World Health Day – 7 April 2011

COMBAT ANTIBIOTIC RESISTANCE

No Action today - No Cure Tomorrow

What is World Health Day?

World Health Day was celebrated on 7 April to mark the founding of the World Health Organization (WHO).  World Health Day this year was dedicated to the global crisis of antibiotic resistance.

What are antibiotics?

Antibiotics are antimicrobial medicines used to treat infections caused by bacteria.  Other antimicrobials include chemotherapeutic agents, antifungal, anti parasitic and antiviral medicines.  The discovery of antimicrobials was one of the most important advances in human history in terms of healthcare – the discovery of antimicrobials saw a dramatic decrease in the suffering resulting from disease and has saved billions of lives over the past 70 years. ⁽¹⁾

Antibiotic resistance – a big problem

Resistance occurs when bacteria change in such a way that they survive exposure to antibiotics.  The primary cause of antimicrobial resistance is genetic mutation of the bacteria. Antibiotic resistance is a consequence of the use (particularly the misuse) of antibiotics. Resistance may not be confined to a single antibiotic, but may affect multiple antimicrobial classes.  When micro-organisms become resistant to most antimicrobials they are called “superbugs”. Antibiotic resistance is a major problem and everyone needs to work together to combat antibiotic resistance - from medical practitioners to patients. ^{(2, 4)}

Facts about antibiotic resistance

• Antimicrobial resistance is one of the world’s biggest health threats.
• South African hospitals are battling with an increase in micro organisms that are resistant to routine antibiotics.
• Antibiotics are the most important resources in combating life-threatening bacterial disease.
• It is estimated that more than 50% of antibiotics are unnecessarily prescribed for upper respiratory infections (URI’s) caused by viruses. Prescribing antibiotics for viral URI’s is the most common misuse of these drugs.  These infections (such as the common cold) will resolve on their own without antibiotics.
• In children, antibiotics are the most common cause of emergency department visits for adverse drug events.
• Children may have up to nine colds each year.  Four out of ten children who present to an outpatient provider with the common cold receive a non-indicated antibiotic.⁽²⁾

Consequences of antibiotic resistance

• Loss of productivity of patient
• Increased risk of hospitalisation
• Increased use of more toxic drugs
• Increased hospital costs
• Increased risk of transfer to ICU.⁽²⁾

How could the public assist in combating inappropriate antibiotic use?

• When an antibiotic is not prescribed it doesn’t mean you aren’t sick.  Ask what else will help relieve symptoms and don’t request an antibiotic when the healthcare provider determines one is not appropriate.
• Antibiotics will not cure a viral infection; protect other individuals from catching the illness; or help you to feel better.
  • Take the antibiotic exactly as the doctor prescribes.  Do not skip doses.  Complete the prescribed course of antibiotic, even if you start feeling better.
  • Only take antibiotics prescribed for you - don’t share or use leftover antibiotics.  Antibiotics treat specific types of infections.  Taking the wrong antibiotic may delay correct treatment and allow bacteria to multiply.
  • Don’t save antibiotics for the next illness.   Any leftover medication should be discarded by your pharmacists once the prescribed course is completed. Prevent infections through good hand hygiene and getting recommended vaccinations ⁽²⁾.                                                                              

Medi-Clinic’s contribution in combating resistance                                                                                       

• Implementation of good hand hygiene practices in all our hospitals.
• Supporting andimplementing the Best Care...Always initiatives.  The Best Care Always… Campaign is a collaborative national initiative aiming to ensure the consistent application of best practices to improve patient safety.  This initiative is supported by the Hospital Association of South Africa (HASA) and endorsed by the Federation of infectious Diseases of Southern Africa (FIDSSA), the Critical Care Society of South Africa (CCSSA) and the South African Society of Anaesthesiology (SASA) amongst others.   
• Medi-Clinic will be implementing care bundles for the prevention of the following healthcare-associated infections:
  • Surgical site infection (SSI)
  • Ventilator-associated pneumonia (VAP)
  • Central line-associated blood stream infection (CLABSI)
  • Catheter-associated urinary tract infection (CA-UTI)
    • Antibiotic Stewardship strategy (initiated by the Best Care…Always Campaign). Antibiotic Stewardship is the responsible use of antibiotics to prevent and treat critical, life threatening infectious disease ^(4,5). 

References

1. World Health Organization. 2011. World Health Day 2011.  Available from: http://www.who.int/world-health-day/2011
2. Centers of Disease Control and Prevention.  2010.  Get Smart Programs:  Know when antibiotics work.  Available from: http://www.cdc.gov/getsmart/
3. Senekal, M. 2010. Current issues in antimicrobial therapy. Continuing Medical Education. 28(2) p9-11.
4. Best Care Always Campaign. Antibiotic Stewardship Bundle. 2011.  Available from:  http://www.bestcare.org.za.
5. Medi-Clinic Nursing News. November 2009.
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