Steps to tackle antibiotic resistance

Who needs to help in tackling antibiotic

resistance?Antibiotic resistance is a complex issue that has

arisen due to multiple, interlinked factors. Therefore, coordinated rather than isolated interventions are necessary to combat this problem5

Coordinated action between the following groups is required:Health care providers1

Patients and the general public1

Governments and industries1

Key problemsPrevalence of deadly infectious diseasesOveruse and misuse of antibiotics by patientsMisdiagnosis of infections and incorrect

prescriptionMisuse of antibiotics in animalsLack of tools to monitor antibiotic resistanceLack of coordination between stakeholders

Retrieved from: CDC Features - Mission Critical: Preventing Antibiotic Resistance [Internet]. Cdc.gov. 2016 [cited 7 April 2016]. Available from: http://www.cdc.gov/features/antibioticresistance/

Usage of antibiotics Misuse of antibiotics contributes to resistance This includes overuse of antibiotics, not finishing a course of

antibiotics, sharing antibiotics, using antibiotics in animals, and so on1,4,5

Patients should finish the prescribed course of antibiotics even when they already ‘feel better’1

Antibiotics should only be used when prescribed by a doctor1,5, and over-the-counter sales of antibiotics need to be closely monitored to prevent misuse

People should not share antibiotics with others or use leftover prescriptions1

The use of antibiotics in the agricultural industry needs to be managed to prevent acceleration of antibiotic resistance4

Infection control The prevalence of infections is often exacerbated by or caused by

unsanitary living conditions, lack of personal and interpersonal hygiene, and lack of infection control within shared facilities

Prevention is better than cure -> preventing infections in the first place is more efficient than having to deal with the costs of treating them

Prevention includes:- Better hygiene practices- Avoiding close contact with sick people- More clean water access- better infection control in health care facilities- immunisation programs for infants and children -> herd immunity- tools to track resistance

Diagnosis and prescription Diagnostic uncertainty is a key factor in antibiotic misuse and

overuse, and thus antibiotic selection pressure and resistance2

Doctors often do not have quick enough diagnostic tests, and are forced to start treating severely ill patients with broad-spectrum antibiotics before lab results arrive3

Some diagnoses are incorrect and result in incorrect antibiotic prescription1,2

Inappropriate or unnecessary antibiotic prescription contributes to resistance

Quicker and more accurate diagnostic tests, using improved information technology and microbiological progress can lead to improved antibiotic selection, dosing and treatment duration4

More accurate prescription is also necessary to ensure that the right antibiotics are being taken1

Policymakers and industry Governments need to support and promote different campaigns,

policies, interventions and regulations to tackle antibiotic resistance1:

Educational campaigns and available information aimed at changing attitudes towards antibiotic prescription and usage, to optimise drug use4

Regulating appropriate use of drugs and medicine1

Encouraging and rewarding research and development into new tools to track and monitor antibiotic resistance and its causes, as well as to better diagnose infection1 and treat disease5

Encouraging infection control across sectors5, not just in health care facilities

Data sharing and cooperation between stakeholders, for a coordinated response to resistance and consistent worldwide control measures1,4,5. This will prevent inconsistent action between taken by countries to tackle the issue

Retrieved from: ReAct - ANTIBIOTIC RESISTANCE – A CALL FOR GLOBAL ACTION [Internet]. Reactgroup.org. 2016 [cited 7 April 2016]. Available from: http://www.reactgroup.org/news/354/18.html

International cooperationThe World Health Organisation (WHO) is actively

involved in coordinating global policies and supporting member states in the fight against antibiotic resistance5

It is also bringing stakeholders together to decide on a common plan to tackle the problem of resistance, and strengthening national stewardship5

Active encouragement of innovation, research and development in relevant industries is also taking place1,5

US plan against resistanceThe White House has released a ‘National Action plan for

Combating Antibiotic-Resistant Bacteria’3

This calls for consistent action across federal agencies and sets five main goals for reducing resistance and antibiotic misuse3:

1- Preventing the spread of antibiotic resistance2- Strengthening surveillance efforts3- Advancing diagnostic testing4- Accelerating the development of new antibiotics5- Improving global collaborationThis is another example of a large scale response

towards antibiotic resistance

Therefore, there are steps that can be taken to remedy the problem at hand

It requires a cooperative and consistent response between people, industries, governments and countries

Hopefully we will see these steps being taken, and the world will not have to deal with the consequences of a post-antibiotic era

Retrieved from: ReAct - ReAct WORLD HEALTH DAY Activitites [Internet]. Reactgroup.org. 2016 [cited 7 April 2016]. Available from: http://www.reactgroup.org/what-we-do/react-world-health-day.html

References1. WHO | WHO’s first global report on antibiotic resistance reveals serious,

worldwide threat to public health [Internet]. Who.int. 2016 [cited 4 April 2016]. Available from: http://www.who.int/mediacentre/news/releases/2014/amr-report/en/

2. Nuermberger E, Bishai W. Antibiotic Resistance in Streptococcus pneumoniae: What Does the Future Hold?. Clinical Infectious Diseases. 2004;38(Supplement 4):S363-S371.

3. Krisberg K. US charting new path to combat growing antibiotic resistance: New action plan coordinates response. The Nation's Health [Internet]. 2016 [cited 7 April 2016];45(4):1-14. Available from: http://thenationshealth.aphapublications.org/content/45/4/1.3.full

4. Harbarth S, Samore M. Antimicrobial Resistance Determinants and Future Control. Emerg Infect Dis. 2005;11(6):794-801.

5. Antimicrobial resistance [Internet]. World Health Organization. 2016 [cited 4 April 2016]. Available from: http://www.who.int/mediacentre/factsheets/fs194/en/