November is “World Antimicrobial Awareness Month”

November 18 to 24 is Antimicrobial Awareness Week, time of the year to raise awareness and talk about Antimicrobial Resistance (AMR).

AMR is becoming a serious threat to humanity, as more and more bacteria and viruses are becoming more resistant to antibiotics and treatment. There are several reasons why this is occurring, and there are several things that people can do to help prevent the growth of AMR.

In this article, we talk about AMR with Darryl Bowers, EHS Director of Pharmacy and Travaughn Baker-Johnson, EHS Director of Infection Control.

INTERVIEW

What is antimicrobial resistance (AMR)? And why is it so important to combat it?

Antibiotic Resistance is an important topic that involves healthcare solutions, as well as advocacy. We are seeing now all over the World bacteria that are simply untreatable. Millions of people are infected each year with a drug- resistant superbug, and a major ethical dilemma on how to combat this problem.

It has been said by the year of 2050, our antibiotics will be so useless, due to resistance, that the annual death total due to infectious disease will be 10 million people a year. As a matter of fact, it will be the #1 cause of death. Antibiotic Resistant Bacteria deaths will far exceeding Cancer.

Why does AMR happen? 

There are many reasons. Public Health Officials estimate that 1/3 of all antibiotics use in the U.S. is either unnecessary or inappropriate. This is because most of them are for self-limiting infections or viral infections that do not benefit from the antibiotic, and this over prescribing can lead to potential resistance.

Another cause of resistance is compliance. There are many people who are not compliant with their treatment. They take their course of treatment for a certain number of days and don’t complete it. This allows resistant bacteria to survive in the body, and this has been known to increase the risk of resistance to develop.

Also, there is a tremendous amount of antibiotic use in agriculture. Often this use is not to treat the animals for infection. It’s used to accelerate their growth. This allows them to reach market size sooner. This is a problem because the resistance strains in farm animals will make their way into the homes of people who consume these animals.

The last reason I would like to share with you as to why AMR is happing, is because, pharmaceutical companies simply has cut back on production of new antibiotics. It cost around 1 billion dollars to bring a drug to market. Pharmaceutical companies ask themselves why spend a billion dollars on a product that will be used for only 7 to 10 days. They would prefer to take that billion and spend on a drug that the patient would take for weeks, years, or a lifetime (e.g. blood pressure, cholesterol, diabetic med.)

What are the consequences of AMR?

I recently read an article that mentioned the British government in collaboration with the Welcome Trust estimated on our current trajectory if we don’t do anything to change. There will be as many as 300 million excess deaths due to antibiotic resistance by 2050. We are currently around 750K globally annually to date. We must understand this is not a town, city, or country problem, this is a global problem. 

Is there a way that people can help stop the spread of drug-resistant infections? If so, what people can do to prevent AMR?

First, I would like to make an appeal to the people to stop requesting and demanding antibiotics. Secondly, I want to make an appeal to all healthcare providers to become better stewards of prescribing and administration of antibiotics. I think the providers should do their due diligent in finding out the causative agents and prescribe antibiotics accordingly. That means to request lab test and set 48-to-72-time out protocols to reexamine the need for continued antibiotic treatment. Lastly, hospitals need to make sure they have effective infection control systems in place.

I would like to end by saying this: I do not hate on the use of antibiotics, and the thought of life without antibiotics is barely imaginable. As a matter of fact, antibiotics have cured more disease then all the other drug classes combined. However, through evolution the life-or-death challenge/battle to survive these organisms have mutated and this mutation has augmented the resistance. 

Darryl Bowers can be reached at: dbowers@emergencyhs.care

INTERVIEW

What is an infection?

An infection occurs when a source agent (bacteria, viruses, yeasts, mold, parasites, etc.) enter a susceptible host through various transmission and start to increase in number while causing a reaction within the body.

What make infections spread?

Infections are spread through various means of transmission that are specific to the organism and its disease process. The 3 main modes of transmission are Contact, Droplet, Airborne: with Vector and vehicle transmission being fewer common modes of transmission for most diseases.

What people can do to help stop the spread of infections?

Hand hygiene, vaccination, staying home while sick, and wearing proper barriers are the most effective ways to prevent infections from spreading in general. Some diseases require specific precautions because of the mode of transmission but usually those factors can only be controlled in a hospital setting.

What to do to avoid the spread of infections in a hospital setting? 

Finishing you full course of antibiotics is very important. When you do not finish your full course of antibiotics because you “feel better”.

How can we prevent the spread of Antibiotic Resistance Infections (AMR)? 

Finishing you full course of antibiotics is very important. By not completing a course of antibiotics you are allowing some of the microorganism causing the infection to live and reproduce, and by exposing them to the antibiotic you give the organism a chance to evolve a resistance to the antibiotic and pass it to future progeny. Other aspects of preventing spread of antibiotic resistant infections within the hospital are carried out by hospital antibiotic stewardship programs.

For further questions, you can contact Travaughn Baker at: tbakerjo@emergencyhs.care

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