Often referred to as the ‘silent pandemic,’ antimicrobial resistance (AMR) was linked to some 5 million deaths worldwide in 2019, including 1.3 million directly attributable to bacterial AMR.^[i] Contributing to this issue, some 47 million unnecessary antibiotic prescriptions are written in the U.S. each year, according to the IQVIA Institute for Human Data Science (Figure 1).^[ii] Yet, fewer new antibiotics are reaching the market, with the last original class of antibiotic discovered in the late 1980s.^[iii] A total of 46 antibiotics were in clinical development as of November 2021, only half of which were ‘innovative,’ according to the World Health Organization.^[iv]

Against this backdrop, the theme of this year’s World Antimicrobial Awareness Week – November 18-24 – is ‘preventing antimicrobial resistance together.' This builds on a global action plan to address AMR by improving awareness and understanding of AMR through effective communication, education, and training.^[v]

Much activity in AMR is currently funded by governments and foundations. An interesting example of a public-private partnership aimed at stimulating R&D activity in the life science sector is the $1 billion AMR Action Fund. Set up in 2020 with the aim of launching two to four new antibiotics within the next decade, this has backing from big pharma and others.^[vi] The AMR Action Fund announced in June 2022 that it was open to proposals for funding of phase 2 and phase 3 clinical studies.^[vii] The fund planned to invest $100 million in 2022 in ‘companies developing clinically differentiated antimicrobials with the potential to treat the most urgent unmet clinical needs.’ ^[viii] Initial awards were recently made to two small life science companies.

Figure 1: Antibiotic prescriptions per 100,000 people by state^[ix]

As part of its commitment to public health, IQVIA has collaborated with the U.S. Centers for Disease Control and Prevention (CDC) and has supported White House efforts to combat overuse and misuse of antibiotics. Information and analysis identified significant regional and local variability in use of antibiotics across the United States. The findings helped illuminate the driving factors behind the increasing number of drug-resistant bacteria strains to inform prevention efforts.[x]

Study uses IQVIA data to identify drivers of inappropriate antibiotic prescribing
In one study highlighted on the CDC website,^[xi] machine-learning modelling was used to examine drivers of inappropriate antibiotic prescribing for acute respiratory illnesses (IQVIA Medical Claims Data (Dx) and IQVIA Longitudinal Prescription Data (LRx)).^[xii] The study found that antibiotics were prescribed in 11% of 42 million visits. Top drivers of inappropriate prescribing were identified as outpatient setting type, particularly urgent care; older patient age mix; and location in the South. These findings give antibiotic stewards an opportunity to target education and resources to places where they are likely to have the most impact.^[xiii]

About AMR
Antimicrobial resistance (AMR) has been identified as one of the most serious public health threats facing us globally. It is estimated that drug resistant infections contribute to nearly 5 million deaths every year^[xiv] . Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. Not only the overuse of antibiotics but also the inappropriate use (inappropriate choices, inadequate dosing, poor adherence to treatment guidelines) contribute to the increase of antibiotic resistance.

About World Antibiotic Awareness Week
To bring awareness to this global issue, the World Health Organization (WHO) first introduced World Antibiotic Awareness week in 2015 after the release of the first WHO Global report on surveillance of AMR (published April 2014) which for the first-time demonstrated data showing the extent of resistance in many parts of the world and the large gaps in the existing national and international surveillance networks. The WHO Awareness week has evolved from antibiotic awareness to World Antimicrobial Awareness Week with a broader focus on preventing the ever-increasing range of infections caused by bacteria, parasites, viruses and fungi no longer susceptible to the common medicines used to treat them. This is also a reflection of how research has evolved to address the issues from a clinical to data to world view and the broadening understanding of the extent of the public health threat.

It has long been recognised the need for an improved and coordinated global effort to contain AMR. In 2001, the WHO Global Strategy for Containment of Antimicrobial Resistance provided a framework of interventions to slow the emergence and reduce the spread of antimicrobial-resistant microorganisms.^[i] This provided a common vision and alignment on purpose to consider the Factors involved in the spread of antibiotic resistance, in the sectors of human medicine in the community and in the hospital, animal production and agriculture, and the environment. These sectors are connected to the misuse of antibiotics in human beings, animals and agriculture which have been identified as the driving factors for the presence ever-increasing range of infections.

Looking ahead, IQVIA will continue to partner with government and industry in the collection and dissemination of antibiotic data, trends, and addressing antibiotic resistance, and with all stakeholders to advance development of innovative antibiotics. By ‘preventing antimicrobial resistance together,’ we can make real steps towards tackling this silent pandemic.

This blog is the first of a series of publications focusing on IQVIA’s work in support of public health.

To learn more about our Infectious Disease and Vaccine Therapeutic Area, please click here.

Infectious Disease research is a dynamic space requiring nimble and innovative solutions. Our team of infectious diseases and vaccines experts respond to the need for speed and flexibility through novel trial design and technology solutions that allow for real-time data delivery.

Read more in this case study titled, “Human Data Science and Antibiotic Overprescribing”.

47 million unnecessary antibiotic prescriptions are written in the U.S. each year, contributing to antibiotic resistance and increased risk for certain infections. Click here to learn more.

References

• Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022 Feb 12;399(10325):629-655. doi: 10.1016/S0140-6736(21)02724-0. Epub 2022 Jan 19. Erratum in: Lancet. 2022 Oct 1;400(10358):1102. PMID: 35065702; PMCID: PMC8841637.
• https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02724-0/fulltext
• https://www.iqvia.com/-/media/iqvia/pdfs/library/case-studies/human-data-science-and-antibiotic-overprescribing.pdf?_=1668535352303
• https://www.nature.com/articles/d41586-020-02884-3
• https://www.who.int/observatories/global-observatory-on-health-research-and-development/monitoring/antibacterial-products-in-clinical-development-for-priority-pathogens
• https://www.who.int/campaigns/world-antimicrobial-awareness-week
• https://www.fiercebiotech.com/biotech/big-pharma-backed-1b-amr-action-fund-picks-first-biotechs-address-address-drug-resistant
• https://amr.solutions/funding-calls/
• https://www.amractionfund.com/blog-2022/news-amr-action-fund-announces-first-investments-in-adaptive-phage-therapeutics-and-venatorx-pharmaceuticals
• https://www.iqvia.com/-/media/iqvia/pdfs/library/case-studies/human-data-science-and-antibiotic-overprescribing.pdf?_=1668535352303
• https://www.iqvia.com/about-us/commitment-to-public-health
• https://www.cdc.gov/antibiotic-use/stewardship-report/current.html
• King LM, Kusnetsov M, Filippoupolitis A, Arik D, Bartoces M, Roberts RM, Tsay SV, Kabbani S, Bizune D, Rathore AS, Valkova S, Eleftherohorinou H, Hicks LA. Using machine learning to examine drivers of inappropriate outpatient antibiotic prescribing in acute respiratory illnesses. Infect Control Hosp Epidemiol. 2022 Jan 10:1-5. doi: 10.1017/ice.2021.476. Epub ahead of print. PMID: 35001867. https://pubmed.ncbi.nlm.nih.gov/35001867/
• https://www.cdc.gov/antibiotic-use/stewardship-report/current.html
• Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet 2022; published online Jan 20. https://doi.org/10.1016/S0140-6736(21)02724-0
• [i] Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015;109(7):309-18. doi: 10.1179/2047773215Y.0000000030. Epub 2015 Sep 7. PMID: 26343252; PMCID: PMC4768623.