Dealing with Anti-microbial Resistance

When it comes to dealing with Anti-microbial resistance (AMR), here are some shocking facts. 490, 000 people developed multi-drug resistant TB globally, in 2016.

The CDC lists urgent and serious threats from:

Urgent Threats

Serious Threats

Concerning Threats

If you need more data about the above, including the number of cases the read here. Additionally, 15,000 people died from drug resistant C difficile. That’s no small number

Anti-microbial Resistance Not Just Doctor’s Problem

Today so many people are handing out antibiotics.

  • Healthcare providers
  • Veterinarians
  • Agricultural farmers
  • Livestock breeders
  • Universities
  • Scientists and researchers
  • Patients themselves

And therefore, it makes no sense to curb the way only healthcare providers dispense antibiotics if we want to solve this problem.

Anti-microbial resistance is not a big deal

No. Anti-microbial resistance is bigger than that. Last year, in Pakistan, 850 people died from drug resistant typhoid. Typhoid! Can you imagine that? In some areas XDR has reached almost 30%. At this rate by 2020, all cases will be resistant. The same is happening in malaria and HIV. Along the Cambodia-Thailand border, P. falciparum has become resistant to most of the antimalarial medicines. This should have been a wake up call in the medical world. As always, it’s not a problem unless it “comes to a theater near you.” Then it’s a problem.

WHO Prescription for AMR

The WHO has been leading the efforts to reduce antimicrobial resistance. They have a prescription.

Doctors, nurses, veterinarians and other health workers

They say health practitioners shouldn’t prescribe or dispense antibiotics unless they are truly necessary. And they may do so only after they’ve made all efforts to test and confirm which antibiotic your human patient or the animal you are treating should have. For instance, it is estimated that in half of all cases, antibiotics are prescribed for viral conditions. They emphasize prevent infections in the first place by ensuring hands, instruments and environment are clean, and employing vaccines where appropriate.

People using healthcare

Patients must take antibiotics only when prescribed by a certified health professional. If they take an antibiotic, they must always complete the full prescription, even if they feel better, because stopping treatment early promotes the growth of drug-resistant bacteria.

Farmers and others in the agriculture sector

Antibiotics given to animals must be used only to control or treat infectious diseases and under veterinary supervision. Misuse of antibiotics in livestock, aquaculture and crops is one of the biggest contributors to antibiotic resistance and its spread into the environment, food chain and humans. Alternatively, clean and uncrowded conditions and vaccination of animals can reduce the need for antibiotics.

Governments

Robust national action plans have to be made to tackle antibiotic resistance. These include improved surveillance of antibiotic-resistant infections, regulation of the appropriate use of medicines. Also, we must educate people about the dangers of overuse.

Industry

The pharmaceutical industry needs to move faster and more aggressively to research and develop new antibiotics. There’s an antibiotic “discovery void” since the late 1980s. There’s an ongoing race between drug development and bacterial evolution. Surprisingly, the EU, the UK, the US and Canada have directly funded basic and clinical research by scientists; working with pharmaceutical companies; and offered monetary prizes for new diagnostics needed to use antibiotics more responsibly.

However, a new, more global approach is needed. The WHO global action plan on antimicrobial resistance is underway but it might be a while before concrete steps are taken.

Your AMR Prevention

Tell us how you’re tackling anti-microbial resistance. Do you have a specific example of how deal with this. Personally, I find many of the resistant bacteria tend to be sensitive to the older antibiotics like Bactrim. It’s like gaming the bacteria, I guess. It’s worked for many of my cases. How about yours? I’d love to know. In the meantime, check out some other posts.