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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Last revised 2015.
Original Word document on: http://www.epnetwork.org/Resources/Standard%20Operating%20Procedure/Supplier%20Delivery%20Note_Form.doc
Original Research
Rev Panam Salud Publica 43, 2019 | www.paho.org/journal | https://doi.org/10.26633/RPSP.2019.31
Antimicrobial Resistance and our Food Systems - Challenges and Solutions
5 Ways Hospital Pharmacists Can Be Antibiotics Aware - Poster
Evaluation and Diagnosis of Penicillin Allergy for Healthcare Professionals
Scientists have known for more than half a century that patients could develop resistance to the drugs used to treat them. Alexander Fleming, who is credited with creating the first antibiotic, penicillin, in 1928, cautioned of the impending crisis while accepting his Nobel prize in 1945: “There ...is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” Since then antibiotics have proved one of the most effective interventions in human medicine. Sadly, the overuse and misuse of this precious resource have brought us to a global crisis of antimicrobial resistance (AMR). To address this crisis nearly seven decades after Fleming’s lecture the first UN general assembly meeting on drug resistance bacteria was convened in September 2017.
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Antibiotics have been a critical public health tool since the discovery of Penicillin in 1928, saving the lives of millions of people around the world. In developing country like ours, where the burden of treatable disease is very high and access to health facilities and laboratories is difficult, a...ntibiotics have long acted as miracle drugs. Today, however, the emergence of drug
resistance in bacteria is reversing the miracles of the past eighty years, with drug choices for the treatment of many bacterial infections becoming increasingly limited, expensive, and in some cases, nonexistent. Diseases previously regarded as relatively easy to manage are much harder to treat as doctors must use “last-resort” drugs that are more costly, take longer to work
and are often unavailable or unaffordable in developing countries. Moreover, regular prescription of antibiotics, random treatment, over the counter sales, inadequate dosage, inclusion of antibiotics in animal feeds and agriculture has contributed equally to emergence of antibiotics resistance as silent epidemic within the country.
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Although 10% of the population in the U.S. reports a penicillin allergy, less than 1% of the population is truly penicillin allergic. Correctly identifying if your patient is penicillin allergic can decrease the unnecessary use of broad spectrum antibiotics.
Since the introduction of penicillin in the early twentieth century, antimicrobial treatments have been utilized not only in human medicine but also in veterinary care – initially to ward off diseases, prevent post-surgery infections, and treat sick farm animals.Global food production... has intensified over the past 50 years due to economic expansion and popu-lation growth. The use of antimicrobials in agriculture – in livestock, fish farming, and even on crops – has grown as well. Antimicrobials are not only used as medicines, but are sometimes also added in low concentrations to animal feed as a way of stimulating growth.
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Historically, the discovery of the sulfa drugs in the 1930s and the subsequent development of penicillin during World War II ushered in a new era in the treatment of infectious diseases. Infections that were common causes of death and disease in the pre-...antibiotic era - rheumatic fever, syphilis, cellulitis and bacterial pneumonia - became treatable, and over the next 20 years most of the classes of antibiotics that find clinical use today were discovered and changed medicine in a profound way. The availability of antibiotics enabled revolutionary medical interventions such as cancer chemotherapy, organ transplants and essentially all major invasive surgeries from joint replacements to coronary bypass. Antibiotics, though, are unique among drugs in that their use precipitates their obsolescence. Paradoxically, these cures select for organisms that can evade them, fueling an arms race between microbes, clinicians and drug discoverers.
Wright BMC Biology 2010, 8:123 http://www.biomedcentral.com/1741-7007/8/12
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In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric bacterial pathogens such as typhoid, ... diarrhoeagenic Escherichia coli and invasive non-‐typhi salmonella, penicillin-‐resistant Streptococcus pneu-‐moniae, vancomycin-‐resistant enterococci, methicillin-‐resistant Staphylococcus aureus and multidrug-‐re-‐sistant Mycobacterium tuberculosis. Resistance to medicines commonly used to treat malaria is of particu-‐lar concern, as is the emerging resistance to anti-‐HIV drugs. Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-‐poor settings.
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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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Antimicrobials have been a critical public health tool since the discovery of penicillin in 1928, saving the lives of millions of people around the world. Today, however, the emergence of drug resistance is reversing the miracles of the past eighty years, with drug choices for the treatment of many ...infections becoming increasingly limited, expensive, and, in some cases, non-existent.
Conscious of the public health threats of AMR to both humans, animals and the environment, the ministries of health and sanitation, agriculture forestry and food security and the environmental protection agency put together a national multi-sectoral coordinating group tasked with the responsibility of establishing mechanisms to integrate all initiatives into a single concerted action and development of the national AMR strategic plan (2018-2022). The National Strategic Plan on Antimicrobial Resistance is the first approach which addresses AMR specifically.
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The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched in 2015 to foster AMR surveillance and inform strategies to contain AMR. The system started with surveillance of AMR in bacteria causing common human infections and has expanded its scope to include surveillance... of antimicrobial consumption (AMC), invasive fungal infections, and a One Health surveillance model relevant to human health. To meet future challenges, it is in continuous evolution to enhance the quality and representativeness of data to inform the AMR burden accurately. As of the end of 2022, 127 countries, territories and areas participate in GLASS.
The fifth GLASS report, produced in collaboration with Member States, summarizes 2020 data on AMR rates in common bacteria from countries, territories, and areas. The report brings new features, including analyses of population testing coverage or AMR trends. For the first time, the report presents 2020 data on AMC at the national level. A new interactive dashboard allow users to explore AMR and AMC global data, country profiles and download the data.
This report marks the end of the early implementation phase of GLASS. In addition to presenting data collected through the latest data call, this report provides a summary of five years of national AMR surveillance data contributed to GLASS from its initiation, presents AMR findings in the context of progress of country participation in GLASS and in global AMR surveillance coverage and laboratory quality assurance systems at (sub)national level.
Patterns of antimicrobial consumption are presented by country with a particular focus on antibacterials. The report also presents the antimicrobial consumption according to the WHO AWaRe antibiotic classification, for penicillins and cephalosporines. From a One Health perspective, the report presents antimicrobial consumption data in the human sector expressed in tons to allow a comparison with antimicrobial consumption from other sectors (not included in this report).
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WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen...t of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
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Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall...y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
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An allergy is when someone has a bad reaction to something in the enviroment that other people can tolerate. We get allergies when our bodies defence system hurt us instead of protecting us.