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Infectious Diseases Society of America

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Infectious Diseases Society of America
Formation1963
TypeProfessional Association
HeadquartersArlington, Virginia
Location
Membership
9,000 as of 2013[1]
President
Barbara Murray

The Infectious Diseases Society of America (IDSA) is a medical association representing physicians, scientists and other health care professionals who specialize in infectious diseases. It was founded in 1963 and is based in Arlington, Virginia. As of 2013, IDSA had more than 9,000 members from across the United States and nearly 100 other countries on six different continents.[1] IDSA’s purpose is to improve the health of individuals, communities, and society by promoting excellence in patient care, education, research, public health, and prevention relating to infectious diseases.

Publications and activities

IDSA publishes the following medical journals:

The IDSA holds an annual meeting featuring presentations by experts in various aspects of infectious diseases, as well as original research abstracts and panel discussions.[2] The IDSA also issues clinical practice guidelines, advocates the development of new antimicrobial drugs and attention to the problem of antibiotic resistance, and promotes the scientific study of vaccination and access to important childhood vaccines. The Society sponsors the HIV Medicine Association (HIVMA), an organization of HIV researchers and specialists, and funds research fellowships for junior investigators in infectious diseases.[3] With the support of a CDC grant IDSA entertains a listserv for infectious disease physicians called Emerging Infections Network. It allows members to check on unusual clinical events, a potentially emerging infectious disease by connecting members to the CDC and other public health investigators and it is capable of queries and surveys.[4]

Antimicrobial Resistance (10 x '20) Initiative

The World Health Organization has identified antimicrobial resistance as one of the three greatest threats to human health.[5] IDSA has identified antimicrobial resistance as a priority for the organization.

In 2010, IDSA launched the 10 x ’20 Initiative, which seeks a global commitment to create an antibiotic research and development enterprise powerful enough to produce 10 new systemic antibiotics by the year 2020. The initiative was launched as a response to the growing problem of antibiotic resistance and the lack of development of new antibiotics.[6]

According to IDSA, new antibiotic development has slowed to a standstill due to market failure and regulatory disincentives. Antibiotics aren’t as profitable as other drugs (e.g., drugs to treat chronic conditions such as diabetes or asthma, which patients take for years). Also, the U.S. Food and Drug Administration (FDA) has long delayed publishing workable guidance describing how companies should design antibiotic clinical trials. Moreover, once a new antibiotic makes it to market, physicians hold it in reserve for only the worst cases rather than rushing to use it on all their patients due to fear of drug resistance. These economic and regulatory disincentives have made it far too difficult for companies to continue developing new antibiotics. It is estimated that the cost to the U.S. health care system of antibiotic resistant infections is $21 billion to $34 billion each year and more than 8 million additional hospital days.[7]

On May 1, 2011, IDSA published a policy paper titled “Combating Antimicrobial Resistance: Policy Recommendations to Save Lives” in Clinical Infectious Diseases.[8] The paper detailed the organization’s recommendations for specific public policy strategies and research activities needed to promote the best interests of patients and health care professionals. Specifically, the paper urged creation of incentives to support antibiotic research and development; new rapid diagnostic tests to more quickly diagnose patients; greater coordination of government agencies to support surveillance, data collection, research, and prevention and control; and aggressive promotion of the judicious use of currently available antibiotics. IDSA’s policy paper also proposed the creation of an Antimicrobial Innovation and Conservation (AIC) Fee that would help pay for antibiotic R&D and stewardship efforts necessary to make progress against antibiotic resistance.[9]

Throughout 2012, IDSA garnered support of several medical organizations and pharmaceutical companies for a new FDA approval pathway, called the Limited Population Antibacterial Drug mechanism, to address an unmet medical need by speeding up development of antibiotics to treat patients who have serious infections for which therapeutic options are insufficient. The LPAD mechanism would allow for testing a drug’s safety and effectiveness in smaller, shorter, and less expensive clinical trials, similar to the Orphan Drug Program.[10]

In addition to the 10 x ’20 Initiative, IDSA supports legislative and administrative efforts to strengthen the U.S. response to antimicrobial resistance, such as enhanced coordination and leadership, surveillance, prevention and control, and research efforts. IDSA also promotes the establishment of antimicrobial stewardship programs and integration of good stewardship practices in every health care facility across the United States and is working to eliminate inappropriate uses of antibiotics in food, animals and other aspects of agriculture.[11]

In a followed up policy report released on April 17, 2013, titled "10 X '20 Progress – Development of New Drugs Active Against Gram-Negative Bacilli: An Update From the Infectious Diseases Society of America", IDSA expressed grave concern over the weak pipeline of antibiotics to combat the growing ability of bacteria, especially the Gram-negative bacilli (GNB), to develop resistance to antibiotics. Since 2009, only 2 new antibiotics were approved in United States, and the number of new antibiotics annually approved for marketing continues to decline. The report could identify only seven antibiotics currently in phase 2 or phase 3 clinical trials to treat the GNB which includes E. coli, Salmonella, Shigella and the Enterobacteriaceae bacteria, and these drugs do not address the entire spectrum of the resistance developed by those bacteria.[12] Some of these seven new antibiotics are combination of existent antibiotics. There are positive signs that the governments and health authorities in US and Europe have recognized the urgency of the situation. Collaborations are formed between the regulatory bodies and pharmaceutical industry with funding and added incentives. The IDSA’s prognosis for sustainable R&D infrastructure for antibiotics development will depend upon clarification of FDA regulatory clinical trial guidance which would facilitate the speedy approval of new drugs, and the appropriate economic incentives for the pharmaceuticals companies to invest in this endeavor.[12]

Lyme disease treatment guidelines

The IDSA recommends against long-term antibiotic treatment for Lyme disease, arguing that it is ineffective and potentially harmful.[13] The American Academy of Neurology and National Institutes of Health similarly recommend against such treatment.[14][15] However, a minority view holds that chronic Lyme disease is responsible for a range of medically unexplained symptoms, sometimes in people without any evidence of past infection.[16] Groups of patients, patient advocates, and physicians who support the concept of chronic Lyme disease have organized to lobby for recognition of this diagnosis, as well as to argue for insurance coverage of long-term antibiotic therapy.[17] Such groups have been critical of the IDSA guidelines on Lyme disease. Both sides of the argument were outlined in the 2008 American documentary film Under Our Skin.

In 2006, Connecticut Attorney General Richard Blumenthal announced an antitrust investigation against the IDSA, accusing the IDSA Lyme disease panel of undisclosed conflicts of interest and of unduly dismissing alternative therapies and "chronic" Lyme disease. Blumenthal's investigation was closed on May 1, 2008 without charges when the IDSA agreed to submit its guidelines for review by a panel of independent scientists and physicians.[18] Views on the motivation and outcome of the investigation varied. Blumenthal's press release described the agreement as a vindication of his investigation and repeated his conflict-of-interest allegations.[19] The IDSA pointed to the closure of the investigation without charges, and the fact that the medical validity of the IDSA guidelines was not challenged.[20] The IDSA cited mounting legal costs and the difficulty of presenting scientific arguments in a legal setting as their rationale for accepting the settlement.[21] A Forbes piece described Blumenthal's investigation as "intimidation" of scientists by Blumenthal, an elected official with close ties to Lyme advocacy groups.[17] The Journal of the American Medical Association described Blumenthal's investigation of the IDSA as an example of the "politicization of health policy" against the weight of scientific evidence, and voiced concern over a chilling effect on future decisions by medical associations.[22]

Pursuant to their agreement with Blumenthal the IDSA guidelines were reviewed by an independent panel subject to strict conflict-of-interest guidelines and vetted by a medical ethicist. The panel supported the original IDSA guidelines, finding that "chronic Lyme disease" and "post Lyme syndrome" lack clear definitions and convincing biological evidence. Further, the report emphasized that several prospective clinical trials of prolonged antibiotic therapy for persistently symptomatic patients uniformly showed evidence of harm without convincing evidence of benefit.[23] Nonetheless, some groups have continued to criticize the IDSA guidelines after the 2012 review.[24][25]

References

  1. ^ a b "Forming the Society". Infectious Diseases Society of America. Retrieved May 29, 2012.
  2. ^ "IDSA Meeting Website". Infectious Diseases Society of America. Retrieved January 20, 2012.
  3. ^ "Facts About IDSA". Infectious Diseases Society of America. Retrieved October 29, 2010.
  4. ^ "Emerging Infections Network". Emerging Infections Network. IDSA. Retrieved 4 June 2014.
  5. ^ Sinha, Vidushi (May 17, 2010). "Antibiotic Resistance Called Growing Threat to Human Health". Voice of America News. Retrieved December 12, 2012.
  6. ^ "Antibiotic Development: The 10 x '20 Initiative". Infectious Diseases Society of America. Retrieved December 12, 2012.
  7. ^ "Facts about Antibiotic Resistance". Infectious Diseases Society of America. Retrieved December 12, 2012.
  8. ^ Spellberg, Blaser, Guidos; et al. (May 2011). "Combating Antimicrobial Resistance: Policy Recommendations to Save Lives". Clin. Infect. Dis. 52 (suppl 5): S397–S428. doi:10.1093/cid/cir153. PMC 3738230. PMID 21474585.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ "Combating Antimicrobial Resistance: Policy Recommendations to Save Lives" (PDF). Infectious Diseases Society of America. Retrieved May 30, 2012.
  10. ^ "Drug Companies, Health Groups Back IDSA Proposal" (Press release). Infectious Diseases Society of America. April 12, 2012. Retrieved August 12, 2012.
  11. ^ "Antimicrobial Resistance". Infectious Diseases Society of America. Retrieved May 30, 2012.
  12. ^ a b Boucher, Helen; Talbot, George; Benjamin, Daniel; Bradley, John; Guidos, Robert; Jones, Ronald; Murray, Barbara; Bonomo, Robert; et al. (2013). "10 X '20 Progress – Development of New Drugs Active Against Gram-Negative Bacilli: An Update From the Infectious Diseases Society of America". Clinical Infectious Diseases. 56 (12). Oxford University Press: 1685–1694. doi:10.1093/cid/cit152. PMC 3707426. PMID 23599308.
  13. ^ Wormser GP, Dattwyler RJ, Shapiro ED, et al. (November 2006). "The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America". Clin. Infect. Dis. 43 (9): 1089–134. doi:10.1086/508667. PMID 17029130.
  14. ^ Halperin JJ, Shapiro ED, Logigian E, Belman AL, Dotevall L, Wormser GP, Krupp L, Gronseth G, Bever CT (2007). "Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 69 (1): 91–102. doi:10.1212/01.wnl.0000265517.66976.28. PMID 17522387.
  15. ^ ""Chronic Lyme Disease" Fact Sheet". National Institute of Allergy and Infectious Diseases. April 17, 2009.
  16. ^ Feder HM, Johnson BJ, O'Connell S; et al. (October 2007). "A critical appraisal of "chronic Lyme disease"". N. Engl. J. Med. 357 (14): 1422–30. doi:10.1056/NEJMra072023. PMID 17914043.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  17. ^ a b Whelan, David (2007-03-12). "Lyme Inc". Forbes. Retrieved 2008-06-24.[dead link‍]
  18. ^ Landers, Susan J (2008-06-09). "Lyme treatment accord ends antitrust probe". American Medical News. Retrieved 2008-06-24.
  19. ^ "Attorney General's Investigation Reveals Flawed Lyme Disease Guideline Process, IDSA Agrees To Reassess Guidelines, Install Independent Arbiter" (Press release). State of Connecticut Attorney General's Office. 2008-05-01. Retrieved 2008-06-24.
  20. ^ "Agreement Ends Lyme Disease Investigation By Connecticut Attorney General: Medical Validity of IDSA Guidelines Not Challenged" (Press release). Infectious Diseases Society of America. 2008-05-01. Retrieved 2008-06-24.
  21. ^ Klein JO (November 2008). "Danger ahead: politics intrude in Infectious Diseases Society of America guideline for Lyme disease". Clin. Infect. Dis. 47 (9): 1197–9. doi:10.1086/592247. PMID 18821849.
  22. ^ Kraemer JD, Gostin LO (February 2009). "Science, politics, and values: the politicization of professional practice guidelines". JAMA. 301 (6): 665–7. doi:10.1001/jama.301.6.665. PMID 19211474.
  23. ^ IDSA Final Report of the Lyme Disease Review Panel of the Infectious diseases Society of America
  24. ^ Johnson, L.; Stricker, R.B. (2010-06-09). "The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines". Philosophy, Ethics, and Humanities in Medicine. Retrieved 2012-09-11.
  25. ^ "Lyme retreatment guidance may be flawed" (Press release). 2012-08-30. Retrieved 2012-09-11.
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