LETTER TO EDITOR
Year : 2020 | Volume
: 8 | Issue : 3 | Page : 92--93
Antimicrobial resistance: Time to discover treatment strategies rather than treatment options
Areena Hoda Siddiqui1, Hridaya Nath Tripathi2,
1 Department of Lab Medicine, Sahara Hospital, Lucknow, Uttar Pradesh, India
2 Department of Internal Medicine, Sahara Hospital, Lucknow, Uttar Pradesh, India
Dr. Areena Hoda Siddiqui
Department of Lab Medicine, Sahara Hospital, Viraj Khand, Gomti Nagar, Lucknow - 226 010, Uttar Pradesh
|How to cite this article:|
Siddiqui AH, Tripathi HN. Antimicrobial resistance: Time to discover treatment strategies rather than treatment options.J Patient Saf Infect Control 2020;8:92-93
|How to cite this URL:|
Siddiqui AH, Tripathi HN. Antimicrobial resistance: Time to discover treatment strategies rather than treatment options. J Patient Saf Infect Control [serial online] 2020 [cited 2023 Mar 30 ];8:92-93
Available from: https://www.jpsiconline.com/text.asp?2020/8/3/92/315741
Antimicrobial resistance (AMR) is becoming a challenge to the global public health that requires action across all health-care sectors (private or public) and society. It threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. In a study by Jim O' Neil, it says that by 2050 AMR will be one of the leading causes of death.
The treatment option for resistant pathogen is very limited. There are very few antibiotics which have the capacity to act against these resistant pathogens. Majority of these belongs to old class of antibiotics which were not being used due to their associated side effects. There are no new antibiotics in the pipeline and pharmaceutical industries are not spending much in discovery of new antibiotics.
This is the phase where we need to discuss various treatment strategies, formulate guidelines depending on the prevalence of pathogens and local antibiogram and consider antibiotic cycling in our healthcare set up. It is the time to implement sequential organ failure assessment scoring system at the emergency (patient admission) ward by education programmes for patient care staffs. We need to educate health-care worker to do risk stratification for all the patients admitted and start antibiotic accordingly. The strategy of celebrating AntiMicrobial Resistance Awareness week needs to be strengthened at hospital and State level where discussions with the stake holders can be helpful.
The misuse of antibiotics at peripheries is the main offender. The patient without any proper work up gets exposed to not so required antibiotics and gains resistance. The phenomenon of overuse of antibiotics occurs when the same patient later on takes admission to tertiary care hospital. The improper dosing of antibiotic is another culprit leading to underuse of antibiotics. The misuse can be overcome by exposing local practitioners to antimicrobial resistance challenges through webinars and interactive discussions.
We need to integrate diagnostic stewardship along with antimicrobial stewardship program initially at tertiary care hospitals where all the latest amenities and technologies are available. The overuse can be overcome by diagnostic stewardship programme which can give timely intimation towards correct diagnosis and helping the consultant in choosing the right antibiotics. An interaction with the diagnostic steward is the need of the hour.
A very important role in preventing AMR is de-escalation of antibiotics. Once the patient improves clinically and diagnostically, there is no risk in de-escalation of therapy.
Therapeutic drug monitoring and right combination of therapy can be considered for certain antibiotics.
Last but not the least public awareness is the first step to begin with. Over the counter the use of antibiotics should be stopped at an individual level. This can be achieved by regular public information bulletin through social media available.
These are the strategies which if strictly followed can help in abating AMR to a large extent.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
|1||New Report Calls for Urgent Action to Avert Antimicrobial Resistance Crisis. Available from: https://www.who.int/news/item/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis. [Last accessed on 2019 Apr 29].|
|2||Lack of New Antibiotics Threatens Global Efforts to Contain Drug-Resistant Infections. Available from: https://www.who.int/news/item/17-01-2020-lack-of-new-antibiotics-threatens-global-efforts-to-contain-drug-resistant-infections. [Last accessed on 2020 Jan 17].|
|3||Jones AE, Trzeciak S, Kline JA. The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med 2009;37:1649-54.|
|4||Balkhy H, Allegranzi B, Magzoub M, Ogunsola S, Fisher D, Pittet D, et al. World Antimicrobial Awareness Week: WHO IPC Global Webinar. Available from: https://www.who.int/news-room/events/detail/2020/11/18/default-calendar/world-antimicrobial-awareness-week-2020. [Last accessed on 2020 Nov 18].|
|5||Masterton RG. Antibiotic de-escalation. Crit Care Clin 2011;27:149-62.|
|6||Kang JS, Lee MH. Overview of therapeutic drug monitoring. Korean J Intern Med 2009;24:1-10.|