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Introduction to resistance

A short video to introduce the educators and the topic of resistance
Hello, I’m Professor Neil Woodford, and I’m a consultant clinical scientist. The rest of this week’s content has been prepared by myself, by Dr Mike Cooper, and Dr David Jenkins, both of whom are consultant medical microbiologists and infection control doctors. The topic of the course is antibiotic stewardship. And this concept underpins many of the global efforts to reduce the impact that antibiotic resistance is having on modern medicine. Antibiotic resistance has been described as a key threat facing humanity by many world leaders, including by the UK’s Prime Minister and by the President of the United States of America, also by the World Health Organisation and many other august national and international bodies and organisations.
I work for Public Health England, where I head its national reference laboratory for confirming unusual resistance in bacteria. As such, we play with some of the most multiresistant bacteria isolated from patients in the UK. From submissions to my unit, I know that the numbers of these bacteria go up year on year.
Resistance makes infections more difficult to treat, leading to poorer outcomes and increasing numbers of deaths. Although rates of resistance may vary between countries, the types of resistance that causes clinical problems are shared between us all. Resistance is a truly global problem. For the remainder of the week, you will get a foundation in resistance. You will learn how it emerges, how it’s detected and measured in the laboratory, how it spreads between bacteria, and how those bacteria spread between patients. You will also learn how we’ve reached the current situation, described as resistance crisis, and of some of the steps that are being taken internationally to ensure that we have a sustainable supply of new antibiotics for future generations.
Antibiotic stewardship is about using the right antibiotic whenever an antibiotic is needed and about not prescribing antibiotics whenever they are unnecessary. This will help ensure that we can preserve the drugs that we have now and will allow us to use better the drugs that we hope will come in the future. We cannot repeat the mistakes that we’ve made in the past, which have almost invariably led to resistance. I hope you enjoy the week.

As we begin to explore and learn more about antimicrobial stewardship our initial focus in Week 1 is going to be on the topic of resistance.

While the topic of this course is intrinsically linked to the subject of antimicrobial resistance it will not go into detail about the mechanisms of resistance of microbes to the drugs we use against them. Knowledge of this topic is not essential to be able to complete this module and participate in antimicrobial stewardship programmes but if you do want to gain a basic understanding of the various ways in which bacteria can destroy or overcome the effects of antibiotics, you may the PDF in “downloads” useful.

In this video Professor Neil Woodford, who heads Public Health England’s national reference laboratory for confirming unusual resistance in bacteria, provides a brief introduction to this important issue.

As you work through this week’s activities you will develop your understanding of:

  • What resistance is and why it matters
  • How resistance has developed
  • The relationship between prescribing and resistance
  • The role of measurement in resistance
  • What can be done about resistance
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Antimicrobial Stewardship: Managing Antibiotic Resistance

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