Agent of Doom: Antimicrobial Resistance

Rangaswamy Siddaiaha, Liaquat Roopesh Johnsonb

a. Department of General Medicine, DM WIMS Medical College, Naseera Nagar, Meppadi, Wayanad, Kerala, India; b. Department of Community Medicine, DM WIMS Medical College, Naseera Nagar, Meppadi, Wayanad, Kerala, India*

Corresponding Author: Liaquat Roopesh Johnson, Department of Community Medicine, DM WIMS Medical College, Naseera Nagar, Meppadi – 673 577, Wayanad, Kerala, India. Email: liaquat99@gmail.com
Published on 26th June, 2015

 

Antimicrobial resistance (AMR) is defined as the resistance of a micro-organism to an antimicrobial drug that was initially effective for the treatment of infections caused by that micro-organism. It is different from antibiotic resistance in that the latter specifically refers to resistance to antibiotics occurring in common pathogenic bacteria while AMR encompasses resistance among other micro-organisms as well-parasites, fungi, and viruses.1

In recent years, AMR has become a global concern – there were 480,000 cases of multi-drug resistant tuberculosis in 2013, with extensively drug-resistant tuberculosis identified in 100 countries. Resistance has also been reported against HIV drugs, anti-malaria drugs, and many common antimicrobials.1

In the European Union alone, about 25,000 deaths and costs of more than $1.5 billion are attributable to AMR.2 However, economic evaluations may never be able to accurately estimate the true cost of AMR- to do so, one must consider the cost and burden associated with having no effective antimicrobial drugs.3

Ironically, AMR is a problem of our own creation. AMR has been attributed to antimicrobial misuse and overuse-unnecessary prescription of antimicrobials; unnecessarily long courses of antimicrobial therapy; consumption of antimicrobials by food-producing animals.4,5 Further, prescribing antimicrobials at sub-therapeutic doses; rapidly switching from one antimicrobial to another; lack of regulatory control over antimicrobials, etc., have accelerated the development of AMR.

The World Health Organization (WHO) highlighted the growing importance of AMR by designating it as the theme for the World Health Day in 2011, and releasing a six-point package to address the problem.6 In the WHO South-East Asia Region, member states adopted the Jaipur Declaration on AMR.7

More recently, in May 2015, the World Health Assembly approved a Draft Global Action Plan against AMR. The document lists five strategic objectives:

  • To improve awareness and understanding of AMR;

  • To reduce the incidence of infection;

  • To optimize the use of antimicrobial agents;

  • To strengthen knowledge through surveillance and research; and to ensure sustainable investment in countering AMR.7

Governments are expected to develop and implement action plans that support the above objectives.

Considerable resistance can be expected from the pharmaceutical industry, and bureaucratic red-tape may only serve to further delay any meaningful action to counter the problem. However, in light of approval of the action plan at the international level, one hopes that pro-active steps will be taken before the situation spirals out of control.

End Note

Author Information

  1. Rangaswamy Siddaiah, Associate Professor, Department of General Medicine, DM WIMS Medical College, Naseera Nagar,Meppadi, Wayanad – 673 577, Kerala, India. Mobile: +91-9562452820. E-mail: drsrangaswamy2469@gmail.com

  2. Liaquat Roopesh Johnson. Assistant Professor, Department of Community Medicine, DM WIMS Medical College, Naseera Nagar, Meppadi, Wayanad – 673 577, Kerala, India. Mobile: +91-8943964816. E-mail: liaquat99@gmail.com

 

Conflicts of Interest

None declared.

References

1. World Health Organization. 2015; Last cited on 2015 Aug 08Available from: http://www.who.int/mediacentre/factsheets/fs194/en/.

2. Fukuda K, World Health Organization 2015; Last cited on 2015 May 30Available from: http://www.who.int/mediacentre/commentaries/antibioticresistance/en/.

3. Smith R, Coast J, The true cost of antimicrobial resistanceBMJ 2013; 346: f1493. [Crossref] [PubMed]

4. Huttner A, Harbarth S, Carlet J, Cosgrove S, Goossens H, Holmes A, Antimicrobial resistance: a global view from the 2013 World Healthcare-Associated Infections ForumAntimicrob Resist Infect Control 2013; 2: 31. [CrossRef] [PubMed] [PMC Free Article]

5. World Health Organization. The evolving threat of antimicrobial resistance: Options for action 2012; Geneva: World Health Organization

6. South East Asia Regional Office of the World Health Organization. World Health Organization Regional Office for South-East Asia 2011; Last cited on 2015 Aug 08Available from: http://www.searo.who.int/entity/world_health_day/media/2011/whd-11_amr_jaipur_declaration_.pdf.

7. World Health Organization. Draft Global Action Plan on Antimicrobial Resistance 2015; Geneva: World Health Organization

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