International Perspectives and Future Directions
The National Action Plan (NAP) has been developed based on the model recommended in the global Action Plan. Local data on on-going interventions were collected from technical informants in the various areas of work. These were analysed using the policy framework provided by the AMR policy document. ...Interventions were developed to address gaps in all five objectives of the global Action Plan. Further consultations were done to ensure that the recommended interventions were feasible, valid and relevant within the systemic contexts pertaining to the various affected sectors.
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In 2017, 3.6 million of the estimated 10 million people with TB worldwide were “missed” by national TB programmes (NTPs). Two thirds of them are thought to access TB treatment of questionable quality from public and private providers who are not engaged by the NTP. The quality of care provided i...n these settings is often not known or substandard. Closing these gaps and ensuring patient-centred care imply that quality-assured and affordable TB services must be made available wherever people choose to seek care.
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The present Consolidated guidelines include a comprehensive set of WHO recommendations for the treatment and care of DR-TB, derived from these WHO guidelines documents. The consolidated guidelines include policy recommendations on treatment regimens for isoniazid-resistant TB (Hr-TB) and MDR/RR-TB, ...including longer and shorter regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care.
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Of the 50 antibiotics in the pipeline, 32 target WHO priority pathogens but the majority have only limited benefits when compared to existing antibiotics. Two of these are active against the multi-drug resistant Gram-negative bacteria, which are spreading rapidly and require urgent solutions.
Gr...am-negative bacteria, such as Klebsiella pneumoniae and Escherichia coli, can cause severe and often deadly infections that pose a particular threat for people with weak or not yet fully developed immune systems, including newborns, ageing populations, people undergoing surgery and cancer treatment.
The report highlights a worrying gap in activity against the highly resistant NDM-1 (New Delhi metallo-beta-lactamase 1), with only three antibiotics in the pipeline. NDM-1 makes bacteria resistant to a broad range of antibiotics, including those from the carbapenem family, which today are the last line of defence against antibiotic-resistant bacterial infections.
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Nature Reviews Microbiology Vol. 17 (2019)pp.51-62
Antimicrobial susceptibility testing (AST) technologies help to accelerate the
initiation of targeted antimicrobial therapy for patients with infections and could potentially
extend the lifespan of current narrow- spectrum antimicrobials. Althoug...h conceptually new and
rapid AST technologies have been described, including new phenotyping methods, digital
imaging and genomic approaches, there is no single major, or broadly accepted, technological
breakthrough that leads the field of rapid AST platform development
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A role for nuclear techniques
Antimicrobials play a critical role in the treatment of human and animal (aquatic and terrestrial) diseases, which has led to their widespread application and use. Antimicrobial resistance (AMR) is the ability of microorganisms to stop an antibiotic, such as an antimic...robial, antiviral or antimalarial, from working against them. Globally, about 700 000 deaths per year arise from resistant infections as a result of the fact that antimicrobial drugs have become less effective at killing resistant pathogens. Antimicrobial chemicals that are present in environmental compartments can trigger the development of AMR. These chemicals can also cause antibiotic-resistant bacteria (ARB) to further spread antibiotic resistance genes (ARG) because they may have an evolutionary advantage over non-resistant bacteria.
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1st edition
This resource provides practical guidance for front line health workers responsible for the diagnosis, management and care of patients with these two diseases. Published in collaboration with the World Diabetes Foundation
Antimicrobial resistance is a global crisis that threatens a century of progress in health and achievement of the Sustainable Development Goals. There is no time to wait. Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation.
These guidelines form part of efforts to institutionalise the prevention and containment of antimicrobial resistance (AMR) in health care facilities in South Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two inte...rrelated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level.
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Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for optimizing antimicrobial use, termed “antimicrobial stewardship” (AMS). Stewardship has since be...en applied in the context of governance of the health sector as a whole, taking responsibility for the health and well-being of the population and guiding health systems at the national and global level.
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The animal health subsector within the agriculture sector is the gatekeeper of antimicrobial resistance (AMR) in livestock, aquaculture, animal products, and the immediate animal environment. In support of member countries taking responsibility for and moving forward with putting AMR monitoring and ...surveillance in place for the animal sector, the Food and Agriculture Organization of the United Nations Regional Office for Asia and the Pacific (FAO-RAP) developed a regional AMR surveillance framework, each pillar of which is complemented by a guideline to reinforce its progressive implementation. The first of this series, Volume 1: Monitoring and surveillance of antimicrobial resistance in bacteria from healthy food animals intended for consumption, is centered on healthy animals reaching consumers and on the protection of public health.
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This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti...cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC release...d the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve 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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ຢາຕ້ານເຊື້ອຈຸລະຊີບ (Antimicrobial medicines) ມີຄວາມສໍາຄັນຫຼາຍຕໍ່ວຽກງານການແພດ, ສາທາລະນະສຸກ, ສຸຂະພາບສັດ ແລະ ການຜະລິດອາຫານ. ເນ...່ອງຈາກວ່າ ຢາດັ່ງກ່າວນີ້ ແມ່ນໃຊ້ເພື່ອປ້ອງກັນ ແລະ ປິ່ນປົວພະຍາດຊືມເຊື້ອ ທີ່ມີ ຈໍາພວກເຊື້ອຈຸລິນຊີ (Bacteria) ເປັນຫນື່ງໃນສາເຫດທີ່ເຮັດໃຫ້ຄົນ ແລະ ສັດເສຍຊີວິດ ໃຫ້ຫຼຸດລົງໄດ້ ແລະ ມີບົດບາດຫຼາຍໃນວົງ ການແພດແຜນປະຈຸບັນ ເປັນຕົ້ນແມ່ນ ການຜ່າຕັດ ຊຶ່ງມີຄວາມສ່ຽງຕໍ່ການຕິດເຊື້ອໄດ້ງ່າຍຈຶ່ງຈໍາເປັນຕ້ອງໄດ້ເພິ່ງພາຢາຕ້ານເຊື້ອຈຸລະ ຊີບ ທີ່ມີປະສິດທິພາບເພື່ອປ້ອງກັນ ແລະ ປິ່ນປົວການຕິດເຊື້ອທີ່ອາດເກີດຂຶ້ນ. ນອກຈາກນີ້ແລ້ວ ມັນຍັງມີຄວາມຈໍາເປັນສໍາລັບ ປ້ອງກັນ ແລະ ປິ່ນປົວ ໃນວຽກງານສັດຕະວະແພດ ແລະ ການກະສິກໍາ ເປັນຕົ້ນ: ການລ້ຽງສັດ, ການປະມົງ, ການປູກຝັງ ແລະ ມີຄວາມສໍາຄັນຕໍ່ ສຸຂະພາບສັດ ພືດ ຕ່ອງໂສ້ການຜະລິດອາຫານ ແລະ ເສດຖະກິດຂອງຊາດອີກດ້ວຍ.
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After completing this activity, pharmacists should be able to:
1. List populations for which the compounding of an oral liquid may be necessary
2. Outline necessary considerations that should be made by the pharmacist to ensure product stability
3. Describe methods used in the compounding of liqu...id preparations
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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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