Antimicrobial Resistance: A Growing Serious Threat for Global Public Health
Abstract
:1. Introduction
2. Timeline of Major Antibiotics Discoveries and Antibiotic Resistance
3. Superbugs
4. Basis of Antibiotic Resistance
5. Sources and Routes of Transmission of AMR
6. Mechanisms of Drug Resistance
6.1. Limiting Drug Uptake
6.2. Modification of Targets for Drug
6.3. Inactivation of Drug
6.4. Efflux of Drug
7. Drivers to AMR
7.1. Misuse and Overuse of Antibiotics
7.2. Increase in Gross Domestic Product (GDP)
7.3. Inappropriate Prescribing Patterns
7.4. Paucity in Futuristic Antibiotics
7.5. Agricultural Use of Antibiotics
7.6. Easy Travel Routes
7.7. Knowledge Gap
8. Clinical Implications of AMR
- Successful treatment of microbial infections including bacterial, fungal, and viral infections is hindered by antimicrobial resistance.
- Emergence and dissemination of new resistant mechanisms threaten the scope of treatment for many common illnesses such as urinary tract infections, upper respiratory tract infections, typhoid, and flu, resulting in treatment failure, permanent disability, or even death.
- The success of cancer chemotherapy, transplantation surgery, and even minor dental procedures will be seriously jeopardized by virtue of AMR unless novel drugs are available.
- AMR infections impose mandatory prolonged treatment with higher healthcare costs and may require expensive alternate drugs.
9. How to Combat AMR
9.1. International Measures
- Establishing and strengthening collaboration among international agencies, governments, nongovernmental organizations, and professional groups.
- Establishing surveillance networks for antimicrobial use and AMR globally.
- Building laboratory capacity for the detection and reporting of pathogens with AMR that have global health impacts.
- Establishing and strengthening international tracking systems for quick identification and mitigation of emerging pathogens.
- International monitoring to control counterfeit antimicrobials across the globe.
- Investing in research, new drug discovery, and vaccines.
9.2. National Strategies
- Implementing an “Antibiotic policy” for judicious use in healthcare and agricultural settings.
- Strengthening of national surveillance, monitoring, and evaluation efforts by integration of public health and veterinary sectors.
- Developing innovative point-of-care diagnostic tests for pathogen identification and resistance monitoring.
- Investing in basic and applied research on new antibiotics and vaccines.
- Building capacity and strengthening international collaboration to combat AMR.
- Adopting antimicrobial stewardship in healthcare settings with essential drug list.
9.3. Rational Use of Antibiotics
9.4. Ban on Over-the-Counter (OTC) Antibiotics
9.5. Infection Prevention and Control (IPC)
- Formation of “infection prevention and control committee”.
- Practices of good hand hygiene.
- Proper diagnosis and successful treatment of infection.
- Responsible use of antimicrobial agents.
- Continuous surveillance and monitoring of antibiotic use and antibiotic resistance.
- Establishing quality antimicrobials supply chain.
- Good microbiological laboratory practices.
9.6. Antimicrobial Stewardship Program (ASP)
9.7. Use of Antibiotics in Animals
9.8. Development of New Drugs and Vaccines
9.9. Introduction of Checkpoints
9.10. Community Engagement
9.11. Alternatives to Antibiotics
9.11.1. Phage Therapy
9.11.2. Antivirulence Drugs
9.11.3. Bacteriocins
9.12. One Health
10. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Salam, M.A.; Al-Amin, M.Y.; Salam, M.T.; Pawar, J.S.; Akhter, N.; Rabaan, A.A.; Alqumber, M.A.A. Antimicrobial Resistance: A Growing Serious Threat for Global Public Health. Healthcare 2023, 11, 1946. https://doi.org/10.3390/healthcare11131946
Salam MA, Al-Amin MY, Salam MT, Pawar JS, Akhter N, Rabaan AA, Alqumber MAA. Antimicrobial Resistance: A Growing Serious Threat for Global Public Health. Healthcare. 2023; 11(13):1946. https://doi.org/10.3390/healthcare11131946
Chicago/Turabian StyleSalam, Md. Abdus, Md. Yusuf Al-Amin, Moushumi Tabassoom Salam, Jogendra Singh Pawar, Naseem Akhter, Ali A. Rabaan, and Mohammed A. A. Alqumber. 2023. "Antimicrobial Resistance: A Growing Serious Threat for Global Public Health" Healthcare 11, no. 13: 1946. https://doi.org/10.3390/healthcare11131946