This guide is a resource for physicians and other health care professionals who provide care and treatment to patients with drug-resistant tuberculosis.
These guidelines present evidence-based recommendations and best practice statements on use of medically important antimicrobials in food-producing animals, based on the WHO list of critically important antimicrobials for human medicine (WHO CIA List). These guidelines aim primarily to help preserve... the effectiveness of medically important antimicrobials, particularly those antimicrobials judged to be critically important to human medicine and also help preserve the effectiveness of antimicrobials for veterinary medicine, in direct support of the WHO global action plan on antimicrobial resistance
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In aquaculture, antibiotics have been used mainly for therapeutic purposes and as prophylactic agents. The contribution to antimicrobial resistance of antibiotics used in aquaculture is reviewed here, using a risk analysis framework. Some recommendations on responsible conduct in this context are pr...oposed, aimed at diminishing the threat of build up of antimicrobial resistance.
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The global tripartite self-assessment survey of country progress in addressing antimicrobial resistance (AMR) is a component of a broader approach for monitoring and evaluation of the global action plan on AMR. This report analyses the results of the second tripartite self-assessment survey
Antibiotics save lives, but poor prescribing practices are putting patients at unnecessary risk for preventable allergic reactions,
super-resistant infections, and deadly diarrhea. Errors in prescribing decisions also contribute to antibiotic resistance, making these drugs less likely to work in th...e future.
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This National Action Plan addresses actions needed to be taken in order to combat antimicrobial resistance (AMR) in the country. It is obligatory to raise awareness of antimicrobial resistance and promote behavioral change through public communication
programmes that targets human, animal and plant... health. Inclusion of the use of antimicrobial agents and resistance in school curricula will further promote better understanding and awareness from an early age. Antimicrobial Resistance knowledge, surveillance and research will be strengthened through establishing a national surveillance system for antimicrobial resistance, establishing and building capacity for a national reference laboratory and designated laboratories for AMR surveillance, developing a national research agenda on AMR and establishing and supporting a coordinated mechanism that will ensure harmonized AMR guidelines, data management and sharing systems in human, animal and plant health settings.
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This action plan for the Kingdom Saudi Arabia to combat antimicrobial resistance has been formulated in the line of the WHO five objectives. It addresses the need for effective “one health” approach involving coordination among numerous national sectors and actors, including human and veterinary... medicine, agriculture, finance, environment, and well-informed consumers. Therefore, a large committee of all stakeholders was formed with five technical subcommittees were established to addresses every aspect
to contain antimicrobial resistance in the country.
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This guideline covers making people aware of how to correctly use antimicrobial medicines (including antibiotics) and the dangers associated with their overuse and misuse. It also includesmeasures to prevent and control infection that can stop people needing antimicrobials or spreadinginfection to o...thers. It aims to change people's behaviour to reduce antimicrobial resistance and thespread of resistant microbes.
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Antibiotic Stewardship (AS) is a coordinated program that promotes the appropriate use of antimicrobials to improve patient outcomes, reduce microbial resistance, and decrease the spread of multi-drug resistant organisms. In clinical settings, stewardship activities focus on measuring and improving ...how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro...bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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Nepal has only recently started its journey on the path to an integrated response to the challenge of antimicrobial resistance (AMR). Despite this, it is notable that the Nepal Health Sector Strategy Plan (HSSP)-2 mentions growing antibiotic resistanceas a public health challenge.
La lista OMS de AIC categoriza la totalidad de los antimicrobianos utilizados en el ser humano en tres grupos en función de su importancia para la medicina humana. Por el momento se limita a los fármacos antibacterianos, muchos de los cuales también se utilizan en la medicina v...eterinaria.El objetivo de la lista es contribuir a gestionar la resistencia a los antimicrobianos y garantizar que todos los antimicrobianos, sobre todo los de importancia crítica, se utilicen de forma prudente en la medicina tanto humana como veterinaria.
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The WHO CIA List should be used as a reference to help formulate and prioritize risk assessment and risk management strategies for containing antimicrobial resistance. The WHO CIA List supports strategies to mitigate the human health risks associated with antimicrobial use in ...food-producing animals and has been used by both public and private sector organizations. The list helps regulators and stakeholders know which types of antimicrobials used in animals present potentially higher risks to human populations and how use of antimicrobials might be managed to minimize antimicrobial resistance of medical importance. The use of the WHO CIA List, in conjunction with the OIE list of antimicrobials of veterinary importance (1) and the WHO Model Lists of Essential Medicines (2) , will allow for prioritization of risk management strategies in the human sector, the food animal sector, inagriculture (crops) and horticulture, through a coordinated multisectoral One Health approach.
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In May 2015, the Sixty-eighth World Health Assembly recognized the importance of the public health problem posed by antimicrobial resistance by adopting the global action plan on antimicrobial resistance (“global action plan”). The global action plan proposes interve...ntions to control antimicrobial resistance, including reducing the unnecessary use of antimicrobials in humans and in animals. The global action plan also emphasizes the need to take a cross-sectoral, “One Health” approach for controlling antimicrobial resistance, involving efforts by actors from many disciplines including human and veterinary medicine.
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Using antimicrobials responsibly is an essential component ofefforts to contain antimicrobial resistance (AMR), and to ensurethat patients receive appropriate treatment. The WHO global action plan on AMR emphasizes the importance of training healthcare professionals in antimicrobial prescribing and ...stew-ardship (AMPS). There are several challenges, however, such asthe wide range of healthcare professionals involved in the pre-scribing process, and the heterogeneity of prescribing rights and practices of different professional groups within and between countries. One way to address these challenges is through developing competencies, which define the minimum standards that all antimicrobial prescribers should reach.
Clinical Microbiology and Infection 25 (2019) 13e19
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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Zoonotic tuberculosis (TB) is a form of TB in people predominantly caused by the bacterial species, Mycobacterium bovis, which belongs to the M. tuberculosis complex. The implications of zoonotic TB go beyond human health. The organism is host-adapted to cattle, where it is refer...red to as bovine TB, and it also causes TB in other animal species including wildlife. Bovine TB has an important economic impact and threatenslivelihoods.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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A view of global supply chains, pressure points, and implications for antimicrobial resistance response
Buruli ulcer (BU) is a bacterial skin infection that is caused by Mycobacterium ulcerans and mainly affects people who reside in the rural areas of Africa and in suburban and beach resort communities in Australia.