"This book explores the role that environmental distribution of antimicrobial resistance genes and antibiotics plays in ecosystem and human health. The text features a multi-disciplinary framework that connects microbiology, environmental toxicology, and chemistry to assess human and ecological risk associated with exposure to antibiotics or antibiotic resistance genes as environmental contaminants. It also considers alternate uses and functions for antimicrobial compounds other than those intended for medicinal purposes in humans, animals, and fish. Recognizing the connectivity between overlapping complex systems, the book discusses the subject from the perspective of an ecosystem approach"--
Themen: Verwendung von Antibiotika in oraler Form in den letzten zwölf Monaten; Bezugsquelle der zuletzt verwendeten Antibiotika: ärztliche Verordnung, medizinische Fachkraft, Reste einer vorhergehenden Behandlung, rezeptfrei aus der Apotheke, rezeptfrei von einer anderen Stelle; Indikation für die zuletzt eingenommenen Antibiotika: Lungenentzündung, Bronchitis, Rhinopharyngitis, Grippe, Erkältung, Halsschmerzen, Husten, Fieber, Kopfschmerzen, Durchfall, Harnwegsinfekt, Haut- oder Wundinfektion; Kenntnistest zu Antibiotika: zerstören Viren, effektiv gegen Grippe und Erkältung, unnötige Einnahme verringert Wirksamkeit, Häufigkeit von Nebenwirkungen; Kenntnis des Zeitpunkts zum Beenden einer Behandlung; Rezeption von Informationen zur unnötigen Einnahme von Antibiotika in den letzten zwölf Monaten; Informationsquellen über die unnötige Einnahme von Antibiotika; Einstellungsänderung zu Antibiotika aufgrund dieser Informationen und konkrete persönliche Reaktion auf diese Information; gewünschte zusätzliche Information zu einzelnen Aspekten von Antibiotika: Resistenz, Anwendung, Indikationen, Verschreibung, Zusammenhänge zwischen der Gesundheit von Menschen und Tieren und der Umwelt; präferierte Informationsquellen für zuverlässige Informationen über Antibiotika; präferierte Aktionsebene zur Bekämpfung der Antibiotikaresistenz: individuell oder innerhalb der Familie, regional oder national, global, alle Ebenen gemeinsam; Befürwortung der Behandlung landwirtschaftlicher Nutztiere mit Antibiotika bei vorliegender Indikation; Einstellung zu einem Verbot von Antibiotika zur Wachstumsförderung landwirtschaftlicher Nutztiere.
Demographie: Alter; Geschlecht; Staatsangehörigkeit; Alter bei Beendigung der Ausbildung; Beruf; berufliche Stellung; Urbanisierungsgrad; Haushaltszusammensetzung und Haushaltsgröße; Region.
Antimicrobial resistance (AMR) is a global health crisis estimated to be responsible for 700,000 yearly deaths worldwide. Since the World Health Assembly adopted a Global Action Plan on AMR in 2015, national governments in more than 120 countries have developed national action plans. Notwithstanding this progress, AMR still has limited political commitment, and existing global efforts may be too slow to counter its rise. The article presents five characteristics of the global AMR health crisis that complicate the translation from global attention to effective global initiatives. AMR is (a) a transboundary crisis that suffers from collective action problems, (b) a super wicked and creeping crisis, (c) the product of trying to solve other global threats, (d) suffering from lack of advocacy, and (e) producing distributional and ethical dilemmas. Applying these five different crisis lenses, the article reviews central global initiatives, including the Global Action Plan on AMR and the recommendations of the Interagency Coordination Group on AMR. It argues that the five crisis lenses offer useful entry points for social science analyses that further nuance the existing global governance debate of AMR as a global health crisis.
Antimicrobial resistance is a worldwide problem that has deleterious long-term effects as the develop-ment of drug resistance outpaces the development of new drugs. Poverty has been cited by the World Health Organization as a major force driving the development of antimicrobial resistance. In developing countries, factors such as inadequate access to effective drugs, unregulated dispensing and manufacture of antimicrobials, and truncated antimicrobial therapy because of cost are contributing to the develop-ment of multidrug-resistant organisms. Within the United States, poverty-driven practices such as medi-cation-sharing, use of “leftover ” antibiotics, and the purchase and use of foreign-made drugs of ques-tionable quality are likely contributing to antimicrobial resistance. However, there is currently a dearth of studies in the United States analyzing the socioeconomic and behavioral factors behind antimicrobial resistance in United States communities. Further studies of these factors, with an emphasis on poverty-driven practices, need to be undertaken in order to fully understand the problem of antimicrobial resis-tance in the United States and to develop effective intervention to combat this problem. (J Am Board Fam Med 2007;20:533–539.) Because the development of drug resistance out-paces the development of new drugs, antimicrobial
The use of antimicrobials, primarily antibiotics, but also antivirals, antiparasitics, and antiseptics is rapidly rising around the world - and with it, antimicrobial resistance (AMR). The current COVID-19 pandemic illustrates both the burden on the health system and the economic costs a pathogen can pose when no medication is available. Concerning resistance, the crux of the matter lies in balancing the need to reduce overall antibiotic consumption while at the same time expanding access in countries where such antibiotics are not easily accessible. The rising use of antibiotics in health and agricultural sectors are driving the increase in antimicrobial resistance. The quick expansion of access and use along with ineffective stewardship have led to alarming resistance rates, particularly in fast-growing middle-income economies - a problem these countries must urgently address. If AMR is not tackled more efficiently, it is estimated that by 2050 ten million people will die each year from common infections that will then no longer be treatable. Concomitant with this will be substantial economic losses predicted to total 2.5 to 3 per cent of global GDP. Hence, the pressure is mounting to secure more international commitment to combat AMR. Lowering antibiotic consumption might slow the pace of the spread of resistance, as every dose raises the risk of resistance building. Hence, the continuous development of new medicines is crucial and requires market intervention to take place. An oft-neglected aspect of the debate over AMR is that especially in low- and middle--income countries many life-saving antibiotics are not or not sufficiently available. This situation undermines controlled distribution and promotes a vicious cycle of poverty and antimicrobial resistance. Antimicrobial resistance is a serious concern and, particularly given the presence of COVID-19, one where action should not be delayed. Policies need to address three issues: First, emerging economies must implement effective policy measures to combat resistance. Second, public funding is required to remedy market failure. Third, international cooperation, particularly in research on diagnostics and prevalence as well as interventions, is necessary to better assess the societal impact of antimicrobial resistance and identify efficient ways to actively address the problem.
The overuse and abuse of antibiotics have contributed to the global epidemic of antibiotic resistance. Current evidence suggests that widespread dependency on antibiotics and complex interactions between human health, animal husbandry and veterinary medicine, have contributed to the propagation and spread of resistant organisms. The lack of information on pathogens of major public health importance, limited surveillance, and paucity of standards for a harmonised and coordinated approach, further complicates the issue. Despite the widespread nature of antimicrobial resistance, limited focus has been placed on the role of environmental factors in propagating resistance. There are limited studies that examine the role of the environment, specifically water, sanitation and hygiene factors that contribute to the development of resistant pathogens. Understanding these elements is necessary to identify any modifiable interactions to reduce or interrupt the spread of resistance from the environment into clinical settings. This paper discusses some environmental issues that contribute to antimicrobial resistance, including soil related factors, animal husbandry and waste management, potable and wastewater, and food safety, with examples drawn mainly from the Asian region. The discussion concludes that some of the common issues are often overlooked and whilst there are numerous opportunities for environmental factors to contribute to the growing burden of antimicrobial resistance, a renewed focus on innovative and traditional environmental approaches is needed to tackle the problem.
Antibiotics underpin all of modern medicine, from routine major surgery through to caesarean sections and modern cancer therapies. These drugs have revolutionized how we practice medicine, but we are in a constant evolutionary battle to evade microbial resistance and this has become a major global public health problem. We have overused and misused these essential medicines both in the human and animal health sectors and this threatens the effectiveness of antimicrobials for future generations. We can only address the threat of antimicrobial resistance (AMR) through international collaboration across human and animal health sectors integrating social, economic and behavioural factors. Our global organizations are rising to the challenge with the recent World Health Assembly resolution on AMR and development of the Global Action plan but we must act now to avoid a return to a pre-antibiotic era.