Comments on: Toward Defining the Non-HIV Infectious Diseases Leadership Group

By: lisa grasso

lisa grasso — Sun, 06 Mar 2011 22:14:30 +0000

how about treatment/trials for pts who are not HIV positive, yet test poz to all the same viruses and may of the same bacteria as HIV+ patients and have similar immunolgical markers…..cd4 counts below300

By: Jeffrey A. Linder, MD, MPH, FACP

Jeffrey A. Linder, MD, MPH, FACP — Fri, 04 Mar 2011 20:16:55 +0000

I have two concerns.
First, any effort to address bacterial antibiotic resistance is welcome. However, I wonder if a group that also has the charge “to have the potential and capability to respond to emerging infectious diseases” sets up this group to have two highly divergent purposes that will detract from both.
Second, in the interest of addressing bacterial antibiotic resistance I would encourage NIAID to think beyond basic science and microbiology and consider expanded evaluation and dissemination of interventions to ensure appropriate use of antibiotics. Non-pneumonic acute respiratory infections account for about 50% of antibiotic prescribing to adults and about 75% of antibiotic prescribing children. Very roughly, half of these prescriptions are unnecessary. Most of these antibiotics are prescribed by primary care physicians.
Repeated admonitions to use antibiotics carefully are not working. We need to be more creative and broaden our thinking about how to decrease inappropriate antibiotic prescriptions and reduce the prevalence of antibiotic resistant bacteria.

By: Lee W Riley

Lee W Riley — Wed, 02 Mar 2011 16:33:31 +0000

I am very pleased that antibiotic resistance was recognized to serve as the main topic to establish a non-HIV infectious disease “leadership group”. However, I am a bit concerned that this leadership group will focus exclusively on clinical trials. I acknowledge that the idea is to take advantage of the clinical trial network that was established through the HIV/AIDS clinical trials. However, such a network can be used for research activities other than just clinical trials. We need to better understand the emergence of drug resistance so that we can devise better prevention strategies. Rehashing antibiotic stewardship is not sufficient. We need to do better epidemiologic research taking advantage of our new understanding of the genetics of drug resistance. I would like to see the network used for such research purposes and urge the leadership group to include such uses instead of just restricting the network to conducting clinical trials.

By: Coleen Cunningham

Coleen Cunningham — Fri, 18 Feb 2011 15:13:05 +0000

While I agree that antimicrobial resistance is an important topic, I am disappointed that the scope of this leadership group will be limited to this topic alone. I believe at the first town hall meeting we were told that it was hoped that the investigators responding to the RFA would outline what diseases they thought had the greatest potential for impact.
Infectious diseases that have a huge impact on mortality include respiratory tract infections and diarrheal disease in children. Improvement in treatment in one or both of these entities would result in a remarkable global change.
I urge NIH to reconsider the decision to limit this network to antimicrobial resistance.