System-wide approaches to antimicrobial therapy and antimicrobial resistance in the UK: the AMR-X framework
- PMID: 38461831
- DOI: 10.1016/S2666-5247(24)00003-X
System-wide approaches to antimicrobial therapy and antimicrobial resistance in the UK: the AMR-X framework
Abstract
Antimicrobial resistance (AMR) threatens human, animal, and environmental health. Acknowledging the urgency of addressing AMR, an opportunity exists to extend AMR action-focused research beyond the confines of an isolated biomedical paradigm. An AMR learning system, AMR-X, envisions a national network of health systems creating and applying optimal use of antimicrobials on the basis of their data collected from the delivery of routine clinical care. AMR-X integrates traditional AMR discovery, experimental research, and applied research with continuous analysis of pathogens, antimicrobial uses, and clinical outcomes that are routinely disseminated to practitioners, policy makers, patients, and the public to drive changes in practice and outcomes. AMR-X uses connected data-to-action systems to underpin an evaluation framework embedded in routine care, continuously driving implementation of improvements in patient and population health, targeting investment, and incentivising innovation. All stakeholders co-create AMR-X, protecting the public from AMR by adapting to continuously evolving AMR threats and generating the information needed for precision patient and population care.
Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Conflict of interest statement
Declaration of interests JA reports being a shareholder of Pfizer, holding both stock and stock options, and is a full-time employee of Pfizer, Medical Affairs Department. DAJ reports payments from Gilead, patents for lung transplant diagnostics, participation in Grace Infection Biobank, and stock options in Pulmocide. SB reports being a shareholder of Pfizer, holding both stock and stock options, and is a full-time employee of Pfizer, Medical Affairs Department. GB reports receiving an honorarium and expenses for a talk on AMR: The current United Kingdom and global landscape at UCB Biopharma UK, Slough, 2022; support from Pfizer UK (pneumococcal vaccine policy), Biomerieux (new diagnostic tests for septic arthritis and bloodstream infections), and AvanzPharma (management of soft tissue infections); and honoraria for attending advisory boards of Pfizer UK (pneumococcal vaccine policy), Biomerieux (new diagnostic tests for septic arthritis and bloodstream infections), and AvanzPharma (management of soft tissue infections). VB reports receiving meeting and travel expenses from the NIHR for work as a public contributor. JB reports grant support from EDCTP, Horizon 2020, Swiss National Science Foundation, and Wellcome; discloses receiving honoraria from Pfizer and Sandoz; is Chair of Trial Steering Group for cASPerCF and CURLY and Independent Data Management Committee member for Avenir and Lakana; is Vice President of SwissPedNet, AMR working group lead for Penta; and received amoxicillin and amoxicillin plus clavulanic acid from Sandoz for PediCAP. CB reports participation in market research companies with no direct communication nor any knowledge of any pharmaceutical companies or products. ADa reports acting as a paid consultant for the pharmaceutical and biotechnology industry—companies and institutions include Adagio, Amplyx, AN2, Bioscript, Bugworks, CARB-X, Closed Loop Medicine, Correvio, Davolterra, Destiny, Evopoint, F2G, Entasis, Gates, GSK, Humanigen, University of Liverpool, Kymab, Melinta, Modis, Orca, Phico, Quince, Roche, SFunga, Scynexis, Sinovent, SNIPR Biome, Spero, tranScrip, and VenatoRx; and has acted as an independent statistician on Data Safety Monitoring Boards for Aridis, Cerium, ContraFect, Egetis, Midatech, Pfizer, Pled, Rare Thyroid, Sanofi, and tranScrip. PD reports salary from serving as Deputy Medical Director, NIHR Clinical Research Network Coordinating Centre, Leeds and London, UK. AdS reports research grants from AstraZeneca, Bayer, GSK, Chiesi, and Insmed; consulting fees from AstraZeneca, Bayer, GSK, Chiesi, Sanofi, Zambon, Gilead, and Insmed; honoraria from AstraZeneca and GSK; and participation on a Data Safety Monitoring Board or Advisory Board of Bayer. RF reports research grants from NIHR and is Chair of NICE Implementation Strategy Group. GH reports grant support from NIHR. AHo reports grant support for NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance and The Wellcome Trust-funded programme CAMO-Net (grant ref: 226691/Z/22/Z); and is current Executive Committee Member and past President of the International Society for Infectious Diseases (ISID), current Scientific Advisory Group for Emergencies (SAGE) Coronavirus Response working group on nosocomial transmission (April, 2018–November, 2020), Chair of Fleming Fund Technical Advisory Group, operated by Department of Health and Social Care & The Fleming Fund, current WHO Health Emergencies Program (WHE) Ad-Hoc Advisory Panel of Infection Prevention and Control Experts for Preparedness, Readiness and Response to COVID-19 (WHE-IPC-AP), and 2017–20 board member, Wellcome-Surveillance & Epidemiology of Drug-resistant Infections Consortium (SEDRIC). SH reports grants from NIHR Health Protection Research Unit in Healthcare Associated infection and Antimicrobial Resistance (Oxford) and membership of the UK Health Security Agency Executive Leadership Team. AHow reports receiving consulting fees from Pfizer. NL reports receiving grant support for the NIHR Clinical Research Network and was the Chair of Board of Trustees of Medical Research Foundation until September, 2023. AM reports grant support from Merck, InfectoPharm, NIHR, GSK, Roche, Nosopharm, and Bioversys; consulting fees from Roche and Bioversys; honoraria from Shionogi; participation on a Data Safety Monitoring Board or Advisory Board for GSK; and membership of the EUCAST Steering Committee. CMa reports support for attending meetings and travel from NHS Research Scotland. SPet reports grant support from NIHR, EDCTP, MRC, Gilead Sciences, Janssen-Cilag, and ViiV Healthcare and is a Data Safety and Monitoring Board member of the The effectiveness and risks of Treating people with Idiopathic Pulmonary fibrosis with the Addition of Lansoprazole (TIPAL): a randomised placebo-controlled multicentre clinical trial. KP reports grant support from Wellcome, Ineos Oxford Institute for AMR Research, Coalition for Epidemic Preparedness and Innovations (CEPI), NIHR, MRC, Waltham Foundation. and EU IMI-2. LS reports being a member of the Government’s Scientific Advisory Committee on Antimicrobial Prescribing, Resistance and Healthcare Acquired Infections (APRHAI). MSh reports grant support from Wellcome Trust, GARDP, and EDCTP; is the Chair of WHO Essential Medicines List Antibiotic Working Group and lead clinical adviser to GARDP; and received amoxicillin and amoxicillin plus clavulanic acid from Sandoz for PediCAP, fosfomycin from InfectoPharm for NeoSep1, and flomoxef from Shionogi. AT reports being a shareholder of Pfizer, with both stock and share options, and being a full-time employee of Pfizer. TvS reports grant funding from NIHR. PWh reports funding from Medical Research Council and NIHR (Health Protection Research Unit) and consulting fees from Pfizer and National institute for Public Health and the Environment. IB reports receiving consulting fees from Astra Zeneca; and support from the National Institute of Health and Care Research (NIHER) as Senior Investigator Award 205131. ML reports research support from NIHR. WH reports grant support from F2G, Pfizer, Bugworks, Phico Therapeutics, UKRI, Wellcome, and GARDP and consulting fees from GSK, Mundipharma, Pulmocide, and F2G and is on the advisory committee for DNDi. All other authors declare no competing interests.
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