From the Guidelines
Antimicrobial resistance (AMR) is one of the most significant public health threats of our time, and it is imperative that we take immediate action to address this issue, as it threatens to undermine decades of medical progress and cause substantial morbidity, mortality, and economic burden. The importance of addressing AMR cannot be overstated, as it affects not only human health but also the quality of life of millions of people worldwide, with an estimated 1.3 million deaths attributed to AMR in 2019 1. Common infections like pneumonia, tuberculosis, and urinary tract infections are becoming increasingly difficult to treat as first-line antibiotics lose effectiveness, and without effective antimicrobials, routine medical procedures such as cesarean sections, joint replacements, and cancer chemotherapy become significantly more dangerous due to the risk of untreatable infections.
Some of the key factors contributing to the rise of AMR include:
- Inappropriate use of antibiotics, such as using them when none are needed or using the wrong antibiotic at the wrong dose, for the wrong duration, and by the wrong route, which is a common problem concerning between 30% and 50% of all antibiotic prescriptions 1
- Misuse and overuse of antibiotics in healthcare, agriculture, and veterinary settings, which has been dramatically accelerated by human activities 1
- Limited treatment options for multidrug-resistant organisms (MDROs), which often include only last-resort antibiotics that are generally associated with high toxicity or poor efficacy 1
To combat this crisis, we must adopt a multifaceted approach including more prudent antibiotic use in humans and animals, better infection prevention and control, increased surveillance of resistant organisms, development of new antimicrobials, and greater public awareness about appropriate antibiotic use. This approach should be based on the most recent and highest-quality evidence, such as the recommendations on first- and second-choice antibiotics for empiric treatment of clinical infections 1. Additionally, it is essential to develop and implement national action plans and actions to tackle AMR, as endorsed by the WHO Member States in 2015 1. By taking immediate and collective action, we can mitigate the impact of AMR and ensure a healthier future for generations to come.
From the Research
Importance of AMR
- Antimicrobial resistance (AMR) is a serious threat to global public health, increasing morbidity and mortality, and associated with high economic costs due to its healthcare burden 2.
- AMR has emerged as a chronic public health problem globally, with a forecast of 10 million deaths per year globally by 2050 3.
- The prominent cause contributing to the current crisis remains to be the overuse and misuse of antimicrobials, particularly the inappropriate usage of antibiotics, increasing the global burden of antimicrobial resistance 3.
Impact on Future
- The consequences of failure to adequately address AMR are profound, with estimations of a return to the pre-antibiotic era, where everyday infections relating to childbirth, surgery, and open fractured limbs could be potentially life-threatening 3.
- AMR itself represents a microcosm of factors, including social anthropology, civil unrest/war, diasporas, ethnic displacement, political systems, healthcare, economics, societal behavior both at a population and individual level, health literacy, geoclimatic events, global travel, and pharmaceutical innovation and investment 3.
- Success will involve individuals, communities, and nations all working together to ensure that the world continues to possess a sufficient armamentarium of effective antimicrobials that will sustain human and animal health, both now and in the future 3.
Strategies to Combat AMR
- Antimicrobial stewardship (AMS) is an organizational or system-wide health-care strategy, designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health 2.
- The "One Health" approach, a holistic and multisectoral approach, is also needed to address AMR's rising threat 2, 3, 4.
- Immediate interventions to contain AMR include surveillance and monitoring, minimizing over-the-counter antibiotics and antibiotics in food animals, access to quality and affordable medicines, vaccines, and diagnostics, and enforcement of legislation 5.