Dr Prashant Pandey, Director R&D, Diversey – APAC Global Technical Services and Regulatory elucidates on the importance of evidence-based prescribing of antimicrobials to prevent AMRs
Antibiotic Resistant Bacteria has been observed with increasing frequency over the past several decades. Bacteria and other pathogens have always evolved and resist the new drugs that medicine has used to combat them. Resistance has increasingly become a problem in recent years because the pace at which we are discovering novel antibiotics has slowed drastically, while antibiotic use is rising. And it is not just a problem confined to bacteria, but all microbes that have the potential to mutate and render our drugs ineffective. The great strides forward made over the past few decades, even to manage malaria and HIV, could be reversed, with several diseases once again spiralling out of control.
What is AMR?
Antimicrobial resistance (AMR) is not a new phenomenon. Pathogens have the ability to develop resistance towards new drugs that medicine has been used to combat them. Further, the more drug exposure there is, the faster resistance develops in people, animal and agriculture. Also, poor management of waste from farms, factories, healthcare settings and households adds to the problem. “AMR is likely to cause nearly 10 million deaths by 2050 and result in significant global economic losses” as per Down to Earth Magazine. AMR does not recognise human or geographic borders.
The culprit: Excessive dosage of antibiotics / antimicrobials
The reason why our surgeons and medical practitioners end up consciously prescribing higher antibiotics and higher doses is, firstly, their low confidence in the execution of prophylactic practices of the hospitals. Secondly, they don’t want any of their patients getting infections during their stay at the hospital or post-surgery recovery. So it is important to understand how AMR creates superbugs, especially at healthcare centres. Superbugs can be broadly defined as any synthetic or naturally occurring chemical or any microorganism that is not commonly monitored in the environment but has the potential to enter the environment and cause known or suspected adverse ecological and(or) human health effects.
Side Effects of AMR
Increase in mortality
AMR threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi which is fatal.
Time spent in hospital
It is necessary to keep hospitals clean and avoid hospital acquired infections.
Apart from treating infections in vulnerable populations of children, women and older persons, antibiotics are critical in complex surgeries and management of various diseases.
Lead to co-lateral damage
When bacteria grow and spread, they can develop mutations in their DNA that make them resistant to certain types of drugs. When antibiotics are used to treat an infection, bacteria without the resistance mechanism die, while those that have the resistance mechanism may continue to live and multiply and leads to creating a superbug.
Why antimicrobial stewardship is important?
Antimicrobial stewardship is the systematic effort to educate and persuade prescribers of antimicrobials to follow evidence-based prescribing, in order to stem antibiotic overuse, and thus antimicrobial resistance.
A critical aspect: AMR in hospital management
Rising use of antibiotics is the main cause of antimicrobial resistance, one of the world’s greatest health threats. Bacteria evolve resistance to drugs naturally over time, becoming superbugs. AMR threatens many of the most important medical advances we have made and therefore needs to be nipped with new hygiene techniques and technologies.
Hospitals and other acute patient care facilities are an important part of the infrastructure of any community. Patients seek care from these institutions to improve health. The risk of acquiring an infection within these institutions represents an unfortunate reality for many.
Addressing the rising threat of AMR requires wider and multi-sectorial approach because antimicrobials used to treat various infectious diseases in animals may be similar to those used in humans. Resistant bacteria arising in the environment may spread from one to the other and from one place to another. It is high time that we take collective action to minimise the emergence and spread of AMR. There is a need to promote prudent and responsible use of antimicrobial agents. Use of antimicrobial agents through cleaning and hygiene detergent products so as to remove soils by chemicals and mechanical actions, reduce the number of microorganisms, including those which adhere to surfaces as biofilms. Through stringent implementation of good hygiene practices in healthcare and animal husbandry it is possible to reduce the necessity for antimicrobials.
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