“Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality.” – WHO, 2017
“Without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill.” WHO, 2017
Handle with Care: World Antibiotic Awareness week is fast approaching on the 13th-19th November. The BARNARDS team is hoping to rally support and raise awareness for this global cause for concern. Use the link at the end of the post to join the campaign.
Antimicrobial resistance (AMR) is the ability of a microorganism to prevent an antimicrobial (such as antibiotics) working against it. This results in the treatment no longer being effective and subsequently infections persist and can spread (WHO, 2017). The overuse and misuse of antibiotics causes unnecessary increase in the number and types of antibiotic resistant organisms in a world where new drug discovery has slowed significantly. Sub-optimal concentrations of antibiotics diminish the number of drug susceptible bacteria leaving bacteria with resistance behind to multiply and thrive and pass resistance mechanisms to offspring and other bacteria at an increased rate. Sub-optimal levels of antibiotics can occur where:
• A prescribed antibiotic course is not finished
• Where antibiotics are available over the counter, without prescription so an incorrect drug or dose is taken.
• Receiving poor quality medicines
• Using antimicrobials as growth-promoters or disease preventative in agriculture or animal rearing.
Antimicrobial resistance is a growing global problem that affects us all, our options for effective drugs is dwindling at a time where no new novel drugs have appeared in recent years and there is ever growing concern that a simple infection, no matter where in the world you may be, could have a morbid outcome from a lack of available effective treatment.
As resistant organisms develop and multiply unhindered by combative drugs, their spread to others is exasperated by poor hygiene and infection prevention and control measures at home and in clinical environments. With global travel becoming ever more accessible, so are opportunities for drug resistant mechanisms to spread internationally within short periods of time.
Neonates in low-middle income countries (LMICs) are particularly at risk from AMR where a significant proportion of neonatal mortalities are believed to be caused by severe infections. In these areas there is a higher burden of bacterial disease and ideal conditions for the emergence and spread of AMR with limited resources to tackle the growing problem (Huynh et al, 2015; WHO, 2017) Information available in this area is limited and it is BARNARDS primary focus to report on the burden of antibiotic resistance in neonates, to determine the scale of the problem, identify the risk factors and contribute towards developing focussed interventions.
Established through our research will be a reliable international network report on AMR in participating sites amongst LMICs and BARNARDS aims to increase the capability of participating laboratories to detect emerging AMR where prompt action can then be taken by providing microbiological lab support and training.
How you can help: By reading and sharing the WHO advice given below and visiting the link to learn more and join the WHO 2017 campaign to raise awareness for how the simple measures detailed below can help tackle antimicrobial resistance!
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 washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date.
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.
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, and covering nose and mouth when sneezing).
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.
To prevent and control the spread of antibiotic resistance, the agriculture sector can:
• 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.
– WHO, 2017
Huynh B-T, Padget M, Garin B, et al. Burden of bacterial resistance among neonatal infections in low income countries: how convincing is the epidemiological evidence? BMC Infectious Diseases. 2015;15:127. doi:10.1186/s12879-015-0843-x.