Approaches to equitable and responsible antibiotic management
Panelists discuss the urgent need to ensure equitable access to novel antibiotics, highlighting global and domestic disparities, the vital role of stewardship programs, and the importance of innovative distribution models, international collaboration, and systemic reforms to bring lifesaving treatments to resource-limited settings.
As the panel wrapped up, the conversation turned to one of the most pressing and difficult challenges in infectious disease care: ensuring equitable access to novel antibiotics, particularly in regions where resistance is most prevalent but resources are limited. Rodney emphasized that antimicrobial stewardship programs (ASPs) are essential everywhere—not just in well-resourced academic centers. He encouraged institutions without formal ASPs to build them and stressed the importance of collaboration, education, and diagnostic management teams. He also highlighted global efforts like expanded access programs, better resistance surveillance, international cooperation on pricing, and equitable distribution as key strategies for improving access while preserving antibiotic effectiveness.
Anita expanded on these points by acknowledging that access disparities exist both within the US (eg, between academic and rural hospitals) and especially between high-income and low- and middle-income countries, where resistance is rampant but new drugs are often unavailable. She noted some optimism around new models—such as Shionogi’s approach with cefiderocol—to expand access in Latin America and other high-burden regions. Still, she emphasized the need for a greater commitment from pharmaceutical companies to make antibiotics available where they are most urgently needed.
Monica added the perspective of a stewardship pharmacist, pointing out the numerous systemic and logistical barriers to access, including insurance hurdles, formulary restrictions, and infrastructure limitations—even within US health care. She stressed that solving this issue requires a multipronged approach: global drug availability, regulatory harmonization, health care financing reform, and creative implementation models like antibiotic subscription models (eg, the “Netflix” model). The panel concluded with a call for innovation, collaboration, and global health equity to ensure that lifesaving antibiotics reach the patients who need them most—wherever they are.
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