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. 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:
- Clinical Infectious Diseases ([1])
- Journal of Infectious Diseases ([2])
- Open Forum Infectious Diseases ([3])
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. 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. 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.
Antimicrobial Resistance (10 x '20) Initiative
The World Health Organization has identified antimicrobial resistance as one of the three greatest threats to human health. 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.
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.
On May 1, 2011, IDSA published a policy paper titled “Combating Antimicrobial Resistance: Policy Recommendations to Save Lives†in Clinical Infectious Diseases. 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.
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.
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.
In a followed up policy report released on April 17, 2013, titled "10 X '20 Progress â€" 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. 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.
Lyme disease treatment guidelines
The IDSA recommends against long-term antibiotic treatment for Lyme disease, arguing that it is ineffective and potentially harmful. The American Academy of Neurology and National Institutes of Health similarly recommend against such treatment. However, many believe that chronic Lyme disease is responsible for a range of medically unexplained symptoms, sometimes in people without any evidence of past infection. 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. Such groups have been critical of the IDSA guidelines on Lyme disease. Many of these groups believe that the IDSA is biased, citing members connections to insurance and pharmaceutical companies. 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. 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. 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. The IDSA cited mounting legal costs and the difficulty of presenting scientific arguments in a legal setting as their rationale for accepting the settlement. A Forbes piece described Blumenthal's investigation as "intimidation" of scientists by Blumenthal, an elected official with close ties to Lyme advocacy groups. 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.
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. Nonetheless, some groups have continued to criticize the IDSA guidelines after the 2012 review.
References
External links
- IDSA website
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