Experts announce global antimicrobial resistance initiative - World preview of the Global White Paper on bacterial resistance in respiratory tract infections - a call for concerted international action

December 17, 2001

CHICAGO, Il - 15 December 2001 - Leading experts from around the world today put forth a global challenge to policy-makers and healthcare professionals to combat the crisis of rapidly increasing antimicrobial resistance. A preview of the first ever Global White Paper1 on Bacterial Resistance in Community-Acquired Respiratory Tract Infections (RTIs) was discussed by an international faculty of leading experts as a prelude to the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), 16-19 December 2001, Chicago, USA.

The Global White Paper is the first publication of the International Forum for Antibiotic Resistance (IFAR), a new multi-disciplinary group of world-renowned experts from six continents including infectious disease specialists, microbiologists, epidemiologists and the International Alliance of Patients Organisations (IAPO).

The paper was presented during a symposium officially supported by the Infectious Disease Society of America (IDSA), the European Society for Clinical Microbiology and Infectious Diseases (ESCMID), and the International Society for Infectious Diseases (ISID) with the participation of the Centers for Disease Control and Prevention (CDC).

"Despite numerous international and national recommendations for resistance control, few large-scale interventions have been implemented and audited and little has been accomplished in the fight against resistant bacteria," explained Prof. Roger G. Finch, President of ESCMID and Professor of Infectious Diseases, The City Hospital and University of Nottingham, Nottingham, UK, a co-editor of the paper. "The 'Global White Paper on Bacterial Resistance in Respiratory Tract Infections' is long overdue and has come at a crucial time to help focus on what needs to be achieved to tackle the ever-increasing problem of antimicrobial resistance".

Community-acquired respiratory tract infections (RTIs) are a major public health concern in terms of morbidity, mortality, and costs. For example, lower RTIs (e.g. pneumonia) are the leading cause of death in developing regions and the fourth leading cause of death in developed regions2. Over the last decade, there has been a rapid increase in resistance to antibiotics among virtually all common bacteria, such as Streptococcus pneumoniae, that cause community-acquired RTIs2. One surveillance study, involving 23 countries worldwide, showed that 40 percent of Streptococcus pneumoniae isolates from patients with RTIs were resistant to penicillin* and 28 percent were resistant to macrolides**3. This demonstrates that many existing antimicrobials are becoming increasingly ineffective against even the most common causes of infections.

"Resistant bacteria do not recognise national boundaries," reiterated Dr Jack S. Remington, Professor of Medicine and Infectious Diseases, Stanford University School of Medicine, Stanford, CA, USA and co-editor of the paper. "The Global White Paper now offers a model for a focused, sustained, multifaceted approach to resistance control around the world, while highlighting key components of successful actions, including the need for new therapies to help tackle resistant bacteria."

Key actions that the Global White Paper calls for include:

- Robust, uniform, global resistance surveillance research and studies to quantify the true impact of resistance on the health of patients with community-acquired RTIs

- Consideration by organizations responsible for resistance control of the factors driving bacterial resistance, including antibiotic use

- Education regarding the significance of resistance and optimal antibiotic usage for RTIs

- Patient involvement in measures to control resistance and development of more convenient, patient-friendly antibiotic regimens

· The Global White Paper is the first truly global initiative to focus on identifying and addressing the challenges in controlling antibiotic resistance in the community via a recommended partnership in action. The Global White Paper advocates a sustained, multifaceted approach to strategic action around the world and challenges all organisations involved in controlling antibiotic resistance to collaborate in implementing effective interventions that achieve real change in the behaviour of all stakeholders, including patients, healthcare workers, and governments.
For further information, please contact: Roseann Ward, Ketchum T: +44 (0)207 611 3661

* Indexed as having intermediate penicillin resistance (minimum inhibitory concentration 0.12-1.0mg/L) or resistant (minimum inhibitory concentration > 2.0mg/L).

** Indexed as having erythromycin resistance (>1 mg/L)

Notes to Editors

The following organisations have supported the Global White Paper satellite symposium at ICAAC, December 2001:

The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) ESCMID was founded in 1983 as a non-profit organisation and currently has more than 2,700 individual members in 93 countries.

The International Society for Infectious Diseases (ISID) ISID was created in 1986 by a merger between the International Congress on Infectious Diseases (ICID) and The International Federation on Infectious and Parasitic Diseases (IFIPD). They currently have 20,000 individual members in 155 countries across the world.

The Infectious Diseases Society of America (IDSA) IDSA was established to promote and recognize excellence in patient care, education, research, public health and the prevention of infectious diseases. They currently have a membership of more than 6,000 physicians, scientists and other health care professionals who specialize in infectious diseases.

International Forum for Antibiotic Resistance (IFAR) IFAR was established in 2001 and aims to develop publications to raise the profile of, and level of debate concerning, bacterial resistance. Currently, the IFAR membership extends to a multi-disciplinary faculty of world-renowned experts from six continents including infectious disease specialists, microbiologists, epidemiologists, and patient advocates


1. Remington JS, Finch RG (Ed). Global White Paper on Bacterial Resistance in Respiratory Tract Infections. Abstracts presented at the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), 16-19, December 2001, Chicago, USA

2. World Health Organisation. Containing Antimicrobial Resistance: Review of the Literature and Report of a WHO Workshop on the Development of a Global Strategy for the Containment of Antimicrobial Resistance. Geneva, Switzerland, 4-5 February 1999. WHO/CDS/CSR/DRS/99.2 (

3. Felmingham, Gruneberg and the Alexander Project Group. The Alexander Project 1999. Preliminary Results: Penicillin and Macrolide Resistance in Streptococcus pneumoniae. Poster presentation P1790 at the 40th ICAAC congress Toronto, 17-20 September 2000

Ketchum UK

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