Authors: Martha Powell, Future Science Group
This month Infectious Diseases Hub is exploring antimicrobial resistance in association with World Antibiotic Awareness Week (13–19 November). In line with this, our Editor, Martha Powell, takes a closer look at the steps that can be taken to prevent the spread of drug resistance.
Measures must be taken on several levels, and recently there has been much emphasis on the need for action, with the Call to Action conference in Berlin in October (12–13) causing a lot of traction in the media. Watch the video to find out more about what you can do as an individual, healthcare professional or policy maker and let us know of any other steps you think are necessary in the comments below.
Summary and transcript
00.10 – The scope of the problem
There’s a growing list of infections that are becoming harder, and in some cases impossible, to treat. For example, there are an estimated 480,000 individuals worldwide suffering from drug-resistant strains of tuberculosis, in addition, earlier this year it was reported that there have been three cases of gonorrhoea considered completely untreatable by all known antibiotics
It has been estimated by the CDC that, in the US alone, there are approximately 23,000 mortalities every year as a result of antibiotic-resistant infections. The WHO have stated that without urgent action, we are heading for a ‘post-antibiotic era’ where minor injuries and common infections, which have been treatable for decades, could once again become fatal
00.55 – Prevention and control
The issue of tackling antimicrobial resistance is complex and widespread. First and foremost, resistance can be accelerated by misuse and overuse of antibiotics, in addition to poor infection and control measures. A comprehensive and collaborative approach to this problem will be required and therefore there are several levels of action to be taken
As an individual, measures include never sharing leftover antibiotics, and always following your healthcare worker’s instructions regarding prescriptions after, a recent debate about whether “completing the course” of antibiotics might actually promote resistance.
Looking at another approach, healthcare providers are advised by the WHO to make efforts to only prescribe antibiotics when necessary – for example, 2016 data suggested up to 30% of antibiotics prescribed in the US are unnecessary – the aim here is to decrease misuse, and reduce usage more generally. In addition, the WHO advocate that healthcare providers communicate with patients about how to correctly take antibiotics and how they can prevent infections
Action is also required on a policy level, including the implementation of national action plans, surveillance of resistant infections, and advocacy of infection prevention and control measures. There has been some progress in this, for example, in May 2017 G20 leaders signed a declaration on global health that included tackling antimicrobial resistance – an action that has been considered a positive step
In addition to this, there are also areas such as the agricultural sector which will also need to take action to reduce overuse and misuse of antibiotics via policy and practice changes.
A collaborative approach has produced some positive results so far – both the UK’s NHS and the US’s CDC have reported decreasing antibiotic prescriptions – however, there is still more to be done
03.00 – Looking forwards
Research must also continue into developing new antibiotics. A new WHO report recently raised concerns over the lack of new drugs in the current pipeline – stating that of the 51 it reported, only 8 were truly innovative
Moreover, other strategies will be important, for example there may be potential in vaccinating against some resistant bacteria. Research is also ongoing into alternatives to traditional antibiotics, such as employing predatory bacteria and bacteriophages to target infections, with some promising results.
Interested in learning more about drug resistance? As part of our focus this month, you can read more about some of these approaches in a short series of opinion pieces, just visit our World Antibiotic Awareness Week homepage linked here.