Antibiotic
resistance
5 February 2018
Key facts
- Antibiotic
resistance is one of the biggest threats to global health, food security,
and development today.
- Antibiotic
resistance can affect anyone, of any age, in any country.
- Antibiotic
resistance occurs naturally, but misuse of antibiotics in humans and
animals is accelerating the process.
- A
growing number of infections – such as pneumonia, tuberculosis,
gonorrhoea, and salmonellosis – are becoming harder to treat as the
antibiotics used to treat them become less effective.
- Antibiotic
resistance leads to longer hospital stays, higher medical costs and
increased mortality.
Introduction
Antibiotics
are medicines used to prevent and treat bacterial infections. Antibiotic
resistance occurs when bacteria change in response to the use of these
medicines.
Bacteria,
not humans or animals, become antibiotic-resistant. These bacteria may infect
humans and animals, and the infections they cause are harder to treat than
those caused by non-resistant bacteria.
Antibiotic
resistance leads to higher medical costs, prolonged hospital stays, and
increased mortality.
The
world urgently needs to change the way it prescribes and uses antibiotics. Even
if new medicines are developed, without behaviour change, antibiotic resistance
will remain a major threat. Behaviour changes must also include actions to
reduce the spread of infections through vaccination, hand washing, practising
safer sex, and good food hygiene.
Scope of the problem
Antibiotic
resistance is rising to dangerously high levels in all parts of the world. New
resistance mechanisms are emerging and spreading globally, threatening our
ability to treat common infectious diseases. A growing list of infections –
such as pneumonia, tuberculosis, blood poisoning, gonorrhoea, and foodborne
diseases – are becoming harder, and sometimes impossible, to treat as
antibiotics become less effective.
Where
antibiotics can be bought for human or animal use without a prescription, the
emergence and spread of resistance is made worse. Similarly, in countries
without standard treatment guidelines, antibiotics are often over-prescribed by
health workers and veterinarians and over-used by the public.
Without
urgent action, we are heading for a post-antibiotic era, in which common infections
and minor injuries can once again kill.
Prevention and
control
Antibiotic
resistance is accelerated by the misuse and overuse of antibiotics, as well as
poor infection prevention and control. Steps can be taken at all levels of
society to reduce the impact and limit the spread of resistance.
Individuals
To
prevent and control the spread of antibiotic resistance, individuals can:
- Only use antibiotics when prescribed by a
certified health professional.
- Never demand antibiotics if your health worker says
you don’t need them.
- Always follow your health worker’s advice when
using antibiotics.
- Never share or use leftover antibiotics.
- Prevent infections by regularly washing hands,
preparing food hygienically, avoiding close contact with sick people,
practising safer sex, and keeping vaccinations up to date.
- Prepare food hygienically, following the WHO Five
Keys to Safer Food (keep clean, separate raw and cooked, cook thoroughly,
keep food at safe temperatures, use safe water and raw materials) and
choose foods that have been produced without the use of antibiotics for
growth promotion or disease prevention in healthy animals.
Policy makers
To
prevent and control the spread of antibiotic resistance, policy makers can:
- Ensure a robust national action plan to tackle
antibiotic resistance is in place.
- Improve surveillance of antibiotic-resistant
infections.
- Strengthen policies, programmes, and
implementation of infection prevention and control measures.
- Regulate and promote the appropriate use and
disposal of quality medicines.
- Make information available on the impact of
antibiotic resistance.
Health professionals
To
prevent and control the spread of antibiotic resistance, health professionals
can:
- Prevent infections by ensuring your hands,
instruments, and environment are clean.
- Only prescribe and dispense antibiotics when they
are needed, according to current guidelines.
- Report antibiotic-resistant infections to
surveillance teams.
- Talk to your patients about how to take
antibiotics correctly, antibiotic resistance and the dangers of misuse.
- Talk to your patients about preventing infections
(for example, vaccination, hand washing, safer sex, and covering nose and
mouth when sneezing).
Healthcare industry
To
prevent and control the spread of antibiotic resistance, the health industry
can:
- Invest in research and development of new
antibiotics, vaccines, diagnostics and other tools.
Agriculture sector
To
prevent and control the spread of antibiotic resistance, the agriculture sector
can:
- Only give antibiotics to animals under veterinary
supervision.
- Not use antibiotics for growth promotion or to
prevent diseases in healthy animals.
- Vaccinate animals to reduce the need for
antibiotics and use alternatives to antibiotics when available.
- Promote and apply good practices at all steps of
production and processing of foods from animal and plant sources.
- Improve biosecurity on farms and prevent
infections through improved hygiene and animal welfare.
Recent developments
While
there are some new antibiotics in development, none of them are expected to be
effective against the most dangerous forms of antibiotic-resistant bacteria.
Given
the ease and frequency with which people now travel, antibiotic resistance is a
global problem, requiring efforts from all nations and many sectors.
Impact
When
infections can no longer be treated by first-line antibiotics, more expensive
medicines must be used. A longer duration of illness and treatment, often in
hospitals, increases health care costs as well as the economic burden on
families and societies.
Antibiotic
resistance is putting the achievements of modern medicine at risk. Organ
transplantations, chemotherapy and surgeries such as caesarean sections become
much more dangerous without effective antibiotics for the prevention and
treatment of infections.
WHO response
Tackling
antibiotic resistance is a high priority for WHO. A global action plan on
antimicrobial resistance, including antibiotic resistance, was endorsed at the
World Health Assembly in May 2015. The global action plan aims to ensure
prevention and treatment of infectious diseases with safe and effective
medicines.
The
“Global action plan on antimicrobial resistance” has 5 strategic objectives:
- To improve awareness and understanding of
antimicrobial resistance.
- To strengthen surveillance and research.
- To reduce the incidence of infection.
- To optimize the use of antimicrobial medicines.
- To ensure sustainable investment in countering
antimicrobial resistance.
A
political declaration endorsed by Heads of State at the United Nations General
Assembly in New York in September 2016 signaled the world’s commitment to
taking a broad, coordinated approach to address the root causes of
antimicrobial resistance across multiple sectors, especially human health,
animal health and agriculture. WHO is supporting Member States to develop
national action plans on antimicrobial resistance, based on the global action
plan.
WHO
has been leading multiple initiatives to address antimicrobial resistance:
World Antibiotic
Awareness Week
Held
every November since 2015 with the theme “Antibiotics: Handle with care”, the
global, multi-year campaign has increasing volume of activities during the week
of the campaign.
The Global
Antimicrobial Resistance Surveillance System (GLASS)
The
WHO-supported system supports a standardized approach to the collection,
analysis and sharing of data related to antimicrobial resistance at a global
level to inform decision-making, drive local, national and regional action.
Global Antibiotic
Research and Development Partnership (GARDP)
A
joint initiative of WHO and Drugs for Neglected Diseases initiative (DNDi),
GARDP encourages research and development through public-private partnerships.
By 2023, the partnership aims to develop and deliver up to four new treatments,
through improvement of existing antibiotics and acceleration of the entry of
new antibiotic drugs.
Interagency
Coordination Group on Antimicrobial Resistance (IACG)
The
United Nations Secretary-General has established IACG to improve coordination
between international organizations and to ensure effective global action
against this threat to health security. The IACG is co-chaired by the UN Deputy
Secretary-General and the Director General of WHO and comprises high level
representatives of relevant UN agencies, other international organizations, and
individual experts across different sectors.
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