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Antibiotics and AMR

This article explores the roles of antibiotics and the threat of AMR.
© BSAC

Antimicrobials are crucial to human health. Antimicrobials are substances that inhibit or destroy bacteria, parasites, viruses, or fungi.

Antimicrobials fall into four categories:

The infographic shows four boxes. Box one reads: “Antibiotics against bacteria, e.g., medicines for bacterial pneumonia.” Box two reads: “Antivirals against viruses, e.g., medicines for herpes and HIV”. Box three reads: “Antifungals against fungi, e.g., medicines for yeast infections”. Box four reads: “Antiparasitic against parasites, e.g., medicines for malaria”.

An antibiotic is an antimicrobial used to treat infections caused by bacteria. Most importantly, antibiotics will have no impact on treating infections caused by viruses.

What is AMR?

Antimicrobial resistance (AMR) is one of today’s most significant public health problems. AMR threatens the prevention and treatment of a growing range of infections caused by bacteria, parasites, viruses, and fungi. These microbes over several decades, develop resistance to antimicrobial medicines to protect themselves from the medicines designed to destroy them. The image below shows the WHO (World Health Organisation) definition of AMR.

A callout box reads: “Antimicrobial resistance (AMR) Microorganisms such as bacteria, fungi, viruses, and parasites change when exposed to antimicrobial medicines such as antibiotics, antifungals, antivirals, antimalarials and anthelmintics. As a result, the medicines become ineffective.”

The problem arose when previously effective antimicrobial medicines, e.g., antibiotics used to treat or prevent infections, no longer worked. This crisis will have a devastating effect on the world as dangerous diseases increase and spread. Three factors determine the AMR crisis, as shown below.

Three images with text. The first image shows two microbes and reads, “Resistant microbial phenotypes are increasing in number.” The second image shows a ring of people holding hands around a globe and reads, “A large, connected human population allows pathogens to spread quickly.” The third image shows a packet of pills and reads, “The extensive use of antimicrobials drives the evolutionary response in microbes.”

The World Health Organization has declared that “AMR is one of the top 10 global public health threats facing humanity.” AMR directly affects patient care and creates critical ongoing challenges to health service delivery. AMR increases the complexity of treatment in patients, the length of hospital stays and the severity of the patient’s illness, putting strain on healthcare systems. In some cases, severe infections caused by pathogens that do not respond to available ‘last-line’ antimicrobials can result in septicaemia and death.

Below are quotes from the world’s leading AMR experts highlighting the extent of the resistance problem.

“Antimicrobial resistance is one of the most pressing issues globally, not only for human health but it is a multi-sectoral problem involving animal health, agriculture, the environment, trade and many other sectors”. – Amina J. Mohammed (Deputy Secretary-General of the UN).
“A lack of effective antibiotics is as serious a security threat as a sudden and deadly disease outbreak. Strong, sustained action across all sectors is vital if we are to turn back the tide of antimicrobial resistance and keep the world safe.” – Dr Tedros Adhanom Ghebreyesus, Director-General of WHO.

A blue globe is shown with vertical lines shooting up into space

Now that you know what AMR is, we will explore the key drivers of AMR and will focus on the need for antimicrobial stewardship (AMS).

© BSAC
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How to set up an Antimicrobial Stewardship Programme

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