The overprescribing and misuse of antibiotics in medicine over the past few decades has given rise to one of the biggest threats to global health today – antimicrobial resistance  – which according to the  Executive Head of Clinical Services and Quality at Life Healthcare Group, Dr Paul Soko, is leading to longer hospital stays, far higher medical costs and increased mortality.

This World Antibiotic Awareness Week (13 – 19 November 2017), the Life Healthcare Group is supporting the WHO’s mission to increase awareness about antibiotic resistance by encouraging members of the general public, health workers and policy makers to follow best practice in the use of antibiotics to avoid the further emergence of antibiotic resistance.

According to the WHO, antibiotics are in danger of losing their effectiveness due to misuse and overuse, and are in many cases not even necessary. Without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries will become untreatable.

“The misuse of antibiotics over the past few decades has contributed to an alarming increase in bacterial resistance, which has since 2014 continuously been highlighted by the WHO as one of the biggest threats to public health today,” said Dr Soko.

Scope of the problem

New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases. A growing list of infections – such as pneumonia, TB, blood poisoning, gonorrhoea and foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.

Globally, 480,000 people develop multi-drug resistant TB each year, and drug resistance is starting to complicate the fight against HIV and malaria, as well.

Without effective antimicrobials for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery (for example, caesarean sections or hip replacements) become very high risk.

According to the WHO, the emergence and spread of resistance is made worse in countries without standard treatment guidelines, antibiotics are often over-prescribed by health workers and veterinarians and over-used by the public.

Prevention and control

“It is important that the public is aware that globally we are running out of effective antibiotics. Antibiotics should only be used for bacterial infections that the body’s own immune response cannot fight, and only when a doctor prescribes them,” said Dr Soko.

“Common colds and flus are for example caused by viruses, not bacteria, meaning that antibiotic therapy would be ineffective to treat these infections. Not only that, by using antibiotic treatment unnecessarily, other bacteria in the environment as well as the ‘healthy’ bacteria in the body gets the opportunity to develop resistance due to exposure, which can potentially cause antibiotic resistant infections later on,” continued Dr Soko.

Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as poor infection prevention and control. Steps can be taken to reduce the impact and limit the spread of resistance for example: not sharing left over antibiotics between family and friends or using left over antibiotics from a previous illness; using antibiotics as prescribed by a healthcare professional and returning unused medicines to local pharmacies for safe destruction.

“The need for antibiotic use can further be reduced by ensuring that all vaccinations are up to date. Vaccine preventable diseases often lead to secondary bacterial infections necessitating the use antibiotics, which could have been prevented if vaccines were up to date,” added Dr Soko.

Fighting resistance

Life Healthcare has been active in Antimicrobial Stewardship (AMS) for a number of years. Through their AMS Programme, the group drives the responsible use of antimicrobials (a collective term for antibiotics, antifungals, antivirals and anti-parasitic medications) to prevent further emergence of resistance. The AMS programme is aligned to the National Department of Health’s AMR National Strategy Framework 2014 – 2024 in response to the World Health Assembly’s endorsement of a global action plan to tackle antimicrobial resistance.

“In addition to the Group’s AMS Programme, stringent Infection Prevention and Control programmes are also in place to assist in the effective management of AMR,” said Dr Soko.

The collaborative effort between doctors, pharmacists, microbiologists, infection prevention specialists, nurses and other healthcare professionals plays a critical role in driving and influencing the implementation of the hospital antimicrobial resistance strategy. The provision of patient information and counselling in terms of safe antimicrobial use and the risks of antimicrobial resistance is important to keep our patients safe and informed.

“We are all responsible for preserving the effectiveness of the only effective antibiotics we have left, whether we prescribe, dispense, provide advice or need to take them,” concluded Dr Soko.

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