Antimicrobial resistance (AMR) is a global health crisis that poses a significant threat to the effective prevention and treatment of infections caused by bacteria, viruses, parasites, and fungi. Overuse and misuse of antimicrobial drugs in humans, animals, and agriculture have accelerated the emergence of resistant strains, making once-treatable infections more difficult to manage. The World Health Organization (WHO) has declared AMR one of the most pressing issues facing humanity, requiring urgent and coordinated action. According to the latest report- The 2022 Global Antimicrobial Resistance and Use Surveillance System (GLASS) report highlights alarming resistance rates among prevalent bacterial pathogens. Median reported rates in 76 countries of 42% for third-generation cephalosporin-resistant E. coli and 35% for methicillin-resistant Staphylococcus aureus are a major concern. For urinary tract infections caused by E. coli, 1 in 5 cases exhibited reduced susceptibility to standard antibiotics like ampicillin, co-trimoxazole, and fluoroquinolones in 2020. It is estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths (https://doi.org/10.1016/S0140-6736(21)02724-0).
The primary objective of addressing antimicrobial resistance is to ensure the continued effectiveness of antimicrobial drugs and safeguard public health. A multi-sectoral, collaborative approach is the key to addressing this menace.
Approach towards preventing AMR
- Robust Surveillance and Monitoring: It is imperative toestablish a robust surveillance system to monitor the prevalence of antimicrobial resistance in humans, animals, and the environment. It is extremely crucial to enhance data-sharing mechanisms at the national and international levels to track resistance patterns and emerging threats.
- Antibiotic Stewardship: It is the duty of every responsible health care provider topromote the responsible use of antibiotics in human healthcare, emphasizing appropriate prescription practices, dosage optimization, and patient education. Antibiotic stewardship programs should be implemented in healthcare settings to monitor and regulate antibiotic usage.
- Adopting a comprehensive One Health Approach is critical that integrates efforts across human health, animal health, and environmental sectors to address the interconnected nature of AMR. It is important to collaborate with the veterinary and agricultural sectors to regulate the use of antimicrobials in animals and agriculture.
- Improve education and awareness by implementing educational programs targeting healthcare professionals, farmers, and the general public on the risks of AMR and the importance of responsible antimicrobial use.
- Strengthen regulatory frameworks to control the production, distribution, and sale of antimicrobial drugs.
A recent directive from the Ministry of Health and Family Welfare recommended that pharmacists should implement Schedule II and III of the Drugs & Cosmetic Rules & sell Antibiotics only on valid prescriptions. It also emphasizes that the doctors should mention the exact indication/reason/justification on their prescriptions while prescribing the anti-microbials to the patients. This is a welcoming step in our endeavour to fight against the menace of antimicrobial resistance.
Author: Dr. Altaf Yousuf Mir (Assistant Professor) IIHMR Delhi
Link:https://www.iihmrdelhi.edu.in/team-iihmr/assistant-professors/dr-altaf-yousuf-mir