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Toolboxes
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1
The era of effective antibiotics is coming to a close. In just a few generations, many “miracle medicines”have been beaten into ineffectiveness by the bacteria they were intended to eradicate. Bacteria quickly adapt to the presence of antibacterial agents in order
...
to survive. The misuse of antibiotics,which is an international problem, only exacerbates the steady evolution of resistance. In August 2010, the journal Lancet Infectious Diseases posed the question "Is this the end of antibiotics?" documentingthe rapid spread of multidrug-resistant bacteriaand predicting that 10 years remain in the useful life of many agents.
more
Lancet Respir Med 2020Published OnlineMarch 20, 2020 https://doi.org/10.1016/S2213-2600(20)30134-
This working paper was conceived to offer practical tips and suggestions on how to establish and sustain the multisectoral coordination needed to develop and implement National Action Plans on AMR (NAPs). It is intended for anyone with responsibility for addressing AMR at country level. Drawing on b
...
oth the published literature and the operational experience of four ‘focal countries’ (Ethiopia, Kenya, Philippines and Thailand), it summarizes lessons learned and the latest thinking on multisectoral working to achieve effective AMR action. The experience in focal countries points to a number of tools and tactics that can be used to help establish and enhance sustainable multisectoral collaboration for AMR action. These can be grouped into four categories: political commitment, resources, governance mechanisms, and practical management.
more
This paper was developed to support AMR coordination committees and others tasked with addressing AMR at country level to do just that. Drawing on the published literature and the operational experience and expertise of different LMICs, the paper points to six key strategies for success and offers a
...
series of practical tips and suggestions on how to implement each one.
more
L’Assemblée mondiale de la Santé, tenue en mai 2015, a adopté un Plan d’action mondial pour combattre la résistance aux antimicrobiens, qui définit 5 objectifs:
mieux faire connaître et comprendre le problème de la résistance aux antimicrobiens grâce à une communication, une éduc
...
ation et une formation efficaces;
renforcer les connaissances et les bases factuelles par la surveillance et la recherche;
réduire l’incidence des infections par des mesures efficaces d’assainissement, d’hygiène et de prévention des infections;
optimiser l’usage des médicaments antimicrobiens en santé humaine et animale;
dégager les arguments économiques en faveur d’investissements durables qui tiennent compte des besoins de tous les pays et accroître les investissements dans la mise au point de nouveaux médicaments, outils diagnostiques, vaccins et autres interventions.
more
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.
more
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.
more
A regional guide for governments in Asia and the Pacific to review, update and develop policies to address antimicrobial resistance and antimicrobial use in animal production
This interim guidance has been updated with advice on safe and appropriate home care for patients with coronavirus disease 2019 (COVID-19) and on the public health measures related to the management of their contacts.
This interim guidance is for LTCF managers and corresponding infection prevention and control (IPC) focal persons in LTCF and updates the guidance published in March 2020. The objective of this document is to provide guidance on IPC in LTCFs in the context of COVID-19 to 1) prevent COVID-19-virus fr
...
om entering the facility and spreading within the facility, and 2) to support safe conditions for visiting through the rigorous application of IPC procedures for the residents’ well-being. WHO will update these recommendations as new information becomes available.
Availabel in English, French, Russian and Spanish
more
The product of all this work is the Standard Treatment Guideline and Essential Medicines List of Common Medical Conditions in the Kingdom of Swaziland. These systematically developed statements are designed to assist practitioners in making decisions about appropriate treatment for specific clinical
...
conditions. They are meant to reflect expert consensus based on a review of current and published scientific evidence of acceptable approaches to diagnosis, man-agement, or prevention of specific conditions.It is enlightening to note that section A of the document contains the STG, and effort has been made to have the conditions commonly encountered in Swaziland classified according to systems. Written in simple, clear language, each section consists of a short definition followed by common symptoms and signs of the disease or condition and then management (pharmacological and nonpharmacological)
more
Временное руководство
6 апреля 2020 г.
В настоящем документе кратко изложены рекомендации ВОЗ по рациональному использованию средств индивидуальной защиты (СИЗ) в
...
медицинских учреждениях и при оказании помощи на дому, а также при обработке грузов; в нем также дана оценка текущего нарушения глобальной цепочки поставок и приведены соображения для принятия решений в ситуации острой нехватки СИЗ.
more
Há três objetivos preliminares desse estudo de transmissão doméstica: 1. Para compreender melhor a extensão da transmissão doméstica estimando a taxa de infecção secundária1 para contatos domésticos em uma maneira individual, e fatores associados com qualquer variação no risco secundár
...
io da infecção. 2. Para caraterizar casos secundários incluindo a escala da apresentação clínica, fatores de risco para a infecção, a extensão e a fração de infecções assintomáticas. 3. Para caraterizar a resposta sorológica que segue a infecção confirmada pelo 2019-nCoV (altamente incentivado, mas opcional dependendo da capacidade e dos recursos do laboratório).
more
COVID-19 and Breastfeeding - Current Guidance for Breastfeading Mothers with COVID-19
Family Larsson; Rosenquist Foundation (dedicated to human milk)
Family Larsson; Rosenquist Foundation (dedicated to human milk)
(2020)
C2
Accessed: 27.03.2020
This handbook follows a comprehensive approach to health system strengthening at borders in order to support IHR national focal points and other national agencies in developing and implementing evidence-based action plans for IHR capacity development at ground crossings. The approach includes the mo
...
vement of travellers and baggage, cargo, containers, conveyances, goods and postal parcels across ground crossings, as well as the interaction with adjacent border communities. Other factors can be considered, if needed, throughout the risk assessment.
more
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.
more
An essential participant in antimicrobial stewardship who has been unrecognized and underutilized is the“staff nurse.”Although the role of staff nurses has not formally been recognized in guidelines for implementing and operating antimicrobial stewardship programs (ASPs) or defined in the medica
...
l literature, they have always performed numerous functions that are integral to successful antimicrobial stewardship. Nurses are antibiotic first responders, central communicators, coordinators of care, as well as 24-hour monitors of patient status, safety, and response to antibiotic therapy. An operational analysis of inpatient admissions evaluates these nursing stewardship activities and analyzes the potential benefits of nurses’formal education about, and inclusion into, ASPs.
Clinical Infectious Diseases - CID 2016:62 (1 January)•CLINICAL PRACTICE
more
Internationally, there is a growing concern over antimicro-bial resistance (AMR) which is currently estimated to ac-count for more than 700,000 deaths per year worldwide. If no appropriate measures are taken to halt its pro-gress, AMR will cost approximately 10 million lives andabout US$100 trillion
...
per year by 2050. In contrast tosome other health issues, AMR is a problem that con-cerns every country irrespective of its level of incomeand development as resistant pathogens do not respect borders.Despite the threat presented by AMR, the 2014 WorldHealth Organization (WHO) and the recent O’Neill re-port describe significant gaps in surveillance, standardmethodologies and data sharing. The 2014 WHOreport identified Africa and South East Asia as the regions without established AMR surveillance systems.
Tadesseet al. BMC Infectious Diseases (2017) 17:616 DOI 10.1186/s12879-017-2713-1
more
The ECDC, the EFSA and the EMA have for the first time jointly explored associations between consumption of antimicrobials in humans and food-producing animals, and antimicrobial resistance in bacteria from humans and food-producing animals, using 2011 and 2012 data currently available from their re
...
levant five EU monitoring networks. Combined data on antimicrobial consumption and corresponding resistance in animals and humans for EU MSs and reporting countries were analysed using logistic regression models for selected combinations of bacteria and antimicrobials. A summary indicator of the proportion of resistant bacteria in the main food-producing animal species was calculated for the analysis, as consumption data in food-producing animals were not available at the species level
more
Effectiveness of Education and an Antibiotic-Control Program in a Tertiary Care Hospital in Thailand
Overuse of antimicrobial agents occurs globally in both community and hospital settings. Misuse of antibiotics can lead to a variety of adverse outcomes, including the development of antimicrobial resistanceand increased cost of hospitalization. This issuehas been particularly problematic in de
...
veloping countries, where antibiotic-management programs rarely exist and where antibiotics can be purchased without aprescription. In Thailand, the rate of antibiotic resistance among gram-positive and gram-negative or-ganisms has increased significantly over the past decade. These findings provide compelling evidence ofthe need for more-rational use of antimicrobial agents in Thailand.
Clinical Infectious Diseases2006; 42:768–752006 by the Infectious Diseases Society of America.
more
