World Health Day 2011: Antimicrobial Resistance
Antimicrobials include antibiotics, antivirals, antifungals, and other medications used to treat life-threatening diseases. Antimicrobial resistance occurs when germs change in a way that reduces or eliminates the effectiveness of drugs to treat them. Widespread overuse and inappropriate use of antimicrobials is fueling an increase in antimicrobial-resistant organisms (germs). Increased resistance is compromising the effectiveness of these important treatments. As resistance increases, the patient's risk for complications or death from infection also increases.
We all have a role to play in preventing antimicrobial resistance. Patients, healthcare providers, hospital administrators, industry, and policy makers can work together to promote appropriate antimicrobial use – ultimately saving lives. Here's how you can help:
How Patients Can Protect Themselves from a Drug-Resistant Infection
- Talk with your doctor about the best treatment for you or your child's illness. (More information on symptom relief)
- Do not demand antibiotics or other medications when a doctor says they are not needed.
- Do not take medications prescribed for someone else. Taking the wrong medicine can delay correct treatment or allow germs to become resistant to the treatment and multiply.
- If your doctor prescribes medication for you or your child:
- Do not skip doses.
- Do not save any medications for the next time you or your child gets sick.
- Take medications as directed. Always follow your doctor's instructions.
How Healthcare Providers Can Help
Quick reference for clinicians -- updated treatment recommendations for specific pathogens:
Healthcare providers can address antimicrobial resistance and have a tremendous impact on protecting patients. There are several steps healthcare providers can take to prevent drug-resistant germs from infecting their patients or being spread in their healthcare facilities.
- Ensure prompt diagnosis of antimicrobial-resistant infections. Work with your laboratory to diagnose resistant infections as quickly as possible so early treatment can be provided.
- Provide appropriate and early treatment. Organisms known to be resistant to antimicrobial treatment have different treatment recommendations. (See box.) Follow the latest recommendations to ensure you are prescribing appropriately.
- Be a good steward of antimicrobials. (See Get Smart for Healthcare)
- Make sure all orders have a dose, duration, and indication. Too often, antimicrobials in hospitals are continued unnecessarily simply because clinicians caring for the patient do not have the information indicating why the antimicrobials were started in the first place, or how long they were to be continued. Ensuring that all antimicrobial orders are accompanied by the dose, duration, and indication will help other clinicians caring for the patient to change – or stop – therapy when appropriate.
- Include laboratory cultures when placing an order. Knowing the susceptibility of the infecting organism can allow clinicians to narrow a broad spectrum therapy, change the therapy to better treat resistant pathogens, or stop therapy when lab results suggest an infection is unlikely.
- Take an "antimicrobial time out," reassessing therapy after 48-72 hours. Antimicrobials are generally started before a patient's full clinical picture is known. Once clinicians have additional information—including microbiology, radiographic, and clinical information—they can decide if the therapy is still warranted.
- Prevention is key. Organisms that have been known to have drug-resistance can be controlled by using vaccination or non-pharmaceutical interventions. For example, influenza can be prevented by getting vaccinated each flu season. Sexually transmitted diseases such as gonorrhea or HIV can be prevented by using condoms. Diseases like malaria can be controlled by ensuring that people living in areas where malaria is a risk sleep under insecticide-treated bed nets. Also, transmission of drug-resistant pathogens in healthcare facilities can be controlled by following infection prevention recommendations. (More on preventing multi-drug resistant infections in healthcare facilities)
CDC Commentaries for Clinicians on Antimicrobial Resistance
- Antimicrobial Resistance Across the Continuum of Care: Winning the War One Battle at a TimeCME/CE
- CDC Commentary: Don't Give In and Give Those Antibiotics!
- Three Steps to Antibiotic Stewardship
- Carbapenem Resistance in the United States: What Should Clinicians Do?
- CDC Commentary: Preventing Carbapenem-Resistant Enterobacteriaceae
- CDC Commentary: Testing for Clostridium difficile Infection
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