Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

Daxesh M P - Combating Antimicrobial Resistance: 2011 is the year of “No action today, No cure tomorrowFig. 1: Key facts and figures highlighting the development ofantibiotics and Essential medicines conceptInitial Discovery of Antibiotics and Development of their4ResistanceDiscovery of Antibiotics Clinical Use Resistance IdentifiedPenicillin – 1940 1943 1940Streptomycin – 1944 1947 1947, 1956Tetracycline – 1948 1952 1956Erythromycin – 1952 1955 1956Gentamycin – 1963 1967 1970AMR became an important issue in the 1960s when5resistance plasmid and transmissibility were detected• WHO published the First Model Essential Medicine List in61977• WHO revises its Model Essential Medicine List every 27years8• WHO recognized global AMR threat in 1998• WHO developed the Global Strategy for the containment of2Antimicrobial Resistance in 2001• WHO and member states are observing 2011 as the year ofAntimicrobial resistance : No action today, No cure tomorrow1to building momentum for rational use of antibioticsIndiaŸ First Comprehensive DrugPolicy – 1978[9]Ÿ National Drug Policy –1986[10]Ÿ First Essential MedicineList – 1996[11]Ÿ N a t i o n a l E s s e n t i a lMedicine List – 2011[11]South AfricaŸ First National Drug Policy– 1996[12]Ÿ First Standard TreatmentGuidelines and EssentialMedicine List – 1996[13]Ÿ Standard TreatmentGuidelines and EssentialMedicine List – 2008[13]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 limited14, 17resources.Health Care Cost of AMRAMR reduces the effectiveness of treatment because patientsremain infectious for longer, thus potentially spreading1resistant microorganisms to others. The application ofeconomics to the problem of antimicrobial resistance extendsbeyond the important point that treatment costs are higher for18, 19, 20infections caused by resistant organisms. The longerduration of illness and treatment, often in hospitals, increaseshealth-care costs as well as the financial burden to families1and societies. The World Health Organization (WHO)estimates that up to 40% of health care costs are related to21procurement of medicines.Indian Journal of Pharmacy Practice Volume 4 Issue 4 Oct - Dec, 2011 3