Antibiotic Stewardship: Protecting a Precious Resource

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Antibiotic Stewardship
Antibiotic Stewardship

Penicillin, one of the world’s first antibiotics, was discovered in 1928 by the British scientist, Sir Alexander Fleming.  It was further developed for medicinal use by Drs. Howard Florey and Ernst Chain of Oxford University. Penicillin was used to treat the infectious diseases of soldiers in the Second World War and, almost immediately, was termed as a ‘miracle drug’ (and indeed it was). Prior to the advent of antibiotics like penicillin, people routinely died from bacterial infections like strep throat, sexually transmitted infections like syphilis and gonorrhea, and pneumonia. An ear infection could lead to permanent hearing loss. An infected wound could lead to amputation. Penicillin revolutionized how we observe diseases, saving hundreds of millions of lives, since its introduction to the health care community.

An ear infection could lead to permanent hearing loss.

An infected wound could lead to amputation.

Antibiotics have greatly reduced the risk of other medical advancements, like open heart surgery, organ transplants, chemotherapy and hip replacements, and have allowed clinicians to further innovate with little fear of infections. It is not too strong a sentiment to say that the discovery of antibiotics is the greatest medical advance of the 20th century. They are a precious resource worth protecting. And we are in danger of losing them.

Fleming, Florey and Chain were awarded the 1945 Nobel Prize in Physiology or Medicine for their discovery of penicillin. In his Nobel Lecture, Fleming warned that misuse of penicillin could lead to resistance, saying:  ” It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.”  Although Fleming was only referring to the issue of under-dosing as a path to antimicrobial resistance, we now know that over-prescribing and dispensing of antibiotics and the over-use of antibiotics in livestock and fish farming are also factors in the current global antibiotic resistance crisis.

Antibiotic Stewardship is the ethic that embodies the responsible use and management of antimicrobial medications to minimize the emergence of antibiotic-resistant infections.

Antibiotic Stewardship includes:

Prescribing and using antibiotics appropriately and only when necessary (for both humans and animals) by:

» ensuring antibiotics are prescribed only for confirmed bacterial infections and only when truly needed

» ensuring that the right antibiotic is prescribed at the proper dose and for the proper duration

» ensuring that prescribed antibiotics are used until the full antibiotic course is finished

Preventing infectious disease by:

» washing your hands

» avoiding contact with sick people, or using the appropriate personal protective equipment (PPE) when contact is unavoidable

» keeping current with vaccinations (humans and animals)

» improving hygiene and sanitation conditions

Promoting and monitoring infection prevention and control measures to combat the misuse of antibiotics by:

» promoting the proper use of antibiotics and the impact of antibiotic resistance

» improving the surveillance and reporting of antibiotic-resistant infections

» strengthening public health strategies around infection prevention and control

Promote Antibiotic Stewardship:

As the World Health Organization (WHO) continues its World Antibiotic Awareness Week (Nov 16-22), InfectionControl.tips encourages you to promote Antibiotic Stewardship in your own community. The WHO website has some great infographics as well as other promotional materials and information to help you get started.  Other organizations, such as the Students for Antimicrobial Stewardship Society, have also been working at the local level to provide both the public and government agencies with the information to make smart choices about antibiotics.

References:

Antibiotics: Handle With Care 2015 Campaign Toolkit (2015). Retrieved from http://www.who.int/mediacentre/events/2015/world-antibiotic-awareness-week/waaw-toolkit.pdf?ua=1

Antibiotics: Misuse puts you and others at risk. (2014, December 12) Retrieved from http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/antibiotics/art-20045720?pg=2

Fleming, Alexander (1945, December 11). Penicillin – Nobel Lecture. Retrieved from http://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-lecture.pdf

Le Saux, Nicole (2014, May 1). Antimicrobial stewardship in daily practice: Managing an important resource [Position Statement]. Retrieved from http://www.cps.ca/documents/position/antimicrobial-stewardship

Markel, Dr. Howard (2013, September 27). The Real Story Behind Penicillin[Blog Post]. Retrieved from  http://www.pbs.org/newshour/rundown/the-real-story-behind-the-worlds-first-antibiotic/

Students for Antimicrobial Stewardship Society. (2015) Retrieved from http://www.sass-canada.ca/

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