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WHO sounds alarm over “devastating” spectre of global antimicrobial resistance

Antibiotic resistance has now been documented in every region of the world and poses a major threat to public health, the World Health Organization (WHO) has warned in a report, “Antimicrobial resistance: global report on surveillance”, published this week (30 April 2014).

WHO says that without urgent, co-ordinated action “the world is headed for a post-antibiotic era, in which common and minor injuries which have been treatable for decades can once again kill”. The loss of effective antibiotics and the implications for public health will be “devastating”, it warns.

The report aims to “kick-start” a global effort to address antimicrobial resistance, through the development of tools and standards, and improved collaboration to track drug resistance, measure its impact and design targeted solutions.

WHO urges pharmacists and other healthcare workers to help tackle resistance by enhancing infection prevention and control measures, and to prescribe antibiotics only when truly needed. It also emphasises the need to prescribe “the right antibiotic(s) to treat the illness”.

The 256-page report is the first time WHO has examined global antimicrobial resistance and incorporates data from 114 countries. It focuses on antibiotic resistance in seven bacteria that cause common serious diseases, such as sepsis, diarrhoea, pneumonia and gonorrhoea; it also includes information on resistance to drugs used to treat infections such HIV, malaria, tuberculosis and influenza.

Resistance to carbapenem antibiotics, the last resort treatment for life-threatening infections caused by the intestinal bacteria Klebsiella pneumoniae, is now present in every region of the world, the report states. In some areas, more than half of infections due to K pneumoniae are resistant to carbapenem antibiotics.

Also “very widespread” is resistance to fluoroquinolones, used to treat urinary tract infections caused by Escherichia coli, while resistance to third-generation cephalosporins, the last resort treatment for gonorrhoea, has been identified in Australia, Canada, Japan, South Africa and many countries in Europe, including the UK.

The report notes that antibiotic resistance is associated with more prolonged illness and greater length of hospital stay — with implications for costs — as well as an increased risk of death. It also reveals that systems to monitor antibiotic resistance are substandard or absent in many countries.

“While some countries have taken important steps in addressing the problem, every country and individual needs to do more,” the report states. In addition to having good surveillance systems, countries should focus on preventing infections through better hygiene, access to clean water, infection control in healthcare facilities and vaccination programmes.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11137995

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