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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries
Brian Godman1,2,3, Abiodun Egwuenu4, Mainul Haque5
1Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK.
Abstract:
Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up.
Insights
Antimicrobial resistance (AMR) is a global health threat. Initiatives to improve antibiotic use in hospitals and ambulatory care, alongside public health messaging, are crucial for combating AMR and misinformation.
Area of Science:
- Public Health
- Infectious Diseases
- Pharmacology
Background:
- Antimicrobial resistance (AMR) poses a significant global threat, increasing morbidity, mortality, and healthcare costs.
- The COVID-19 pandemic has exacerbated antibiotic overuse, highlighting the urgent need for effective AMR containment strategies.
- Addressing AMR is a high priority for international, national, and regional health organizations.
Purpose of the Study:
- To review ongoing initiatives aimed at improving antimicrobial utilization across various sectors.
- To identify successful strategies for combating antimicrobial resistance (AMR).
- To highlight the importance of vaccines, including COVID-19 vaccines, in AMR control efforts.
Main Methods:
- A narrative review of existing activities and programs focused on antimicrobial use and AMR reduction.
- Analysis of point prevalence surveys in hospitals to identify areas for quality improvement.
- Examination of educational interventions in ambulatory care settings.
Main Results:
- Point prevalence surveys have successfully guided quality improvement programs, particularly antimicrobial stewardship programs in hospitals.
- Educational initiatives have proven effective in reducing inappropriate antibiotic prescribing for viral infections in ambulatory care.
- There is a critical need for new quality indicators and public health messaging for ambulatory care to combat misinformation.
Conclusions:
- Effective AMR containment requires a multi-sectoral approach, including robust antimicrobial stewardship and targeted educational programs.
- Public health messaging is essential to combat misinformation, especially during pandemics.
- Ensuring regular access to effective treatments for diseases like HIV, malaria, and tuberculosis is vital for reducing resistance.
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