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September 2008
Vol. 18, No. 9
From the President
IDSA Ascendant

With our next Annual Meeting drawing near and my term as your president drawing to a close, I am proud to have presided over the Society as its status as the definitive source of ID information has continued to grow. On the major infectious diseases issues of the day, policymakers now come to us regularly for insight.

For example, the Bush administration recently has been considering a policy tacitly encouraging individuals to stockpile antibiotics at home in case of a future anthrax attack. Administration officials came to IDSA for advice, and the Society advised them it was a bad idea: The benefits are unclear and the risks are considerable. Antibiotic misuse—already common—would likely become more widespread as people self-diagnosed and self-treated for a wide range of symptoms whether or not a bio-emergency was occurring, with the accompanying risks of adverse reactions and increasing resistance. Furthermore, the policy would likely create inequities as only individuals with financial resources and access to a health care provider would be able to benefit. Administration officials listened and are now rethinking the issue.

By the same token, IDSA has been one of several leading medical societies advising the federal government against home stockpiling of antiviral drugs as part of pandemic influenza plans. The risks of inappropriate use, adverse reactions, and rapidly emerging resistance outweigh any theoretical benefit. Again, IDSA’s input has led the administration to change course. IDSA has been invited to deliver comments on other proposals in late October at an advisory committee meeting of the Food and Drug Administration (FDA).

IDSA also has become FDA’s go-to source on antimicrobials. For years, the Society has been pressing FDA on a number of antimicrobials issues, including long-overdue guidance for industry on how to conduct clinical trials for antibiotics against several serious infections. This past year has brought a sea change at FDA. The agency has issued four clinical trial design guidances for industry and has invited IDSA’s input on several more. IDSA and FDA co-sponsored a workshop in January on clinical trials for community-acquired pneumonia and are planning another next year for hospital-acquired and ventilator-associated pneumonia.

FDA’s heightened attention to antibacterial drugs is in part due to the IDSA’s growing influence on Capitol Hill. IDSA endorsed the legislation that required FDA to publish many of the guidances the agency released over the past year. That legislation also requires FDA to update breakpoints for antimicrobials regularly. As a result, FDA has not only acted to modify the breakpoints for penicillin to treat pneumococcal pneumonia and vancomycin to treat staph infections, but also issued guidance outlining how the agency plans to keep on track in updating breakpoints for the long term.

In this case and others, IDSA could not have achieved what it did without the dedicated advocacy work of key volunteers. When it comes to policy issues that affect all of us as infectious diseases specialists—from pandemic influenza to physician payments to antimicrobial availability—your experience, your insights, your voice, and your membership in IDSA matter, now more than ever.

You recently received an e-mail asking you to help the Society build its grassroots network by becoming a Key Member-Advocate. If you haven’t done so already, please take a moment and fill out the brief questionnaire.

It has been an honor to serve as your president. I look forward to seeing you this October at the 48th Annual ICAAC/IDSA 46th Annual Meeting in Washington, DC.
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