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One Health and the Control and Prevention of Antimicrobial Resistance

Neil Clancy, M.D. | Associate Professor of Medicine, University of Pittsburgh

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In his presentation titled "One Health and the Control and Prevention of Antimicrobial Resistance" Dr. Neil Clancy, Chief of Infectious Diseases at the VA Pittsburgh Healthcare System, describes the rise of drug-resistant superbugs, the economic and health-related effects these bugs have on the patients and hospitals, and what is being done to fight them.

Dr. Clancy shares the story of a 65-year-old lung transplant recipient who comes down with pneumonia. She receives antibiotics, only to develop a new, resistant disease, for which she needs a new drug. All goes well until the drug is and she relapses, creating a need for another new treatment option. The cycle continues and when she does not respond to the new medications, she dies after about 50 days of infection.

With the rise of CRE (Carbapenem Resistant Enterobacteriacaeae) superbugs, 10 million deaths due to drug-resistant infections are projected to occur every year by 2050. This comes with economic consequences for patients due to the high cost of prolonged inpatient treatment, compounded by the ineffectiveness of said treatment. The threat of resistant bacteria not only affects hospital diseases but also community diseases. Dr. Clancy notes that it doesn't help that the number of FDA approved drugs on the market is decreasing, as the FDA is now interested in microbiomes rather than antibiotics.

In order to fight this, hospitals must implement stewardship programs. Although there is no one template, accountability, drug expertise, and education are among the core elements of such a program, and as seen in Pittsburgh hospitals, these programs are effective in reducing drug use and cost and shortening the duration of drug treatments. In Pittsburgh's VA hospital, the total use of antibiotic prescriptions was reduced. All of this is interconnected to our environment by what we use and put into the planet, and Dr. Clancy concludes that researchers must educate hospitals as a strategy to combat these resilient strains.

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About the Speakers

About the Speaker

Cornelius J. (Neil) Clancy, M. D. is Chief of Infectious Diseases at the VA Pittsburgh Healthcare System, director of the Mycology Research Unit and XDR Pathogen Lab at the University of Pittsburgh, and tenured associate professor of medicine at the University of Pittsburgh. His clinical, translational and basic science research laboratory is funded by the National Institutes of Health and Department of Veterans Affairs to pursue inter-related areas of investigation in medical mycology, extensively-drug resistant Gram-negative bacterial infections, and antimicrobial resistance and pharmacokinetics-pharmacodynamics. Dr. Clancy has published over 170 papers in the peer-reviewed biomedical literature. He has delivered keynote addresses related to his research and contemporary issues in infectious diseases and microbiology at numerous international medical and scientific conferences. Dr. Clancy serves on the Infectious Diseases Society of America’s Committee on Antimicrobial Resistance. He has received awards for excellence as a clinical educator by the Universities of Pittsburgh and Florida.