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Introduction to Antimicrobial Resistance

Introduction to Antimicrobial Resistance

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Introduction to Antimicrobial Resistance

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  1. Introduction toAntimicrobial Resistance Dr Poonam Khetrapal Singh Deputy Regional Director

  2. Outline • What is antimicrobial resistance (AMR) and its implications? • Why are we worried about AMR in SEA Region? • What are the possible solutions? • What is WHO doing? • What we all can do?

  3. Outline • What is antimicrobial resistance (AMR) and its implications • Why are we worried about AMR in SEA Region • What are the possible solutions • What is WHO doing • What we all can do

  4. Antimicrobial (Antibiotics) resistance • Resistance is unresponsiveness to antimicrobial agents in standard doses • A natural biologicalunstoppablephenomenon which is driven by rampant misuse of antimicrobial agents • 50%of antibiotics are prescribed inappropriately • 50%of patients have poor compliance • 50% of populations do not have access to essential antibiotics • 50% of antibiotics in some countries are used for animal growth promotion

  5. Resistance has huge negative impact on health • Longer duration of illness • Longer treatment • Higher mortality • Treatment with expensive drugs • Increased burden on health system • Negates technological advances in medical sector • Complex surgeries • Transplantations and other interventions • Patient acts as reservoir of resistant organisms which are passed to community and health-care workers • Huge economic impact on individual and society

  6. Outline • What is antimicrobial resistance (AMR) and its implications • Why are we worried about AMR in SEA Region • What are the possible solutions • What is WHO doing • What we all can do

  7. Resistance is negating “wonder drugs” in SEAR • Tuberculosis • MDR-TB < 3% : 130,000 cases annually, XDR-TB: Reported from 4 countries • Kala-azar • 60% resistance in pentavalent antimony and 25% in pentamidine • Typhoid fever • MDR Salmonella Typhi prevalent all over Region • Causing 10% Case Fatality Rate (CFR) in children (preantibiotic era: 12.8%) • Hospital associated infections • Staphylococcus aureus: >50% isolates in hospitals are methicillin-resistant (MDR) • Acinetobacter baumannii: >50% of patients infected with resistant strains die • Pseudomonas, Klebsiella, Serratia: MDR persist in hospital settings, and cause huge mortality morbidity • Malaria • 400 million people at risk of infection with resistant parasite

  8. Superbugs* are visible manifestations of our prolonged failure to preserve antibiotics Superbugs Accumulation of resistance to multiple antibiotics Self medication and poor compliance Known but neglected. Need immediate action Inappropriate use of antibiotics selection & multiplication of resistant strains Weak surveillance & regulatory systems Known but inevitable Continuous natural evolution of resistance in bugs ** Methicillin resistant Staph aureus, MDR-and XDR Mycobacteria, ESBL producing Gram negative bacteria and NDM-1 producing enterobacteriaceae bacteria are few examples of superbugs because these fail to respond to large number of commonly used antibiotics

  9. Outline • What is antimicrobial resistance (AMR) and its implications • Why are we worried about AMR in SEA Region • What are the possible solutions • What is WHO doing • What we all can do

  10. Possible solutions • Discover new drugs faster than emergence of resistance • Promote discovery, development and dissemination of new antimicrobial agents • Prevent emergence of resistance by reducing selection pressure by appropriate control measures • Rationalize the use of available antimicrobial agents

  11. Antibiotics: Roadway

  12. Possible solutions • Discover new drugs faster than emergence of resistance • Rationalize the use of available antimicrobial agents • Prevent emergence of resistance by reducing selection pressure by appropriate control measures • Promote discovery, development and dissemination of new antimicrobial agents Implementation requires a strategy with comprehensive national initiatives/plans

  13. Regional Strategy on AMR and Resolution of RC63 • Governance • Regulatory • Capacity building • Community education • Research

  14. Outline • What is antimicrobial resistance (AMR) and its implications • Why are we worried about AMR in SEA Region • What are the possible solutions • What is WHO doing • What we all can do

  15. WHO material for technical support…. Available at www.searo.who.int/AMR

  16. Outline • What is antimicrobial resistance (AMR) and its implications • Why are we worried about AMR in SEA Region • What are the possible solutions • What is WHO doing • What we all can do

  17. “antimicrobial resistance is possibly the single biggest threat facing the world in the area of infectious diseases”. Antibiotics are a precious resource We need to preserve this resource by working together Use Antibiotics rationally