amr and rational use of antibiotics workshop dr mary murray react

8/15/2019 AMR and Rational Use of Antibiotics Workshop Dr Mary Murray ReAct

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Antimicrobial resistance ‐ what are we talking about?

Antimicrobial resistance (AMR)

Antiviral Antiparasitiic

ABR

agen s

(e.g drugs for

HIV)

agents

(e.g drugs for =Antibiotics

(e.g. drugs

for

u ercu os s

and

diseases

…


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main focus of the workshop

Compared to other health problems,

we are not talking about a specific disease

Instead, we are talking about a medicalproduct that is no longer working against

bacteria causing many common infectious

diseases


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Common diseases‐ becoming non‐treatable

Blood

n ec ons

Surgical

infections

onorr ea

AntibioticAntibioticResistanceResistance

Pneumonia Typhoid

fever


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In addition, many medical procedures

are affected and threatened b ABR

Care of

pre erm

children

Trans‐

plantations

Major

surgical

procedures

AntibioticAntibioticResistanceResistance

treatment Safe child

deliveries


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Who is affected by ABR?

Ever one !

However ……

→… vulnerable o ulations with the hi hest

infectious disease

burden

pays

the

highest

price

→… these populations are also the ones that have

least

access to

current

and

future

interventions

to manage antibiotic resistance


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Cost Implications of growing antibiotic resistance ARE

Typhoid fever

Cost of antibiotics for non-resistant cases $3-5

Cost of antibiotics for resistant cases

Azithromycin $35-42

ra cep a ospor ns ce x me -

Parenteral cephalosporins (ceftriaxone) $84-104

Average Treatment Costs for Typhoid (US$)

Child weighing 20 kg using standard treatment guidelines

Source: AKU Pharmindex 2004 & WHO guidelines 2003


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We are beginning to sense that the hidden problem is much larger than we imagined


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bacteria and the global spread of resistance

• Poor sanitation and hygiene

• Alarming decline in antibiotics development


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A Global Problem

Worldwide spread of the 23F clone of penicil lin

resistant pneumococci

France

U. K

USA

Japan

Korea

Mexico

Colombia

Taiwan

Singapore

Argentina Brazil S. Africa


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ESBL (CTX-M) producing Enterobacteriaceae

2001-2002

Endemici ty Sporadic reports

2007

Endemic it y Sporad ic repor ts 2005


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The drug development pipeline for

antibiotics has

gone

dry

• T e ast anti iotic c ass was iscovere in

1987 ! No new drugs for:

•

- Typhoid fever - Shigella

ineffective due to antibiotic resistance- Gonorrhoea- Urinary tract infections

• The pharmaceutical industry has

neither the

- oo n ec ons- ..........

-innovative capacity nor the commercialinterest to develop novel antibiotics

........


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Strategies to stop manage antibiotic

res stance

Prolong the lifespan of existing drugs

Rational Usee er agnos cs

Prevent the spread of resistant bacteria

Improved hygieneInfection control

Development of new antibiotics

Controlled distribution and use of new future antibiotic A new global system to preserve the effectiveness of antibiotics


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Antibiotic Resistance

Caused by human activity and by over‐ consumption

of a obal resource

A failure of public policy & global governance, research prioritization and the current market system

,

organizations and individuals to take action

Through our activism, need to inspire people to hold us all

collectively accountable

NasaNasa 1969: Earthrise over the moon from Apollo II1969: Earthrise over the moon from Apollo II


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Encouraging Multisectoral Regional Networks

China

IndiaSouth East

A r ca

America

Australia

amr and rational use of antibiotics workshop dr mary murray react

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