Formularies are lists of antibiotics that are suggested for certain healthcare settings. In developing a recommended formulary, countries should consider the needs of patients and facilities where they receive care. For example, clinicians in rural or primary health centers may need wide access to f...irst-line antibiotics (e.g., penicillin, ampicillin, TMP-SMX), but last resort antibiotics such as carbapenems or colistin might be limited to tertiary care hospitals. Efforts to create antibiotic formularies may be linked to efforts within countries to create or update essential medicine lists (EML).
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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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2016-2018 Early implementation,
This report presents 2015 data on the consumption of systemic antibiotics from 65 countries and areas, contributing to our understanding of how antibiotics are used in these countries. In addition, the report documents early efforts of the World Health Organization (...WHO) and participating countries to monitor antimicrobial consumption, describes the WHO global methodology for data collection, and highlights the challenges and future steps in monitoring antimicrobial consumption.
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One health Response to AMR Containment.
In a significant move for the public health sector, Kerala has become the first state in India to launch an action plan to combat the growing cases of antimicrobial immunity, arising primarily from irrational use of medicines and excessive antibiotics used in... livestock and poultry.
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The Lancet Planetary Health, Volume 2, ISSUE 9, Pe398-e405, September 01, 2018.
Reduction of antibiotic consumption will not be sufficient to control antimicrobial resistance because contagion—the spread of resistant strains and resistance genes—seems to be the dominant contributing factor. Im...proving sanitation, increasing access to clean water, and ensuring good governance, as well as increasing public health-care expenditure and better regulating the private health sector are all necessary to reduce global antimicrobial resistance.
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The pre-clinical pipeline shows more innovation and diversity, with 252 agents being developed to treat WHO priority pathogens.
However, these products are in the very early stages of development and still need to be proven effective and safe. The optimistic scenario, the report indicates, is for... the first two to five products to become available in about 10 years.
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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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The GAP articulates five objectives for tackling AMR, and sets out the tasks required to achieve them, highlighting
roles and responsibilities for country governments, the One Health Tripartite organizations (FAO, OIE and WHO) and other national and international partners. To ensure that all stakeh...olders assume their roles and responsibilities, and to assess whether they are collectively effecting the necessary change in AMR, the implementation of the GAP needs to be routinely monitored and evaluated. To that end, the Tripartite organizations co-developed a monitoring and evaluation (M&E) framework for the GAP, as outlined in this document
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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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Antimicrobial or antibiotic resistance is a multi-sectoral global threat affecting human and animal health, food safety, plants, fisheries and the environment as a whole.
Hence, there is a need for a multi-sectoral approach to address AMR. The resulting FAO Action Plan on antimicrobial resistance h...as four components to address the AMR threat.
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Antimicrobial Resistance - What is it?
Fact Sheet
Veterinarians are leaders and stewards in preserving the effectiveness of antibiotics for animals and people. Working with animal owners and producers, veterinarians can slow antibiotic resistance by implementing disease prevention strategies and improving the use of antibiotics while also guarante...eing high-quality medical care for animal patients.
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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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This manual will contribute directly to the fourth focus area of the FAO Action Plan by promoting the prevention of infections and the prudent use of antibiotics in the pig and poultry sectors. The pig and poultry sectors are addressed together, as these sectors generally have the highest use of ant...ibiotics. This manual is jointly applicable to veterinarians, other health professionals and farmers; a key to success in using antibiotics effectively and prudently is good dialogue among these professions.
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In recognition of the growing problem of antimicrobial resistance (AMR), its increasing threat to human, animal and plant health, and the need for a One Health approach to address this issue, the 39th Session of the Codex Alimentarius Commission (CAC) agreed it was important for the food safety comm...unity to play its part and re-established the ad hoc Codex Intergovernmental Task Force on Antimicrobial Resistance (TFAMR) ). The objectives of the Task Force were
to revise the current Codex Code of Practice to Minimise and Contain Antimicrobial Resistance and to develop new guidance on surveillance programmes relevant to foodborne AMR.
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This publication describes an arduous campaign to tackle the use of antimicrobials - specifically antibiotics - in the Danish swine-producing sector thanks to the collaboration between the regulatory sector within the Ministry of Environment and Food, private veterinary practitioners and swine produ...cers. The document is a retrospective tribute to all those who had the foresight to make significant changes to ensure consumer protection - improving hygiene at primary sites, developing options for intervention, identifying sites for intervention, setting targets, restructuring the relationship between the veterinary services and farmers, and implementing changes in behaviour for greatest impact
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Interim practical manual supporting implementation of the WHO guidelines on core components of infection prevention and control programmes
A growing body of evidence demonstrates that hospital based programs dedicated to improving antibiotic use, commonly referred to as “Antibiotic Stewardship Programs (ASPs),” can both optimize the treatment of infections and reduce adverse events associated with antibiotic use. This document summ...arizes core elements of successful hospital Antibiotic Stewardship Programs. It complements existing guidelines on ASPs from different American organizations.
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These guidelines form part of efforts to institutionalize the prevention and containment of antimicrobial resistance (AMR) in healthcare facilities in South Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interr...elated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level. They aim to serve as a practical, step-by-step or ‘how-to’ guide, addressing the infection prevention and AMS components of a robust response in a hospital. They draw on
evidence from various international guidance documents and standards for interventions that have been shown to be successful in infection
prevention and AMS programmes. These interventions have been customised to the South African hospital setting based on local
experiences in the public and private health sectors. This was done through a series of workshops and requests for comment involving
country-level experts.
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