August 2017 – Antimicrobial Resistance: The Way Forward 2017 (Part II)

In this second article, the focus will be on specific areas that the various stakeholders should undertake in the fight against AMR.

Prevention and control

Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as by poor infection prevention and control. Steps can be taken at all levels of society to reduce the impact and limit the spread of resistance.

Individuals

To prevent and control the spread of antibiotic resistance, individuals can:

  • Only use antibiotics when prescribed by a certified health professional
  • Never demand antibiotics if your health worker says you don’t need them
  • Always follow your health worker’s advice when using antibiotics
  • Never share or use leftover antibiotics
  • Prevent infections by regularly by washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date

Policy Makers

To prevent and control the spread of antibiotic resistance, policy makers can:

  • Ensure a robust national action plan to tackle antibiotic resistance is in place
  • Improve surveillance of antibiotic-resistant infections
  • Strengthen policies, programmes, and implementation of infection prevention and control measures
  • Regulate and promote the appropriate use and disposal of quality medicines
  • Make information available on the impact of antibiotic resistance
  • Ensure adequate and sustained funding to support these programmes

Health Professionals

To prevent and control the spread of antibiotic resistance, health professionals can:

  • Prevent infections by ensuring your hands, instruments, and environment are clean
  • Only prescribe and dispense antibiotics when they are needed, according to current guidelines
  • Report antibiotic-resistant infections to surveillance teams
  • Talk to your patients about how to take antibiotics correctly, antibiotic resistance and the dangers of misuse
  • Talk to your patients about preventing infections (for example, vaccination, hand washing, safer sex, covering nose and mouth when sneezing and cough hygiene)

Healthcare Industry

To prevent and control the spread of antibiotic resistance, the health industry can:

  • Invest in research and development of new antibiotics, vaccines, diagnostics and other tools

In February 2017, WHO published a list of priority pathogens for which research and development of new antibiotics is actively encouraged.

Priority 1: CRITICAL

  • Acinetobacter baumannii, carbapenem-resistant
  • Pseudomonas aeruginosa, carbapenem-resistant
  • Enterobacteriaceae, carbapenem-resistant, ESBL-producing

Priority 2: HIGH

  • Enterococcus faecium, vancomycin-resistant
  • Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
  • Helicobacter pylori, clarithromycin-resistant
  • Campylobacter spp., fluoroquinolone-resistant
  • Salmonellae, fluoroquinolone-resistant
  • Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant

Priority 3: MEDIUM

  • Streptococcus pneumoniae, penicillin-non-susceptible
  • Haemophilus influenzae, ampicillin-resistant
  • Shigella spp., fluoroquinolone-resistant

Agriculture Sector

To prevent and control the spread of antibiotic resistance in the agriculture sector, the following is advised:

  • Only give antibiotics to animals under veterinary supervision
  • Not use antibiotics for growth promotion or to prevent diseases
  • Vaccinate animals to reduce the need for antibiotics and use alternatives to antibiotics when available
  • Promote and apply good practices at all steps of production and processing of foods from animal and plant sources
  • Improve biosecurity on farms and prevent infections through improved hygiene and animal welfare

AMR is a widespread and complex issue. The World Antibiotic Awareness Week was first started in 2015 and occurs annually in mid-November. A lot of the education will involve physicians and the community to ease the pressure on physicians to reduce antibiotic prescriptions and reduce the development of antibiotic resistance. With increased awareness, it is hoped that it will galvanize concerned citizens to work hard to avoid the worse case scenario when the end of modern medicine occurs as a result of antimicrobial resistance.