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Tackling anti-microbial resistance: ethical framework for rational antibiotic use
Jasper Littmann1, Annette Rid2, Alena Buyx3
1Robert Koch Institute, Berlin, Germany.
European Journal of Public Health
|October 17, 2017
Summary
Rational antibiotic use programs aim to reduce resistance but can create ethical conflicts. An ethical framework is proposed to help clinicians and policymakers navigate these dilemmas and ensure patient safety while preserving antibiotic effectiveness.
Area of Science:
- Medical Ethics
- Infectious Diseases
- Health Policy
Background:
- Antimicrobial resistance necessitates rational antibiotic use to preserve effectiveness.
- Clinical guidelines advocate for reducing unnecessary or minimally effective antibiotic prescriptions.
Purpose of the Study:
- To analyze the ethical implications of rational antibiotic use programs.
- To address the ethical dilemma faced by clinicians, patients, and policymakers.
- To develop a practical ethical framework for evaluating antibiotic stewardship policies.
Main Methods:
- Ethical analysis of rational antibiotic use programs.
- Review of existing guidance for acceptable risks in clinical research.
- Development of a six-step ethical framework for policy evaluation.
Main Results:
- Rational antibiotic use can lead to ethical conflicts, potentially harming patients.
- Delayed antibiotic treatment, such as switching to second-line options, can increase mortality.
- The conflict between individual patient interests and future antibiotic effectiveness is a significant ethical challenge.
Conclusions:
- Existing risk guidance can inform antibiotic stewardship.
- A new ethical framework aids clinicians and policymakers in evaluating rational antibiotic use policies.
- The framework supports clinical practice and health policy development for responsible antibiotic prescribing.