Future directions in countering antimicrobial resistance

May 15: News Medical Lifescience

The fight against bacteria that are resistant to antibiotics is a crucial element of medical and microbiological research today. The phenomenon of antibiotic resistance itself is a part of the expression of the bacterial genome, and therefore can be expected to emerge in whatever situation antibiotics are used, and to increase with the number of drugs used.

This is how multidrug antibiotic resistance occurs in patients treated with several drugs, and how intractable microbial infections occur. It is for this reason that health care workers the world over must use antibiotics only when bacterial infections have been proved to be present and only when these infections cannot be properly treated without their use in a timely fashion.

This trend of antibiotic use only when absolutely required is termed antibiotic stewardship and is the goal towards which healthcare processes are tending within the UK.

The UK government requested a report by Lord Jim O’Neill, in 2014, on antimicrobial resistance (AMR) as well as the scarcity of new antimicrobial drugs in the market. This underlines the threat posed by AMR which is now one of the three major risks on the Global Risk Register, along with terrorism and climate change, causing about 700,000 deaths annually.

It is estimated that this figure could rise by an additional 10 million per year by the year 2050. The impact of this number may be better assessed if we understand that this is an incredible eight times more than the number of fatalities from road traffic accidents, and exceeds the total number of cancer deaths.

A leading research body, the European Center for Disease Prevention and Control (ECDC), reports that about 25,000 deaths occur from AMR in Europe each year, and two-thirds of these fatal outcomes follow infections by Gram-negative bacteria.

In those European nations that are at the bottom of the economic scale, less than one in a hundred patients obtain treatment from centers which can identify such microbes by microscopy or microbiologic techniques. Thus, a devastating epidemic of antimicrobial resistance is bound to ravage the world very soon, according to England’s Chief Medical Officer, Sally Davies.

Mast is a private firm in the UK which has been synthesizing products for antibiotic susceptibility tests since 1957. It retains its leadership in this area, leveraging 60 years of development and manufacturing experience with new services termed mastpharma.

The purpose of these offerings is to make test devices which contain the drug being tested for antibiotic susceptibility, thus facilitating the commercial development of new antibiotics by making it easier to test for resistance.

The company can provide customized test devices to examine antibiotic susceptibility in vitro and to compare the efficacy of new drugs against currently useful compounds. It also provides multiple cartridge sets for testing to ensure compliance with the international standards of the European Committee on Antimicrobial Sensitivity Testing (EUCAST) and Clinical Laboratory Standards Institute (CLSI).

Necessary  Steps:

To control antibiotic susceptibility, it is necessary to find better ways to halt the spread of infections as well as to put up more effective controls on existing methods. One important aspect in this regard is knowledge of how physicians prescribe drugs in the UK, because several community trials focusing on the use of near-patient testing and antibiotic prescribing by GPs have resulted in prescription only to patients who are proved to be infected.

Ensuring best prescribing practices is a powerful part of antibiotic stewardship. It also reveals how essential it is for health professionals at all levels to continue learning and to expand the reach of such educational opportunities to include them all, making the struggle against AMR a common foe against which all of them can unite by useful action.
 

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