The World Health Organization refers to antibiotic resistance as one of the greatest threats to human health. The world is facing a global disaster unless action is taken now to preserve antibiotic effectiveness into the future.
Much of the advancement in modern medicine has been made possible through access to antibiotics and even though antibiotics are not effective against most acute respiratory infections they remain the mainstay of treatment for infectious diseases.
The pipeline of new antibiotics has almost completely dried up and use of the antibiotics we have will inevitably lead to resistance. Patients who acquire an antibiotic-resistant infection stay in hospital longer and have higher morbidity and mortality.
The factors leading to bacterial resistance are complex and multifactorial. Along with infection control and surveillance, antimicrobial stewardship aims to reduce inappropriate use of antibiotics and improve patient outcomes. Antimicrobial stewardship is a collective set of strategies to improve the appropriateness and minimise the adverse effects of antibiotic use including resistance, toxicity and costs. Stewardship is achieved by promoting the selection of the optimal antibiotic regimen, dose, duration and route of administration.
Australia is one of the highest users of antibiotics in the world
Australia is one of the highest users of antibiotics in the developed world, with around 22 million prescriptions written every year in primary care.
General practitioners prescribe the greatest proportion of antibiotics in Australia, mostly for acute respiratory tract infections. Antibiotics remain the most common class of medicine prescribed in general practice.
Resistant organisms are increasing in the community. These require treatment with antibiotics such as vancomycin, carbapenems and fluroquinolones, which are often used when all other antibiotics have failed. For example between 2001 and 2010, the incidence of MRSA in the community doubled from 10 to 20% of all reported S. aureus infections. In Tasmania, a recent increase in Clostridium difficile – an infection closely correlated with antibiotic use – was observed. This was most likely linked to transmission and infection pathways in the community, not within hospitals, and was driven substantially by antibiotic use in the community.
On a more positive note, when the selective pressure of antibiotics is removed, resistance can be reversed. In the 12 months following antibiotic cessation in individual patients in the community, resistance fades towards zero.
Thank you to Australian Prescriber for this info: http://www.australianprescriber.com/magazine/36/4/116/20#R2
