HLM) on AMR at UNGA 2024 in New York City...
Dear All, Heads up! Having...
Note: Be sure to take...
Update on 11 October 2023: The...
Dear All,Along with more than...
Dear All (and with thanks to...
Dear All, Two items for...
Dear All, Three things today......
Dear All, Greetings from ECCMID...
Dear All,A key theme of...
Dear All,Following hard on the...
Dear All, A short one...
Dear All, We are swimming...
Antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics. And routine operations like hip replacements or organ transplants could be deadly because of the risk of infection.
AMR Fireside Chats
1/18 videos
1
Episode 17 w/ Ella Balasa and Rob Purdie of WHO Task Force of AMR Survivors - AMR Fireside Chat
38:24
2
Episode 16 w/ Ramanan Laxminarayan, PhD - AMR Fireside Chat
32:59
3
Episode 15 w/ Mark Albrecht, PhD - AMR Fireside Chat
43:55
4
Episode 14 w/ Lynn Silver - AMR Fireside Chat
56:23
5
Episode 13 w/ Kevin Outterson - AMR Fireside Chat
30:01
6
Episode 12 w/ Tina Joshi, PhD - AMR Fireside Chat
34:22
7
Episode 11 w/ Martin Heidecker - AMR Fireside Chat
32:31
8
Episode 10 w/ Anna Govett - AMR Fireside Chat
14:54
9
Episode 9 w/ Fatema Rafiqi, PhD - AMR Fireside Chat
34:10
10
Episode 8 w/ Ghada Zoubiane, PhD - AMR Fireside Chat
35:04
11
Episode 7 w/ Trevor Lithgow, PhD - AMR Fireside Chat
35:41
12
AMR Snapshots: Episode 2 - John Rex (Editor-In-Chief, AMR.Solutions)
26:25
13
Episode 6 w/ Maryn McKenna - AMR Fireside Chat
45:50
14
Episode 5 w/ Christine Årdal - AMR Fireside Chat
43:44
15
Episode 4 w/ Peter Beyer - AMR Fireside Chat
39:21
16
Episode 3 w/ Kevin Outterson - AMR Fireside Chat
11:45
17
Episode 2 w/ Henry Skinner, PhD - AMR Fireside Chat
15:44
18
Episode 1 w/ Kevin Outterson - AMR Fireside Chat
52:56
Modeling the value of an effective antibiotic — Megiddo et al.
Dear All: I have previously written about the challenge of applying health technology assessment (HTA) to estimate the monetary value of an effective antibiotic: To my knowledge,
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Lessons in Discovery from Lynn Silver + Pro-con on alternatives to antibiotics
Dear All: “Good decisions come from experience, and experience comes from bad decisions … and paying attention.” You’ve probably heard the first part of that
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Developing systemic & inhaled antibiotics for lung infections
Dear All: I missed it personally, but by all reports the session on 3 June 2017 at ASM Microbe entitled “Development of New Drugs and
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Mirror Bacteria: An AMR threat of unprecedented magnitude
Dear All (wonkish but stick with it … I’m going to try very hard to de-wonk it), In an absolutely terrifying paper and technical report
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Chemical vs. drugs (Part 2): How do you discriminate? / More on halicin
This newsletter is part of a series — here are the links to Part 1, (this one is Part 2), Part 3, Part 4, and Part 5. Also relevant
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Global survey of novel antibiotic reimbursement models / PASTEUR Act introduced to US House
Dear All (wonkish alert, but the details are fascinating … and with thanks to Kevin Outterson for co-authoring!), Two related items of note for today.
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Lancet: 10-20-30 targets to address AMR by 2030
Dear All (wonkish alert … but definitely worth the effort! Refill your coffee!),Ramanan Laxminarayan and about 40 colleagues from around the world have just published in
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In Praise of Non-Inferiority
Dear All (wonkish but intended for everybody to read and absorb): 27 Jan 2021 update: This topic now has its own YouTube video! As the
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New mechanisms for antibiotic reimbursement in the United States: CMS’s IPPS FY2020 Final Rule
Dear All (and with thanks to Kevin Outterson for substantial help with this newsletter), On August 2, 2019, the US government agency that administrates Medicare &
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The 6 meanings of “Lack of Access” (UNSLAP)
Dear All, We often talk about the problem of lack of access to new antibiotics. In late 2021, for example, we explored data showing that multi-year
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Impact of PASTEUR: 9.9m lives saved, ROI of 125:1
Dear All (and with thanks to Kevin Outterson for being lead author on this newsletter), (wonkish alert on this one … refresh your coffee and
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Scary, Scarier, Scariest (Part 2): What can YOU do about it?
Long note alert— apologies! Get a cup of coffee and settle in… Dear All: My 22 Apr 2019 note entitled Scary, Scarier, Scariest: Achaogen / FT
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The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism.
The bipartisan PASTEUR Act is the strongest bill ever written to strengthen antibiotic development and use. It will fix our market failures, expand the pipeline for next generation antibiotics, and save lives. We can’t sit on our hands as this public health crisis arrives – we have to act now.
Summaries
Notes: Newsflash ... BARDA have...
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Dear All (Wonkish alert! Coffee-up!),Today...