Obama plan to fight antibiotic resistance may limit treatment for Lyme disease

The task force by Executive Order must submit an action plan by February 15, 2015, outlining specific steps on how to implement a national strategy to combat antibiotic resistance and accelerate research and development on new antibiotics by 2020.

The task force will be led by the secretaries of Health and Human Services, the Department of Defense and the Department of Agriculture. A Presidential Advisory Council will also include nongovernmental experts to provide advice and guidance on strengthening surveillance of infections, researching new treatments and developing alternatives to using antibiotics in agriculture.

President’s Council of Advisors on Science and Technology (PCAST) recently released a report finding that bacteria are growing resistant to antibiotics, in part, due to individuals overusing antibiotics. The report also points out that significant amounts of antibiotics are being used in raising farm animals for human consumption and that this is a “matter of serious concern.”

I applaud the President for taking on the fight against antibiotic resistance. And while it’s important to acknowledge the lives lost due to infections not responding to antimicrobial treatment, it’s equally important to keep in mind all the patients who benefit from antibiotic treatments, particularly those suffering from Lyme disease and other tick-borne infections. These patients often have no alternative treatment options, and long-term antibiotics have been found through evidence-based studies to improve their quality of life, restoring them to pain-free, productive lives.

The Obama Executive Order did not include protections to ensure that individuals with other conditions have access to the antibiotics they need. Individuals with Lyme and related tick-borne diseases require antibiotics to prevent serious long-term illness. The International Lyme and Associated Diseases Society (ILADS) 2014 evidence-based treatment guidelines concluded that the benefits of antibiotics can outweigh risks in Lyme disease despite concerns regarding emerging antibiotic resistance.

The ILADS guidelines concluded, “Clinicians should discuss antibiotic retreatment with all patients who have persistent manifestations of Lyme disease. These discussions should provide patient-specific risk–benefit assessments for each treatment option and include information regarding C. difficile infection and the preventative effect of probiotics (although none of the subjects in the retreatment trials developed C. difficile infection).”

According to the CDC, there are at least 300,000 reported cases of Lyme disease (not including other tick-borne infections) each year in the United States. Given that Lyme disease has become a national public health crisis and that the only treatment option involves the use of antibiotics, it’s critical that researchers and physicians experienced in treating Lyme and tick-borne diseases are included in the discussions to ensure that these patients will have access to antibiotics when the benefits outweigh the risks.