Clinicians should be aware of their role and responsibility for maintaining the effectiveness of current and future antibiotics. Health workers can help tackle resistance by:
- Enhancing infection prevention and control;
- Prescribing and dispensing antibiotics when they are truly needed; and
- Prescribing and dispensing the right antibiotic(s) to treat the illness.
Judicious, careful and rational use of antimicrobials is an integral part of good clinical practice. This attitude maximizes the utility and therapeutic efficacy of treatment, and minimizes the risks associated with emerging infections and the selection of resistant pathogens. The indiscriminate and excess use of antimicrobial drugs appears the most significant factor in the emergence of resistant microorganisms in recent years.
Antimicrobial resistance (AMR) is a natural phenomenon that occurs as microbes evolve. However, human activities have accelerated the pace at which microorganisms develop and disseminate resistance. Injudicious use of antibiotics and other antimicrobials, as well as poor prevention and control of infections, are contributing to the development of such resistance.
The impact of AMR worldwide is significant, both in economic terms, and clinical morbidity and mortality because it may:
- lead to some infections becoming untreatable;
- lead to inappropriate empirical treatment in critically ill patients where an appropriate and prompt treatment is mandatory;
- increase length of hospital stay, morbidity, mortality and cost; and
- make necessary alternative antimicrobials which are more toxic, less effective, or more expensive.
The global nature of AMR calls for a global response, both in the geographic sense and across the whole range of sectors involved.
Emergence of AMR, combined with very few new antimicrobial agents in the drug development pipeline, indicates that awareness and understanding of antimicrobial resistance is necessary.
Clinicians should be aware of their role and responsibility for maintaining the effectiveness of current and future antimicrobials. Health workers can help tackle resistance by:
- enhancing infection prevention and control;
- prescribing and dispensing antimicrobials when they are truly needed; and
- prescribing and dispensing the right antimicrobial(s) to treat the illness.
An antimicrobial-based approach should involve a delicate balance between the optimisation of empirical therapy, which has been shown to improve clinical outcomes, and the reduction of excessive antimicrobial use, which has been proven to increase the rate of emergence of anti-microbial resistant strains.
Although most clinicians are aware of the problem of antimicrobial resistance, most underestimate its importance; judicious antimicrobial management decisions is an integral part of responsible medication prescribing behavior.
Many calls to action on antimicrobial resistance have been made over the past years, but there has been very little progress.
The World Health Organization (WHO) endorsed a global action plan to tackle antimicrobial resistance. It sets out five strategic objectives:
- to improve awareness and understanding of antimicrobial resistance;
- to strengthen knowledge through surveillance and research;
- to reduce the incidence of infection;
- to optimize the use of antimicrobial agents; and
- to develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.