‘Rising antimicrobial resistance, a serious threat to economic growth’
1) What is antimicrobial resistance?
- Antimicrobial resistance is resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infections caused by it.
- Resistant microorganisms (including bacteria, fungi, viruses and parasites) are able to withstand attack by antimicrobial drugs, such as antibacterial drugs (e.g. antibiotics), antifungals, antivirals, and antimalarials, so that standard treatments become ineffective and infections persist, increasing the risk of spread to others.
2)How Antimicrobial resistance can occur?
- There are three main ways by which resistance can occur: by natural resistance in certain types of bacteria, by genetic mutation, or by one species acquiring resistance from another.
- The evolution of resistant strains is a natural phenomenon that occurs when microorganisms replicate themselves erroneously or when resistant traits are exchanged between them.
- The use and misuse of antimicrobial drugs accelerates the emergence of drug-resistant strains. Poor infection control practices, inadequate sanitary conditions and inappropriate food-handling encourage the further spread of antimicrobial resistance.
3) What is the difference between antibiotic and antimicrobial resistance?
- Antibiotic resistance refers specifically to the resistance to antibiotics that occurs in common bacteria that cause infections.
- Antimicrobial resistance is a broader term, encompassing resistance to drugs to treat infections caused by other microbes as well, such as parasites (e.g. malaria), viruses (e.g. HIV) and fungi (e.g. Candida).
4) Why is antimicrobial resistance a global concern?
- New resistance mechanisms emerge and spread globally threatening our ability to treat common infectious diseases, resulting in death and disability of individuals who until recently could continue a normal course of life.
- Without effective anti-infective treatment, many standard medical treatments will fail or turn into very high risk procedures.
4.1) Antimicrobial resistance kills
- Infections caused by resistant microorganisms often fail to respond to the standard treatment, resulting in prolonged illness, higher health care expenditures, and a greater risk of death.
- As an example, the death rate for patients with serious infections caused by common bacteria treated in hospitals can be about twice that of patients with infections caused by the same non-resistant bacteria.
4.2) Antimicrobial resistance hampers the control of infectious diseases
- Antimicrobial resistance reduces the effectiveness of treatment; thus patients remain infectious for a longer time, increasing the risk of spreading resistant microorganisms to others. (For example, MDR TB in India)
4.3) Antimicrobial resistance increases the costs of health care
- When infections become resistant to first-line drugs, more expensive therapies must be used. A longer duration of illness and treatment, often in hospitals, increases health care costs as well as the economic burden on families and societies.
4.4) Antimicrobial resistance jeopardizes health care gains to society
- The achievements of modern medicine are put at risk by antimicrobial resistance. Without effective antimicrobials for prevention and treatment of infections, the success of organ transplantation, cancer chemotherapy and major surgery would be compromised.
5) What accelerates the emergence and spread of antimicrobial resistance?
- The development of antimicrobial resistance is a natural phenomenon. However, certain human actions accelerate its emergence and spread. The inappropriate use of antimicrobial drugs, including in animal husbandry, favours the emergence and selection of resistant strains, and poor infection prevention and control practices contribute to further emergence and spread of antimicrobial resistance.
6) Need for concerted actions
Antimicrobial resistance is a complex problem driven by many interconnected factors. As such, single, isolated interventions have little impact. Coordinated action is required to minimize emergence and spread of antimicrobial resistance.
People can help tackle resistance by:
- hand washing, and avoiding close contact with sick people to prevent transmission of bacterial infections and viral infections such as influenza or rotavirus, and using condoms to prevent the transmission of sexually-transmitted infections;
- getting vaccinated, and keeping vaccinations up to date;
- using antimicrobial drugs only when they are prescribed by a certified health professional;
- completing the full treatment course (which in the case of antiviral drugs may require life-long treatment), even if they feel better;
- never sharing antimicrobial drugs with others or using leftover prescriptions.
Health workers and pharmacists can help tackle resistance by:
- enhancing infection prevention and control in hospitals and clinics;
- only prescribing and dispensing antibiotics when they are truly needed;
- prescribing and dispensing the right antimicrobial drugs to treat the illness.
Policymakers can help tackle resistance by:
- improving monitoring around the extent and causes of resistance;
- strengthening infection control and prevention;
- regulating and promoting appropriate use of medicines;
- making information widely available on the impact of antimicrobial resistance and how the public and health professionals can play their part;
- rewarding innovation and development of new treatment options and other tools.
Policymakers, scientists and industry can help tackle resistance by:
- fostering innovation and research and development of new vaccines, diagnostics, infection treatment options and other tools.
7) WHO’s response
WHO is guiding the response to antimicrobial resistance by:
- bringing all stakeholders together to agree on and work towards a coordinated response;
- strengthening national stewardship and plans to tackle antimicrobial resistance;
- generating policy guidance and providing technical support for Member States;
- actively encouraging innovation, research and development.
WHO is already working closely with the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) to promote best practices to avoid the emergence and spread of antibacterial resistance, including optimal use of antibiotics in both humans and animals.
WHO has developed, a draft global action plan to combat antimicrobial resistance which has been submitted to the sixty-eighth World Health Assembly, taking place in May 2015.
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