Prevention and control of antimicrobial resistance: WHD2011 1
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Transcript Prevention and control of antimicrobial resistance: WHD2011 1
Introduction to
Antimicrobial Resistance
Dr Poonam Khetrapal Singh
Deputy Regional Director
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Prevention and control of antimicrobial resistance: WHD2011
Outline
What is antimicrobial resistance (AMR) and its
implications?
Why are we worried about AMR in SEA Region?
What are the possible solutions?
What is WHO doing?
What we all can do?
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Prevention and control of antimicrobial resistance: WHD2011
Outline
What is antimicrobial resistance (AMR) and its implications
Why are we worried about AMR in SEA Region
What are the possible solutions
What is WHO doing
What we all can do
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Prevention and control of antimicrobial resistance: WHD2011
Antimicrobial (Antibiotics) resistance
Resistance is unresponsiveness to antimicrobial agents in
standard doses
A natural biological unstoppable phenomenon which is driven
by rampant misuse of antimicrobial agents
– 50% of antibiotics are prescribed inappropriately
– 50% of patients have poor compliance
– 50% of populations do not have access to essential antibiotics
– 50% of antibiotics in some countries are used for animal growth promotion
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Prevention and control of antimicrobial resistance: WHD2011
Resistance has huge negative impact on health
Longer duration of illness
Longer treatment
Higher mortality
Treatment with expensive drugs
Increased burden on health system
Negates technological advances in medical sector
– Complex surgeries
– Transplantations and other interventions
Patient acts as reservoir of resistant organisms which are
passed to community and health-care workers
Huge economic impact on individual and society
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Prevention and control of antimicrobial resistance: WHD2011
Outline
What is antimicrobial resistance (AMR) and its implications
Why are we worried about AMR in SEA Region
What are the possible solutions
What is WHO doing
What we all can do
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Prevention and control of antimicrobial resistance: WHD2011
Resistance is negating “wonder drugs” in SEAR
Tuberculosis
– MDR-TB < 3% : 130,000 cases annually, XDR-TB: Reported from 4 countries
Kala-azar
– 60% resistance in pentavalent antimony and 25% in pentamidine
Typhoid fever
– MDR Salmonella Typhi prevalent all over Region
– Causing 10% Case Fatality Rate (CFR) in children (preantibiotic era: 12.8%)
Hospital associated infections
– Staphylococcus aureus: >50% isolates in hospitals are methicillin-resistant (MDR)
– Acinetobacter baumannii: >50% of patients infected with resistant strains die
– Pseudomonas, Klebsiella, Serratia: MDR persist in hospital settings, and cause huge mortality
morbidity
Malaria
– 400 million people at risk of infection with resistant parasite
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Prevention and control of antimicrobial resistance: WHD2011
Superbugs* are visible manifestations of our prolonged failure to preserve antibiotics
Known but neglected.
Need immediate action
Known but
inevitable
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** 8
Methicillin
resistant
Staph aureus,
Mycobacteria, ESBL
producing Gram
negative bacteria and NDM-1 producing
Prevention
and MDR-and
controlXDR
of antimicrobial
resistance:
WHD2011
enterobacteriaceae bacteria are few examples of superbugs because these fail to respond to large number of commonly used antibiotics
Outline
What is antimicrobial resistance (AMR) and its implications
Why are we worried about AMR in SEA Region
What are the possible solutions
What is WHO doing
What we all can do
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Prevention and control of antimicrobial resistance: WHD2011
Possible solutions
Discover new drugs faster than emergence of resistance
Promote discovery, development and dissemination of new
antimicrobial agents
Prevent emergence of resistance by reducing selection
pressure by appropriate control measures
Rationalize the use of available antimicrobial agents
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Prevention and control of antimicrobial resistance: WHD2011
Antibiotics: Roadway
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Prevention and control of antimicrobial resistance: WHD2011
Possible solutions
Discover new drugs faster than emergence of resistance
Rationalize the use of available antimicrobial agents
Prevent emergence of resistance by reducing selection
pressure by appropriate control measures
Promote discovery, development and dissemination of new
antimicrobial agents
Implementation requires a strategy with comprehensive
national initiatives/plans
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Prevention and control of antimicrobial resistance: WHD2011
Regional Strategy on AMR and Resolution of RC63
Governance
Regulatory
Capacity building
Community
education
Research
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Prevention and control of antimicrobial resistance: WHD2011
Outline
What is antimicrobial resistance (AMR) and its implications
Why are we worried about AMR in SEA Region
What are the possible solutions
What is WHO doing
What we all can do
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Prevention and control of antimicrobial resistance: WHD2011
WHO material for technical support….
Available at www.searo.who.int/AMR
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Prevention and control of antimicrobial resistance: WHD2011
Outline
What is antimicrobial resistance (AMR) and its implications
Why are we worried about AMR in SEA Region
What are the possible solutions
What is WHO doing
What we all can do
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Prevention and control of antimicrobial resistance: WHD2011
“antimicrobial resistance is
possibly the single biggest
threat facing the world in
the area of infectious diseases”.
Antibiotics are
a precious resource
We need to preserve this
resource by working
together
Use Antibiotics rationally
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Prevention and control of antimicrobial resistance: WHD2011