Antimicrobial resistance, including to antibiotics, no longer is a prediction for the future, but already is happening in every region of the world, according to the World Health Organizations first report on the issue.
The problem has the potential to affect anyone, of any age, in any country, according to the report.
Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill, Keiji Fukuda, MD, MPH, WHOs assistant director-general for health security, said in a news release.
Effective antibiotics have been one of the pillars allowing us to live longer, live healthier and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.
The report, Antimicrobial resistance: Global report on surveillance, notes that resistance is occurring across many different infectious agents, but focuses on antibiotic resistance in seven different bacteria responsible for common, serious diseases such as sepsis, diarrhea, pneumonia, urinary tract infections and gonorrhea. The results document resistance to antibiotics, especially last-resort antibiotics, in all regions of the world.
Resistance to carbapenem antibiotics, the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, Klebsiella pneumoniae, has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, sepsis, infections in newborns and illnesses requiring intensive care. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.
Resistance to fluoroquinolones, one of the most widely used antibacterial medicines for the treatment of urinary tract infections caused by E. coli, is widespread. In the 1980s, when these drugs were first introduced, resistance was virtually zero. Today, treatment is ineffective in more than half of patients in many parts of the world.
Treatment failure of third-generation cephalosporins, the last resort of treatment for gonorrhea, has been confirmed in many developed countries. More than 1 million people are infected with gonorrhea around the world every day.
Antibiotic resistance causes people to be sick for longer and increases the risk of death. For example, people with methicillin-resistant Staphylococcus aureus are estimated to be 64% more likely to die than people with a non-resistant form of the infection. Resistance also increases the cost of healthcare with lengthier stays in hospital and more intensive care required.
Tackling the problem
Important actions, according to the WHO, include implementing basic systems to track and monitor antibiotic resistance; and preventing infections through better hygiene, access to clean water, infection control in healthcare facilities and vaccination, thereby reducing the need for antibiotics. The WHO also highlights the need to develop new diagnostics, antibiotics and other tools to help healthcare professionals stay ahead of emerging resistance.
Individuals can use antibiotics only when prescribed; complete the full prescription, even if they feel better; and never share antibiotics with others or use leftover prescriptions.
Clinicians can enhance infection prevention and control; prescribe and dispense antibiotics only when truly needed; and take care to prescribe and dispense the right antibiotic to treat a particular illness.
Policymakers can strengthen resistance tracking and laboratory capacity; regulate and promote appropriate use of medicines; foster innovation and research and development of new tools; and promote cooperation and information sharing among all stakeholders.
Summary (PDF): http://apps.who.int/iris/bitstream/10665/112647/1/WHO_HSE_PED_AIP_2014.2_eng.pdf?ua=1
Full report (PDF): http://apps.who.int/iris/bitstream/10665/112642/1/9789241564748_eng.pdf?ua=1
Infographic (PDF): http://who.int/drugresistance/publications/infographic-antimicrobial-resistance-20140430.pdf?ua=1