This commentary is by Dr. Lindsay M. Smith, an assistant professor of medicine at Larner College of Medicine, an infectious diseases physician at UVM Medical Center, and director of the medical center’s Antimicrobial Stewardship Program; and by John Ahern, a clinical infectious diseases pharmacist at UVM Medical Center.
Nov. 18 marked the beginning of the United States recognition of Antibiotic Awareness Week and World Antimicrobial Resistance Awareness Week.
The World Health Organization has declared that antimicrobial resistance is one of the top 10 global public health threats facing humanity. In 2019, approximately 5 million deaths worldwide were attributed to antimicrobial-resistant bacteria. By 2050, it is projected that 10 million deaths will be attributed to antimicrobial-resistant bacteria.
World AMR Awareness Week is a global campaign that is celebrated annually to improve awareness and understanding of antimicrobial resistance and encourage best practices among the public, One Health stakeholders, and policymakers, who all play a critical role in reducing the further emergence and spread of antimicrobial-resistant organisms.
Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medications, making infections harder to treat and increasing the risk of disease spread, severe illness, and death.
Inappropriate and unnecessary antibiotic prescribing has a direct impact on the selection for antimicrobial-resistant organisms.
Antibiotics are one of the greatest contributions to modern medicine. Not only have antibiotics saved millions of lives in their ability to treat infections, but antibiotics have also made other aspects of medicine possible, such as cancer treatment, stem cell and solid organ transplant, joint replacement surgery, and care of premature infants.
However, we are now living in the post-antibiotic era due to antimicrobial resistance. While in Vermont we have never seen a totally drug-resistant bacteria causing an infection, this scenario has happened around the world, and we must do everything we can to prevent it.
Almost all hospitals and clinics across the U.S. must have antimicrobial stewardship programs. These are spearheaded by infectious diseases physicians and pharmacists, in collaboration with microbiologists, nurses and information technologists to promote the best practices of antimicrobial prescribing.
This includes ensuring that all antibiotic prescriptions are necessary and appropriate by selecting the optimal drug, dose, duration of therapy, and route of administration. By doing this, we hope to preserve antibiotics as an effective therapy for all who need them.
The Covid-19 pandemic has shown how small the world actually is. A novel virus has replicated and traveled the world many times over. The same is happening with bacteria. We are not isolated in Vermont. We have seen a rise in multi-drug-resistant organisms and more are likely to cause problems if we do not all act.
The biggest impact we can make is to remain as healthy as possible. Washing your hands and being up to date with vaccinations are two huge impacts you can have on your own personal health, the health of your family, and the health of your community.
- Human clinicians and veterinarians: Prescribe antibiotics only when absolutely necessary and prescribe the narrowest spectrum antibiotic for the shortest duration possible.
- Patients: Please take your prescriptions as directed.
- Farmers: Administer antibiotics only when your animals are ill, not to promote growth of the animal.
Antibiotics are a limited resource. We must preserve their utility so that their benefit will be preserved for future generations.
To accomplish this, we must all do our part to limit the development and spread of antimicrobial -resistant organisms by taking and prescribing antibiotics wisely.