Combating Antimicrobial Resistance

Antibiotics are medicines that attack bacteria in various ways to disable their structures and functions and, thereby, treat and, in some cases, prevent bacterial infections.

However, high proportions of Antimicrobial resistance (AMR) to common treatments have become a global phenomenon that poses a profound threat to human health, with negative effects on patient outcomes and health expenditures.

AMR is the resistance of microorganisms (bacteria, viruses, protozoa, fungi and some parasites) to antimicrobial medicines (antibiotics, antivirals and antimalarials), to which the microorganism was previously sensitive. In other words, the resistant microorganisms change in ways that make them withstand attack by antimicrobial medicines and render the medications used to cure the infections they cause ineffective.

According to the World Health Organization (WHO) Global Report on Surveillance of AMR 2014, AMR has become a serious public health problem as health systems can hardly find treatment options for common infections.

Data provided by 114 countries indicate that 7 common bacteria are known to be responsible for serious diseases from bloodstream infections to gonorrhea, while significant gaps have been found to exist in tracking of antibiotic resistance.

Available statistics indicate that about 440,000 new cases of multidrug resistance tuberculosis (MDR-TB) emerge annually, to the extent that standard treatments become ineffective, with infections persisting and spreading to others, causing at least 150 deaths, with Extensive drug-resistant tuberculosis (MDR-TB) having been reported in 64 countries.

According to WHO, AMR is a consequence of the use and, particularly, the misuse of antimicrobial medicines and develops when a microorganism mutates or acquires a resistant gene. Thus when patients failed to take the full course of a prescribed antimicrobial or when poor quality antimicrobials are used, resistant microorganisms are likely to emerge and spread.

Other factors that threaten the possibility of providing cure with antibiotics are poor hygiene and overcrowding which accelerate the spread of resistance in hospitals, poor infection prevention and control practices, depleted arsenals of diagnostics, medicines and vaccines, lack of or limited availability of tools and systems for the monitoring and evaluation of AMR, and the failure of the pharmaceutical industry to engage in research and develop new classes of antibiotics.

AMR threatens a return to the pre-antibiotic era as many diseases will defy treatment, with serious implications for the attainment of health-related targets of the Millennium Development Goals (MDGs).

AMR also increases the cost of health care and financial burden to government and care givers as more expensive therapies and increased isolation care are required, when infections become resistance to first line medicines and when the duration of illnesses last longer, often in hospitals.

AMR is a disincentive to the gains made in health care delivery, the reason being that with the lack of effective antimicrobials for the care and prevention of infections, achievements of modern medicine, are exposed to risk and the success of treatments like organ transplantation, cancer chemotherapy and major surgery will become compromised.

AMR also compromises health security and damages trade and economies as resistant micro-organisms spread across countries and continents.

Urgent action is, therefore, required to prevent death from common infections and minor injuries.

Essentially, the need for antibiotics should be reduced by preventing infections. And to prevent infections, there is the need to submit oneself to vaccination, and practice better hygiene while access to clean water and sanitation must be ensured.

To reduce AMR, antibiotics should not be shared with others, neither should left-over prescriptions be used. Again, antibiotics should be used only when they are prescribed and, where prescribed, the full prescription must be completed even if one feels better.

Meanwhile, in May 2014, the World Health Assembly (WHA) requested WHO to develop a draft global action plan to combat AMR and to ensure that all countries have the capacity to combat AMR, taking into account existing action plans and all available evidence and best practice, and apply a multisectoral approach by consulting and submit Draft Global Action Plan to the WHA in 2015.

Source:  G.D. Zaney