Grants

Extending the Cure

Responding to the growing threat of antibiotic resistance

Bacteria that are resistant to our antibiotics are spreading faster than our efforts to stop them. Research by Extending the Cure (ETC) shows that some parts of the country continue to use antibiotics at high rates, and that the overall share of resistant bacteria increased by more than 30 percent between 1999 and 2010.

The ETC research team, based at the Center for Disease Dynamics, Economics & Policy (CDDEP), believes that while we can't beat the bacteria, we can slow them down by recognizing that antibiotics are a natural resource that we must use conservatively if we want them to remain effective. By issuing regular research and commentary on topics such as health care-associated infections,  trends in drug resistance, and the costs—both human and economic—posed by rising resistance rates, ETC is laying groundwork for the comprehensive solutions needed to combat this problem.

Read the inaugural report

Contact

The Center for Disease Dynamics, Economics & Policy

1616 P Street, N.W., Suite 600 Washington, DC, 20036-1436

Ramanan Laxminarayan, PhD, MPH
Project Director

Superbugs Are Closer Than You Think

Extending the Cure has released a three-minute animated video that tells the story of how antibiotic-resistant “superbug” bacteria have become a serious public health threat that affects everyone. The video frames the problem uniquely: We must treat antibiotics as a natural resource that can be depleted with overuse, just like water, trees, and other resources on which we all depend.

The video lays out specific steps that everyone – including doctors, hospitals, and consumers – can take to tackle the problem.

#Superbugs contribute to more deaths than AIDS, traffic accidents, or flu combined.

Brian Quinn

Brian Quinn, team director and senior program officer

A Pioneering Approach to a Public Health Problem

At RWJF, we believe today’s health care problems demand innovative solutions. Pioneer grantee Extending the Cure (ETC) takes a unique approach, looking at this public health problem through an economic lens. ETC proposes comprehensive, incentive-based solutions that both discourage unnecessary antibiotic use and encourage the development of new drug therapies, among other strategies,” says Brian C. Quinn, team director and senior program officer for the Pioneer Portfolio.

 

Alarming Trends in Antibiotic Use

Extending the Cure’s ResistanceMap shows that some parts of the country continue to use antibiotics at alarming rates, which can be a driver of drug resistance. The overall share of resistant bacteria increased by more than 30 percent between 1999 and 2010, and states in the Southeast consumed more than twice as many antibiotics as those in the West. This regional gap is widening over time, suggesting that the problem is getting significantly worse in some parts of the country.

View the full ResistanceMap

States Vary in Prescribing Antibiotics

States Vary in Prescribing Antibiotics

A new state-by-state comparison shows how the number of prescriptions filled in each state matches up with the national average.

Nationwide Antibiotic Use Varies

Nationwide Antibiotic Use Varies

Although nationwide prescriptions for antibiotics have decreased overall, the change was not uniform across states. This new map reveals that certain parts of the country are using antibiotics at much higher rates.

In 2010, East South Central states filled more than 2x as many #antibiotic scripts as Pacific states

#Antibiotic resistance threatens to return us to an era where bacterial infections will be deadly

The way we use #antibiotics today impacts how effective they will be in the future in other patients

Published research and issue briefs from Extending the Cure

2007-23_Tully_Dental_Pipeline_RWJF--236_HIRES

Drug-Resistant Bacteria Pose Deadly Threat to Hospitals and Nursing Homes

Drug-resistant bacteria known as CRE are appearing with greater frequency in hospitals and long-term care centers, according to a new Vital Signs report from the Centers for Disease Control (CDC) and Prevention. Infections with CRE, or carbapenem-resistant Enterobacteriaceae (CRE), strike the sickest patients, who are often in intensive care units and nursing homes, and can be fatal in 40 to 50 percent of cases. Researchers at Extending the Cure contributed to the CDC report.

· Read an op-ed about the report by ETC Director Ramanan Laxminarayan

· Read a guest blog post on KevinMD by ETC researcher Daniel J. Morgan about how hospitals are tackling CRE outbreaks

Read the Vital Signs report
Klebsiella pneumoniae bacteria illustration - CDC

Increases in Drug-Resistant Pneumonia Present Major Infection Control Challenge

Rates of carbapenem-resistant Klebsiella pneumonia (CRKP) rose significantly from 1999 to 2010, according to a new report from Extending the Cure. Antibiotics used as a last resort to treat CRKP infections are losing their effectiveness. Resistance to cephalosporin antibiotics more than doubled during this time period, according to the report authors.

Read more
Health Care Leaders Are Taking Action

Health Care Leaders Are Taking Action

Antibiotic overuse can be a driver of drug resistance, which can jeopardize lives. That’s why more than 20 national health organizations, including the Robert Wood Johnson Foundation, have joined with the CDC to issue a Joint Statement on a set of principles to address this serious public health threat.   

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Extending the Cure Matter of Life or Death

A Matter of Life and Death

Ramanan Laxminarayan, ETC project director, authored “A Matter of Life and Death,” a cover story in the Milken Institute Review last month that provides an economic analysis of the problem of antibiotic resistance. In the piece, he points to market incentives driving up resistance rates and proposes that solutions focus on conserving current and future antibiotics while simultaneously encouraging new drug development.

Read more
Extending the Cure

Seasonality and Temporal Correlation Between Community Antibiotic Use and Resistance in the United States

Greater antibiotic prescribing, particularly during winter months, is linked to seasonal increases in antibiotic resistance, according to this study published in the journal Clinical Infectious Diseases. The new research found that spikes in prescription sales for two popular groups of antibiotics during flu season led to a rapid increase, one month later, in resistant Escherichia coli (E. coli) in hospitals.

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Extending the Cure

"One-Size-Fits-All"? Optimizing Treatment Duration for Bacteria Infections

With attention focused on reducing overprescription, there has been little examination of whether drug resistance can be slowed by reducing the dosage and duration of antibiotic treatments. This study relies on ecological theory and mathematical models to predict the behavior of bacteria in different situations to develop a theory of when antibiotic treatments can be shortened, and a framework for continued study of treatment design.

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Extending the Cure

Communicating Trends in Resistance Using a Drug Resistance Index

Antibiotics are losing their effectiveness around the world as bacterial pathogens become resistant to some drugs. But by how much and over what time? To communicate the average effectiveness of the set of antibiotics used to treat a given bacterial infection, researchers set out to develop a drug resistance index that could be understood by non-practitioners, including policy-makers.

Read more

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REad what People are saying about Extending the Cure...

...In the New York Times: "Infection with Klebsiella pneumoniae is a serious danger to older hospitalized patients”

...In The Atlantic Wire: “The Center for Disease Dynamics, Economics, and Policy offers a tool to track the growth of resistant bacteria over time.”

...In Infection Control Today: “Strains of Antibiotic-Resistant Staph Show Seasonal Preference for Infection.”

...In USA Today: "Southeast paying health price for high antibiotic use"

...In Reuters: "Antibiotics Overuse: Health Experts Seek Action To Curb Rise Of Drug-Resistant Superbugs"

...In Wired: "The Persistence of Resistance And Some Reasons Why"

...In the Boston Globe: "Antibiotic overuse making common urinary tract infections harder to treat"

 

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