Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

Indian Journal of Pharmacy PracticeAssociation of Pharmaceutical Teachers of IndiaCombating Antimicrobial Resistance: 2011 is the year of “No action today, No curetomorrow”1 1 2Daxesh M.P , Ganachari M.S , Sunitha C.S*1Department of Pharmacy Practice, KLE University College of Pharmacy, Belgaum, Karnataka2Pharmacy Practice and Administration, Faculty of Pharmacy, Rhodes University, Grahamstown, South AfricaA B S T R A C TSubmitted: 10/10/2011Accepted:9/11/2011The Antibiotic era, which started in the 1940s, changed human demography and the profile of infectious diseases in the world. Despite theadvantages antibiotics had in improving public health across countries, continued irrational use of antimicrobials has resulted in increasinginstances of antimicrobial resistance (AMR). AMR is emerging as a global public health problem resulting in increasing morbidity, mortality andfinancial costs to treat resistant infections. AMR is causing an increased burden on the financial stability of health care systems globally, but hasthe greatest negative impact on developing countries which continue to struggle with weak infrastructures and limited resources – both humanand financial. AMR reduces the effectiveness of available, cost-effective treatments because patients remain infectious for longer and spreadresistant microorganisms to others. Developing countries, societies, families and individual patients continue to bear longer duration of illnessand treatment which increases health-care costs and their financial burden. Due to the increased incidence of resistant microorganisms in bothhospitals and community settings, the antimicrobial resistance crisis is increasing at an alarming rate and is expected to increase at a similar orhigher rate in future as antimicrobial agents continue to become ineffective. Other than irrational use of antibiotics in humans, indiscriminatemisuse of antibiotics in agriculture and animal husbandry is fuelling increased AMR. This critical juncture necessitates professionalism andaccountability towards public health from pharmacists, who can play a crucial role in promoting rational use of antimicrobials and monitoring ofAMR.Keywords: Antimicrobial Resistance, World Health Day, Global Problem, Role of Pharmacist, Cost and consequences, AMR ChallengesAntimicrobials and AMR ChallengesPeople live longer and healthier lives today because ofpowerful and effective medicines such as antimicrobialswhich are available to treat infectious diseases. Prematuredeath from various infectious diseases occurred until the1discovery and availability of antimicrobials in the 1940s.However, the introduction of every antimicrobial agent intoclinical practice has been followed by the detection of strainsof microorganisms that are resistant, i.e. able to multiply inthe presence of drug concentrations higher than the2concentrations in humans receiving therapeutic doses.Antimicrobial resistance (AMR) is the resistance of amicroorganism to an antimicrobial medicine to which it waspreviously sensitive. Resistant organisms (such as bacteria,viruses and some parasites) are able to withstand attack byantimicrobial medicines, such as antibiotics, antivirals, andantimalarials, so that standard treatments become ineffective,Address for Correspondence:Sunitha C S, Pharmacy Practice and Administration, Faculty of Pharmacy,Rhodes University, Grahamstown, South AfricaE-mail: s.srinivas@ru.ac.zaand infections persist and may spread to other people. AMR isa consequence of continued misuse and irrational use ofantimicrobial medicines, allowing microorganisms to mutate3or acquire a resistant gene.Some microorganisms, such as Multidrug-Resistant TB(MDR-TB), Extensively Drug Resistant TB (XDR-TB),Methicillin resistant Staphylococcus aureus, Vancomycinresistant enterococci, Streptococcus pneumoniae and otherpathogens, have developed resistance to clinically usefulantibacterial agents in both developed and developing14countries. AMR is emerging as a global public health15problem with a resulting increase in morbidity and mortality.The 60th World Health Assembly (WHA) in April 2007highlighted the serious problem of the continued overuse andinappropriate use of antibiotics worldwide based on 79216surveys in low and middle income countries. The morbidity,mortality and financial cost of antimicrobial infections posean increasing burden on the financial stability of local,regional and national health care systems globally but havethe greatest impact on developing countries with limitedresources.14, 17Indian Journal of Pharmacy Practice Volume 4 Issue 4 Oct - Dec, 2011 2