Steps that are necessary to combat antibiotic resistance

1. Steps to tackle antibiotic
resistance

2. Who needs to help in tackling
antibiotic resistance?
 Antibiotic resistance is a complex issue that has arisen due
to multiple, interlinked factors. Therefore, coordinated rather
than isolated interventions are necessary to combat this
problem5
Coordinated action between the following groups is required:
 Health care providers1
 Patients and the general public1
 Governments and industries1

3. Key problems
 Prevalence of deadly infectious diseases
 Overuse and misuse of antibiotics by patients
 Misdiagnosis of infections and incorrect prescription
 Misuse of antibiotics in animals
 Lack of tools to monitor antibiotic resistance
 Lack of coordination between stakeholders

4. Retrieved from: CDC Features - Mission Critical: Preventing Antibiotic Resistance [Internet]. Cdc.gov. 2016
[cited 7 April 2016]. Available from: http://www.cdc.gov/features/antibioticresistance/

5. Usage of antibiotics
 Misuse of antibiotics contributes to resistance
 This includes overuse of antibiotics, not finishing a course of
antibiotics, sharing antibiotics, using antibiotics in animals, and so
on1,4,5
 Patients should finish the prescribed course of antibiotics even
when they already ‘feel better’1
 Antibiotics should only be used when prescribed by a doctor1,5, and
over-the-counter sales of antibiotics need to be closely monitored to
prevent misuse
 People should not share antibiotics with others or use leftover
prescriptions1
 The use of antibiotics in the agricultural industry needs to be
managed to prevent acceleration of antibiotic resistance4

6. Infection control
 The prevalence of infections is often exacerbated by or caused by
unsanitary living conditions, lack of personal and interpersonal
hygiene, and lack of infection control within shared facilities
 Prevention is better than cure -> preventing infections in the first
place is more efficient than having to deal with the costs of treating
them
 Prevention includes:
- Better hygiene practices
- Avoiding close contact with sick people
- More clean water access
- better infection control in health care facilities
- immunisation programs for infants and children -> herd immunity
- tools to track resistance

7. Diagnosis and prescription
 Diagnostic uncertainty is a key factor in antibiotic misuse and
overuse, and thus antibiotic selection pressure and resistance2
 Doctors often do not have quick enough diagnostic tests, and are
forced to start treating severely ill patients with broad-spectrum
antibiotics before lab results arrive3
 Some diagnoses are incorrect and result in incorrect antibiotic
prescription1,2
 Inappropriate or unnecessary antibiotic prescription contributes to
resistance
 Quicker and more accurate diagnostic tests, using improved
information technology and microbiological progress can lead to
improved antibiotic selection, dosing and treatment duration4
 More accurate prescription is also necessary to ensure that the right
antibiotics are being taken1

8. Policymakers and industry
 Governments need to support and promote different campaigns,
policies, interventions and regulations to tackle antibiotic resistance1:
 Educational campaigns and available information aimed at changing
attitudes towards antibiotic prescription and usage, to optimise drug
use4
 Regulating appropriate use of drugs and medicine1
 Encouraging and rewarding research and development into new
tools to track and monitor antibiotic resistance and its causes, as well
as to better diagnose infection1 and treat disease5
 Encouraging infection control across sectors5, not just in health care
facilities
 Data sharing and cooperation between stakeholders, for a
coordinated response to resistance and consistent worldwide control
measures1,4,5. This will prevent inconsistent action between taken by
countries to tackle the issue

9. Retrieved from: ReAct - ANTIBIOTIC RESISTANCE – A CALL FOR GLOBAL ACTION [Internet]. Reactgroup.org.
2016 [cited 7 April 2016]. Available from: http://www.reactgroup.org/news/354/18.html

10. International cooperation
 The World Health Organisation (WHO) is actively
involved in coordinating global policies and supporting
member states in the fight against antibiotic resistance5
 It is also bringing stakeholders together to decide on a
common plan to tackle the problem of resistance, and
strengthening national stewardship5
 Active encouragement of innovation, research and
development in relevant industries is also taking
place1,5

11. US plan against resistance
 The White House has released a ‘National Action plan for
Combating Antibiotic-Resistant Bacteria’3
 This calls for consistent action across federal agencies and
sets five main goals for reducing resistance and antibiotic
misuse3:
1- Preventing the spread of antibiotic resistance
2- Strengthening surveillance efforts
3- Advancing diagnostic testing
4- Accelerating the development of new antibiotics
5- Improving global collaboration
 This is another example of a large scale response towards
antibiotic resistance

12.  Therefore, there are steps that can be taken to remedy
the problem at hand
 It requires a cooperative and consistent response
between people, industries, governments and countries
 Hopefully we will see these steps being taken, and the
world will not have to deal with the consequences of a
post-antibiotic era 

13. Retrieved from: ReAct - ReAct WORLD HEALTH DAY Activitites [Internet]. Reactgroup.org. 2016 [cited 7 April
2016]. Available from: http://www.reactgroup.org/what-we-do/react-world-health-day.html

14. References
1. WHO | WHO’s first global report on antibiotic resistance reveals serious,
worldwide threat to public health [Internet]. Who.int. 2016 [cited 4 April 2016].
Available from: http://www.who.int/mediacentre/news/releases/2014/amr-
report/en/
2. Nuermberger E, Bishai W. Antibiotic Resistance in Streptococcus pneumoniae:
What Does the Future Hold?. Clinical Infectious Diseases. 2004;38(Supplement
4):S363-S371.
3. Krisberg K. US charting new path to combat growing antibiotic resistance: New
action plan coordinates response. The Nation's Health [Internet]. 2016 [cited 7
April 2016];45(4):1-14. Available from:
http://thenationshealth.aphapublications.org/content/45/4/1.3.full
4. Harbarth S, Samore M. Antimicrobial Resistance Determinants and Future
Control. Emerg Infect Dis. 2005;11(6):794-801.
5. Antimicrobial resistance [Internet]. World Health Organization. 2016 [cited 4 April
2016]. Available from: http://www.who.int/mediacentre/factsheets/fs194/en/