Antibiotic Stewardship: A Critical Step to Reduce Resistance

In the last year, I’ve learned a great deal about antibiotics. I’ve talked to experts about their use, misuse, and strategies to address antibiotic resistance.  Here’s what I learned and what opportunities I see ahead.

Last year, we saw growing attention towards the important issue of antibiotic resistance.  The issue of antibiotic resistance is now a topic of discussion among leaders in the U.S. and across the globe.  For example, the World Health Organization (WHO) published a 2014 report called “Antimicrobial Resistance:  Global Report on Surveillance.” They report than antimicrobial resistance (AMR) is a “serious threat to global public health.”  Likewise, the President’s Council of Advisors on Science and Technology (PCAST) published a 2014 report on “Combating Antibiotic Resistant Bacteria.” The Council further emphasized the importance of combating this growing challenge.

 

What is antibiotic resistance and why is it such an important issue today?

Antibiotic resistance is when a germ no longer responds to a drug.  In other words, the prescribed treatment no longer works.  When resistance occurs, an infectious disease becomes a major threat to public health.

Health professionals use antibiotics to treat infectious diseases in humans. Often, they can be lifesaving.  Antibiotics are also used to treat sick animals.  Veterinarians feel a moral and ethical duty to treat sick animals – whether pets or livestock. Hear more of the veterinarian perspective from Morgan Scott, DVM, PhD, of Texas A&M (right).

Last year, I spoke with Dr. Terry Dwelle, MD, MPHTM, FAAP, CHP, State Health Officer of the North Dakota Department of Health. Dr. Dwelle shared perspectives from both public health and agriculture.  Dr. Dwelle highlighted that “inappropriate prescribing” for both human and animals is a key cause of resistance.  Veterinarians and livestock producers continue to take proactive steps to reduce use of antibiotics. Physicians have also made strides, even in the face of pressure from patients to prescribe antibiotics.  The following examples published in Emerging Infectious Disease, illustrate patient perceptions about antibiotics in patient care.

  • 12% of Americans have recently taken antibiotics.
  • 27% believed taking antibiotics during a cold made them better.
  • 32% believed taking antibiotics during a cold prevented more serious illness.
  • 48% expected antibiotics when seeking medical care with a cold.
  • 58% not aware of the health risks of antibiotics.

Ref:  Emerg Inf Dis: 9;9, pp 1128-1134 – JD Eng, et al

 

Antibiotic Stewardship:  A Path Forward

Combating antibiotic resistance and preserving available health treatments for the future is critical. To achieve this, we need investment from all stakeholders – public health and agriculture.  Both physicians and veterinarians agree: there is a need for a collaborative approach. Fully understanding the challenges of antibiotic resistance requires, animal and human health experts working together.  This cooperation can ease public concerns.

Experts representing public health and agriculture define antibiotic stewardship as “the commitment to always use antibiotics appropriately and safely – only when they are needed and to treat disease” and agree on charting a path to reduce resistance.  Some experts agree that less is best as the supply of medically important antibiotics is limited, while others champion additional stewardship initiatives.  Champions in public health, animal agriculture, the Center for Disease Control (CDC), and consumers agree that antibiotic stewardship initiatives among physicians and veterinarians is a key path forward to reducing the threat of resistance.

Curious about the term “human antibiotics” and what it means? Check out our expert Q & A with Justin Bugeron, BVMS

 

 

Resources:

One Health Initiative
Blog:  PCAST Releases New Report on Combatting Antibiotic Resistance
WHO:  Antimicrobial Resistance Global Report on Surveillance – 2014 Summary
NIAA White Paper:   Antibiotic Use and Resistance: Moving Forward Through Shared Stewardship