Existing evidence confirms that the more we use antibiotics the more selection of resistant organisms occur and this alongside a scarcity in development of new antibiotics means our expectations for future healthcare will require new approaches and changes in attitudes, behaviours and beliefs about antibiotic use.
We have built a healthcare system on the expectation that antibiotics will prevent or control infection but with increasing AMR this is no longer the case and with a need to conserve existing antibiotics we will need to concentrate on embedding best infection prevention and control practice and antibiotic stewardship in both human and animal healthcare.
There is also a need to educate the general public globally, that antibiotics are not necessary for most simple self limiting infections which can also be prevented from spreading by simple self help actions and hygiene discipline
Publication of the “UK Five Year Antimicrobial Resistance Strategy (AMR) 2013 to 2018” with the UK devolved administrations identifies many of the priorities to be addressed and includes a call to action in an effort to address the increasing problem of AMR
The strategy acknowledges that AMR is a global problem and that international partnerships need to be strengthened if the threat is to be understood and reduced.
The overarching goal of the strategy is to slow the development and spread of AMR and has three strategic aims: -
1. To improve knowledge and understanding of AMR
2. To conserve and steward the effectiveness of existing treatments
3. To stimulate the development of new antibiotics, diagnostics and novel therapies
These three aims will be underpinned by seven key areas informed by the 2011 EU AMR Strategic Action Plan and recommendations set out in the Chief Medical Officers Annual report 2012
The organisations who will lead the work programmes are the Department of Health, Department for the Environment, Food and Rural Affairs (DEFRA) and Public Health England
The UK’s commitment to tackle AMR will focus on 7 key areas for future action: -
1. Improving infection prevention and control practices in human and animal health, both through enhanced dissemination and implementation of best practice and better use of surveillance data and diagnostics
2. Optimising prescribing practice through implementation of antimicrobial stewardship programmes that promote rational prescribing and better us of existing and new rapid diagnostics
3. Improving professional education, training and public engagement to improve clinical practice and promote wider understanding of the need for more sustainable use of antibiotics
4. Developing new drugs, treatments and diagnostics through better collaboration between research councils, academia, industry and others; and by encouraging greater public-private investment in the discovery and development of a sustainable supply of effective new antimicrobials, rapid diagnostics, and complementary tools for use in health, social care, and veterinary systems
5. Better access to and use of surveillance data in human and animal sectors through new arrangements that facilitate greater consistency and standardisation of the data collected across the system and encourage improved data linkage
6. Better identification and prioritisation of AMR research needs to focus activity and inform our understanding of AMR. This may identify alternative treatments to new drugs as well as new or improved rapid or point-of-care diagnostic tests for humans and animals
7. Strengthened international collaboration working with and through a wide range of governmental and non-governmental organisations, international regulatory bodies and others to influence opinion, galvanise support, and mobilise action to deliver the scale of change needed globally
To meet the challenges ahead the programme will require a wide range of public and private sector bodies to help deliver this integrated programme to safeguard human and animal health. It will also require co-operation and re-education of the general public to change behaviour and expectations in antibiotic customs, locally, nationally and internationally