World Antibiotic Awareness Week 16 to 22 November 2015

World Antibiotic Awareness Week 16 to22
November 2015



The first World Antibiotic Awareness Week is adopted by WHO
from 16 to 22 November 2015. This campaign aims to increase awareness of global antibiotic resistance and to encourage best practices among the general public, health workers, policy-makers and the agriculture sector to avoid the further emergence and spread of antibiotic resistance.

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, become antibiotic resistant. These bacteria may then infect humans and are harder to treat than non-resistant bacteria. Antibiotic resistance leads to higher medical costs, prolonged hospital stays and increased mortality.

Antimicrobial resistance is occurring everywhere in the world, compromising our ability to treat infectious diseases, as well as undermining many other advances in health and medicine. The goal of the global action plan is to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them.

Antibiotic resistance compromises the treatment of infectious diseases and undermining advances in health and medicine. Antibiotic resistance occurs naturally, but misuse of antibiotics in humans and animals is accelerating the process. A new survey, released recently by World health organization, coincides with the launch of World Antibiotics Awareness Week — a global initiative to improve understanding of the problem and change the way antibiotics are used.

Antibiotic resistance


Antibiotic resistance is one of the biggest threats to global health today. It can affect anyone, of any age, in any country including India.

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, and gonorrhoea—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, become antibiotic resistant. These bacteria may then infect humans and are harder to treat than non-resistant bacteria.

Antibiotic resistance leads to higher medical costs, prolonged hospital stays and increased mortality. In the European Union alone, drug-resistant bacteria are estimated to cause 25,000 deaths and cost more than US$1.5 billion every year in healthcare expenses and productivity losses. The world urgently needs to change the way we prescribe and use 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 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 emerge and spread globally every day, threatening our ability to treat common infectious diseases. A growing list of infections—such as pneumonia, tuberculosis, blood poisoning and gonorrhoea—are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.

In countries india where antibiotics can be bought without a prescription, emergence and spread of resistance is made worse. Similarly, in countries without standard treatment guidelines, antibiotics are often over-prescribed by health workers 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.

The general public can help by:

Preventing infections by regularly washing hands, practicing good food hygiene, avoiding close contact with sick people and keeping vaccinations up to date

Only using antibiotics when prescribed by a certified health professional

Always taking the full prescription

Never using left-over antibiotics

Never sharing antibiotics with others.

Health workers and pharmacists can help by:

Preventing infections by ensuring hands, instruments and environment are clean

Keeping patients’ vaccinations up to date

When a bacterial infection is suspected, perform bacterial cultures and testing to confirm

Only prescribing and dispensing antibiotics when they are truly needed

Prescribing and dispensing the right antibiotic at the right dose for the right duration.

Policymakers can help by:

Having a robust national action plan to tackle antibiotic resistance

Improving surveillance of antibiotic-resistant infections

Strengthening infection prevention and control measures

Regulating and promoting the appropriate use of quality medicines

Making information on the impact of antibiotic resistance available

Rewarding the development of new treatment options, vaccines and diagnostics.

The agricultural sector can help by:

Ensure that antibiotics given to animals - including food-producing and companion animals - are only used to treat infectious diseases and under veterinary supervision.

Vaccinate animals to reduce the need for antibiotics and develop alternatives to the use of antibiotics in plants.

Promote and apply good practices at all steps of production and processing of foods from animal and plant sources.

Adopt sustainable systems with improved hygiene, biosecurity and stress-free handling of animals.

Implement international standards for the responsible use of antibiotics, set out WHO.

The healthcare industry can help by:

Investing in new antibiotics, vaccines, and diagnostics.

Recent developments

While there are some new antibiotics in development, none of these 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.

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. Without effective antibiotics for the prevention and treatment of infections, organ transplantations, chemotherapy and surgeries such as caesarean sections become much more dangerous.

In india

India has one of the highest antibiotic resistance rates.

It's our own fault.

In India and elsewhere, we use antibiotics too much. We use them to treat coughs and colds — for which they're ineffective.

We are using antibiotics in animal feed in an attempt to prevent disease and to fatten cows and chickens. And the more we use antibiotics, the greater the likelihood that clever bacteria will evolve in ways that resist the attack of antibiotics. So once-treatable infections become difficult or impossible to cure.


Now we're learning that antibiotic resistance isn't just a rich-country issue.
Resistance is a problem everywhere. It's truly a global problem and requires an urgent response.

E. coli from contaminated water or food, for example, is resistant to many drug types in regions around the world. But India has the highest rates of resistance to nearly every drug available to treat it. Strains of E. coli tested in labs there were more than 80 percent resistant to three classes of drugs, and treatment options there are increasingly limited, the report found.

And MRSA, a dangerous staph infection often contracted in hospitals that does not respond to many antibiotics, is found at high rates in the United States, Romania, Portugal, Vietnam and India — rich, middle-income and poor countries alike.


Antibiotic resistant strains of bacteria, hitching on trains, planes and ships, have made their way from wealthy countries to poor countries, and back again.

So why not just keep seeking and developing new antibiotics? In the race between new drug development and bacteria that evolve to outsmart even the latest last-resort drug, the bacteria will eventually win. That's because the bugs evolve to develop resistance to new drugs faster than science can make them.

And new drugs are increasingly expensive. Low-income countries will not be able to afford them.


It will take country-by-country education of patients, physicians and hospitals to bring down levels of inappropriate use around the world. Reducing the use of antibiotics can help the problem of resistance. "In the absence of antibiotics, resistant bacteria more easily die out. In many cases, if we stop overusing antibiotics, resistance will go substantially down.


But inappropriate use of antibiotics allows greater and greater numbers of bacteria to inherit genes resistant to particular antibiotics — and some bacteria are resistant to every such drug in the medical arsenal. "We wipe out the bacteria that aren't resistant, and we're left with the ones that survive.

Our countries has among the highest rates of antibiotic resistance for 12 common bacteria including Escherichia coli (E. coli), Salmonella, Klebsiella and methicillin-resistant Staphylococcus aureus (MRSA) in the 30 countries studies.

The rates in India were particularly alarming. For example in 2014 in India 57% of the infections caused by Klebsiella pneumoniae, were found to be resistant to the last-resort antibiotic class of drugs carbapenems, up from 29% in 2008. This is particularly crucial as “Carbapenem antibiotics are for use in the most dire circumstances—when someone’s life is in danger and no other drug will cure the infection.

The Rampant rise in antibiotic use poses a major threat to public health in India, especially when there’s no oversight on appropriate prescribing.



This type of situation is another reminder for the country to quickly implement its new guidelines on antibiotic  use .


Greater emphasis on hygiene for coughs, colds and other infectious diseases is needed amid growing antibiotic resistance across the world.

The guidelines should  aimed at changing behaviour among the public on antibiotic use, advocates national and local campaigning on handwashing and other self-care techniques for preventing infectious diseases rather than taking antibiotics. It recommends teaching children and students on proper handwashing techniques as well as convincing people that self limiting conditions do not require antibiotics.


Given the critical public health challenge that antibiotic resistance in India poses, we have yet to see policy level recognition of building public awareness on the issue. The Indian guidelines so far have targeted physicians and pharmacists who are crucial stakeholders in tackling the problem. However, unless the public is part of the process, it would be impossible to holistically address the problem of antibiotic resistance in the country.

We are also in need for updating the existing laws of sale of over-the-counter drugs in India and more importantly enforcing them.

Overview

Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. An increasing number of governments around the world and India are devoting efforts to a problem so serious that it threatens the achievements of modern medicine. A post-antibiotic era – in which common infections and minor injuries can kill – far from being an apocalyptic fantasy, is instead a very real possibility for the 21st Century.

This WHO report, produced in collaboration with Member States and other partners, provides for the first time, as accurate a picture as is presently possible of the magnitude of AMR and the current state of surveillance globally.

The report makes a clear case that resistance to common bacteria has reached alarming levels in many parts of the world and that in some settings, few, if any, of the available treatments options remain effective for common infections. Another important finding of the report is that surveillance of antibacterial resistance is neither coordinated nor harmonized and there are many gaps in information on bacteria of major public health importance.

Strengthening global AMR surveillance is critical as it is the basis for informing global strategies, monitoring the effectiveness of public health interventions and detecting new trends and threats. As WHO, along with partners across many sectors moves ahead in developing a global action plan to mitigate AMR, this report will serve as a baseline to measure future progress.


High background rates of infectious disease plus a large pharmaceutical industry plus an increasingly affluent population that can afford antibiotics. “You put all the things together and it’s this gigantic petri dish of experimentation that is resulting in highly pathogenic strains.”