Antibiotic Resistance; Types, Causes, How way Overcome It?

Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality.

The world urgently needs to change the way it prescribes and uses antibiotics. Even if new medicines are developed, without behaviour change, antibiotic resistance will remain a major threat. Behaviour changes must also include actions to reduce the spread of infections through vaccination, hand washing, practising safer sex, and good food hygiene.

Scope of the problem

Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases. A growing list of infections – such as pneumonia, tuberculosis, blood poisoning and gonorrhoea – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.

Where antibiotics can be bought for human or animal use without a prescription?, the emergence and spread of resistance is made worse. Similarly, in countries without standard treatment guidelines, antibiotics are often over-prescribed by health workers and veterinarians and over-used by the public.

Without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill.

Prevention and control

Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as poor infection? prevention and control. Steps can be taken at all levels of society to reduce the impact and limit the spread of resistance.

Individuals

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 by washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date.

Policy makers

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.
• 

Health professionals

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).

So, what can we do to prevent antibiotic resistance in healthcare settings

Patients, healthcare providers, healthcare facility administrators, and policy makers must work together to employ effective strategies for improving antibiotic use—ultimately improving medical care and saving lives.

Patients can:

• Ask if tests will be done to make sure the right antibiotic is prescribed.
• Take antibiotics exactly as the doctor prescribes. Do not skip doses. Complete the prescribed course of treatment, even when you start feeling better.
• Only take antibiotics prescribed for you; do not share or use leftover antibiotics. Antibiotics treat specific types of infections. Taking the wrong medicine may delay correct treatment and allow bacteria to multiply.
• Do not save antibiotics for the next illness. Discard any leftover medication once the prescribed course of treatment is completed.
• Do not ask for antibiotics when your doctor thinks you do not need them. Remember antibiotics have side effects.
• Prevent infections by practicing good hand hygiene and getting recommended vaccines.

Healthcare providers can

• Prescribe antibiotics correctly – get cultures, start the right drug promptly at the right dose for the right duration. Reassess the prescription within 48 hours based on tests and patient exam.
• Document the dose, duration and indication? for every antibiotic prescription.
• Stay aware of antibiotic resistance patterns in your facility.
• Participate in and lead efforts within your hospital to improve prescribing practices.
• Follow hand hygiene and other infection control measures with every patient.

Healthcare Facility Administrators and Payers Can:

To protect patients and preserve the power of antibiotics, hospital CEOs/medical officers can:

Adopt an antibiotic stewardship program that includes, at a minimum, this checklist

1. Leadership commitment: Dedicate necessary human, financial, and IT resources.
2. Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
3. Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
4. Action: Take at least one prescribing improvement action, such as requiring reassessment within 48 hours to check drug choice, dose, and duration.
5. Tracking: Monitor prescribing and antibiotic resistance patterns.
6. Reporting: Regularly report to staff prescribing and resistance patterns, and steps to improve.
7. Education: Offer education about antibiotic resistance and improving prescribing practices.

Work with other health care facilities to prevent infections, transmission, and resistance.

Healthcare industry

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.

Agriculture sector

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.

Recent developments

While there are some new antibiotics in development, none of them are expected to be effective against the most dangerous forms of antibiotic-resistant bacteria.

Given the ease and frequency with which people now travel, antibiotic resistance is a global problem, requiring efforts from all nations and many sectors.

Impact

When infections can no longer be treated by first-line antibiotics, more expensive medicines 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.

Antibiotic resistance is putting the achievements of modern medicine at risk. Organ transplantations, chemotherapy? and surgeries such as caesarean sections become much more dangerous without effective antibiotics for the prevention and treatment of infections.

WHO response

Tackling antibiotic resistance is a high priority for WHO. A global action plan on antimicrobial resistance?, including antibiotic resistance, was endorsed at the World Health Assembly in May 2015. The global action plan aims to ensure prevention and treatment of infectious diseases with safe and effective medicines.

The “Global action plan on antimicrobial resistance” has 5 strategic objectives:

• To improve awareness and understanding of antimicrobial resistance.
• To strengthen surveillance and research.
• To reduce the incidence of infection.
• To optimize the use of antimicrobial medicines.
• To ensure sustainable investment in countering antimicrobial resistance.

Heads of State at the United Nations General Assembly in New York in September 2016 committed to taking a broad, coordinated approach to address the root causes of AMR across multiple sectors, especially human health, animal health and agriculture. Countries reaffirmed their commitment to develop national action plans on AMR, based on the global action plan. WHO is supporting Member States to develop their own national action plans to address antimicrobial resistance.

In response to the first objective of the global action plan, WHO is leading a global, multi-year campaign with the theme “Antibiotics: Handle with care”. The campaign was launched during the first World Antibiotic Awareness Week in November 2015.

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