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
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Dear All (Wonkish alert! Get...
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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...
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Update on 11 October 2023: The...
Dear All,Along with more than...
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Dear All, Two items for...
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Dear All, Greetings from ECCMID...
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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
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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Language matters: CRE vs. CPE; SDD vs. I; and MDR, XDR, PDR, UDR vs. DTR
Note: See also these related newsletters: 13 Jan 2019 (link) on DTR as part of the language of resistance and 7 June 2020 (link) on
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Novel Biology, Novel Utility, & the Illusion of Skill: What to develop? What to reward?
Dear All (wonk-ish note alert and also with particular thanks as always to Kevin Outterson for helping to refine this newsletter): Sparked at least in
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How hard (and how) to Pull? Net value of Pull via a Transferrable Exclusivity Extension (TEE)
Dear All (wonkish alert … get your coffee!), EFPIA have recently released a report estimating the value of a Transferable Exclusivity Extension (TEE, report, press
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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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News from Davos 2020: Some positive signs, but overall a fragile antibiotic market at a tipping point
Dear All (and heads-up for a rather lengthy and wonkish note … settle in for the details), Last week saw substantial AMR-related news released in
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IDSA White Paper on developing narrow-spectrum antimicrobials + editorial by G. Drusano
Dear All (long note alert … there’s a lot of material below my signature): Just published today is an IDSA White Paper entitled “Developing Antimicrobial
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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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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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NIAID workshop: What is a robust PK-PD package?
Dear All: The ~150 of us who gathered in Washington yesterday and today for the NIAID’s PK-PD workshop enjoyed a very rich conversation. It’s really
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Draft FDA guidance on anti-infectives for children: It’s (mostly) all about PK and safety
Dear All (wonkish alert … the first 3 segments are non-wonkish but the last 2 are in the wonkish zone … titrate your plasma caffeine
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Melinta goes bankrupt / Never let a good crisis go to waste
Dear All (long-ish, wonk-ish note alert … lots of details to absorb): This newsletter has a followup here. Sadly, Melinta Therapeutics, Inc. declared bankruptcy just
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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...
Aside: If you've enjoyed the...
See also This related newsletter:...
Dear All (and with thanks...
Dear All (Wonkish alert! Coffee-up!),Today...