Focus on antimicrobial resistance concerns

Imagining a world where infectious diseases cannot be treated sounds like an apocalyptic nightmare from a film. Yet this is the scenario that we may face in 15-20 years time, due to the emerging and increasingly difficult issue of antibiotics no longer being effective against common bacteria. There are very few new families of antibiotics being researched at the moment, and it is said to take many years, and many thousands of dollars to develop and bring them to market. Modern surgery, organ transplants and chemotherapy for the immune-compromised, without the benefit of prophylactic antibiotic cover, would return to being very high risk treatments and many patients would die of currently treatable illnesses and infections. The clever little microbes and viruses are way ahead of us and can mutate, change and adapt as we have seen with bird flu and other diseases, thus being difficult to treat. What is to be done? Slowly the call for action is growing among those with the greatest awareness of the issue. The World Health Organization, microbiologists and epidemiologists, as well as the Chief Medical Officer, have raised the problem higher up the political agenda, but grass roots awareness seems to be lagging behind. The World Health Organization identified that antimicrobial resistance (AMR) is a complex problem, driven by many interconnected factors, so that isolated interventions have little overall impact, and co-ordinated responses are required.

Facts

Deaths from acute respiratory infections, diarrhoeal diseases, measles, AIDs, malaria and tuberculosis account for more than 85% of deaths worldwide. Resistance to drugs in most of these pathogens causing these diseases ranges from 0%-100%. In the developed world, antibiotic resistant microbes are the cause of 60% of all hospital-acquired infections. Multiple medicine resistant tuberculosis ranges from a low of 5.3% in New Zealand to 100% in Russia. Treating one patient with multi-resistant TB can cost as much as treating 100 patients with tuberculosis. In some countries 30%-60% of primary healthcare patients receive antimicrobials. This is about twice what is clinically indicated. Some bacterial infections reported in Japan defy every antibiotic known to modern medicine. The World Health Professions Alliance Fact sheet,1 which demonstrates their concern with the issue also makes some recommendations for action. One of the key recommendations is that ‘healthcare professionals should raise awareness among their patients of their antimicrobial therapy, the risks and benefits, the importance of compliance with the prescribed regimen, and the problem of antimicrobial resistance’.