The Resistance Web ™, developed by The Clinical Pharmacokinetics Laboratory (CPL) at the Millard Fillmore Hospital in Buffalo, NY, offers health care professionals and medical researchers immediate access to the results of 10 years of drug resistance tracking and associated drug utilization data and demographic information. The site will help to alert medical professionals to drug resistance patterns, the dangers of over-prescribing antibiotics and to encourage increased focused surveillance activities.

"We have intuitively known for many years that improper drug usage will impact the levels of bacterial resistance in our community," said Jerome J. Schentag, Pharm. D., Director of the CPL and a faculty member of the State University of New York (SUNY) at Buffalo School of Pharmacy, who has studied the relationship between antibiotic use and microbial resistance for more than 20 years. "Analyzing bacterial resistance trends with antibiotic utilization may be the key to a better understanding of how we as researchers and clinicians can modify our prescribing habits to slow the increase in resistance to commonly prescribed antibiotics. Resistance Web ™ is an important tool to raise awareness of the seriousness of this matter."

The site houses a powerful database enabling the user to construct customized queries on susceptibility patterns of different bacteria to specific antibiotics, regionally and nationally. The database is accessible to health care professionals, including infection control professionals, infectious disease specialists, pharmacists and medical researchers.

Resistance Web™ offers access to susceptibility data and patterns for clinical bacterial isolates gathered through surveillance and benchmarking studies conducted by the CPL since 1988. Analysis reports of the database's information, conducted regularly by CPL researchers, will be posted on the website and sent via email to its members. To ensure that Resistance Web™ is as comprehensive as possible, institutions are encouraged to submit their own data for review and potential uploading to the database.

Tracking a Trend

For example, a critical care specialist in a community hospital with an emerging resistance problem in the medical intensive care unit can log-in to the CPL trends database and run a query to investigate the relationship between the use of various types of antibiotics, indicated on the site by generic name, and the bacteria's historical rate of susceptibility to those antibiotics.

"The site's rapid delivery of information is a major advancement in the effort to prolong the life of viable antibiotics," said Dr. Schentag. "It takes seven to 10 years to develop a new antibiotic and bacteria just a few months or years to develop resistance to it. Currently the medical world is faced with a significant lag between the time that surveillance studies of resistance are done and the time that the information is presented to the medical community. We're simply using the web's immediacy to speed the process between identifying a resistance problem and reacting to it."

The site's database is divided into two major categories, one that tracks trend data and another that reports results of spot surveillance studies. Registered members can go on-line to locate specific information relevant to their area of interest. Trend data are composed of yearly information matched with antibiotic use information and are updated quarterly. Spot surveillance studies investigate the activity of various panels of antibiotics versus a defined sample of clinical bacterial isolates collected for a specified period of time.

The multi-hospital, Millard Fillmore Health System (MFHS), and the State University of New York at Buffalo School of Pharmacy established the Clinical Pharmacokinetics Laboratory (CPL) as a joint venture in 1972. Since then, the CPL has matured into a multidisciplinary health care research center with more than 75 full-time and 15 part-time employees. The CPL sponsors fellowship training in clinical pharmacokinetics and pharmacodynamics, infectious diseases, clinical pharmacology, and pharmacometrics. Rhône-Poulenc Rorer Pharmaceuticals Inc. provides initial funding for the Resistance Web ™ project through an unrestricted educational grant.

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