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Sprenger the guardian antibiotic 270618def

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Sprenger the guardian antibiotic 270618def

  1. 1. 1 | Antibiotic Guardian Workshop Improving awareness and AMR in Europe Marc Sprenger, MD PhD , Director AMR 27 June 2018
  2. 2. 2 | What is the scene?
  3. 3. 3 | Klebsiella pneumoniae  Bloodstream infection, urinary tract infection, surgical-site infection and pneumonia  Carbapenem-resistant KP mortality rate +/- 50% 1
  4. 4. 4 | Carbapenem-resistant K.pneumoniae 2010 EARS-net 2016 CAESAR
  5. 5. 5 | Acinetobacter spp.  Urinary tract infections, skin/soft tissue infections, blood stream infections, pneumonia and meningitis  30% mortality in hospitalized patients3
  6. 6. 6 | Multidrug-resistant Acinetobacter spp. 2014 EARS-net 2016 CAESAR
  7. 7. 7 | Methicillin-resistant Staphylococcus aureus (MRSA) 2009 EARS-net 2016 CAESAR
  8. 8. 8 | AMR is the Greatest Threat to Modern Medicine Profound health consequences – Individuals, health systems, food systems, and practice of medicine Economic and other intersectoral implications – Development, agriculture, food, business, etc. Long-term threat with no end in sight unless fundamental changes are made
  9. 9. 9 | Factors Contributing to AMR Holmes at al., 2016
  10. 10. 10 | Use of Antibiotics Is On The Rise Van Boeckel et al. The Lancet Infectious Diseases 2014 14, 742-750DOI: (10.1016/S1473- 3099(14)70780-7) Total global antibiotics consumption increased 30%
  11. 11. 11 | AMR and the SDGs Untreatable infections in animals threaten food prod AMR hardest on the poor Antibiotic residues (hosp, pharma & agri contaminate water AM core components health systems Balance access, innovation and conservation of AM *Cumulative costs AMR $120 trillion by 2050 Require multi-stakeholder partnerships *World Bank Group Report on Drug-Resistant Infections (March 2017)
  12. 12. 12 | Global Action Plan Antimicrobial Resistance Adopted by World Health Assembly in 2015 Recognized & supported by FAO (Resolution 4/2015) and OIE (Resolution 26) governing bodies in 2015 Bring AMR to UNGA!
  13. 13. 13 | Global Action Plan's 5 Strategic Objectives 1. Improve awareness and understanding 2. Strengthen knowledge through surveillance & research 3. Reduce the incidence of infection 4. Optimize the use of antimicrobial medicines 5. Ensure sustainable investment Develop National Action Plan
  14. 14. 14 | Antibiotics Consumption (JIACRA ECDC/EFSA/EMA, 2017) 0 20 40 60 80 100 120 140 160 180 200 In humans mg/kg biomass 2014
  15. 15. 15 | Antibiotics Consumption 0 50 100 150 200 250 300 350 400 450 Human (mg/kg) In food prod animals & humans mg/kg biomass (JIACRA ECDC/EFSA/EMA, 2017)
  16. 16. 16 | Patient Pressure to Prescribe Antibiotics
  17. 17. 17 | World Antibiotic Awareness Week (13 – 19 November 2017) Antibiotic resistance is a global health crisis that should be addressed with the utmost urgency. -Dr. Tedros Adhanom Ghebreyesus, Director General World Health Organization
  18. 18. 18 | Awareness: 2017 WAAW: 131 countries 15K+ views 9.2 M impressions 175K+ engagements Global Social Channel Performance Total Countries Participating Global video views 21M+ 75.5K+ 850K+ Global social channel impressions Campaign website page views 29K+ engagements Global pieces of coverage 94 22 11 Region of the Americas Eastern Mediterranean RegionAfrica Region 26 European Region 37 South East Asia Region 10 Western Pacific Region 25 As there was no hard news story, a press advisory was released, and there were a total of: The web and social media were very successful with:
  19. 19. 19 | Behaviour Change Activities: Focus on Thailand Antibiotic Smart Use campaign: Awareness, Education and Policy
  20. 20. 20 | Behaviour Change Activities: Focus on Thailand Antibiotic Smart Use campaign: Awareness, Education and Policy
  21. 21. 21 | Cumulative number of countries enrolling to GLASS 2 10 19 27 32 32 35 37 38 38 41 43 43 46 49 51 56 56 56 56 57 59 60 63 64 68 5 13 18 20 20 23 24 27 30 30 31 31 36 38 40 47 47 47 47 48 49 52 53 54 58 0 10 20 30 40 50 60 70 80 Total Enrolment completed Enrolment call 21.03.2016
  22. 22. 22 | Enrolment completed (n=58) Enrolment in progress (n=10) Status of countries enrolled in GLASS As of 30 April 2018*
  23. 23. 23 | Global Action Plan's 5 Strategic Objectives 1. Improve awareness and understanding 2. Strengthen knowledge through surveillance & research 3. Reduce the incidence of infection 4. Optimize the use of antimicrobial medicines 5. Ensure sustainable investment Develop National Action Plan
  24. 24. 24 | Methicillin-resistant Staphylococcus aureus (MRSA) 2009 EARS-net 2016 CAESAR
  25. 25. 25 |
  26. 26. 26 | Prof. Celine Pulcini
  27. 27. 27 |
  28. 28. 28 | Antibiotic Use in Dentistry In the UK, dentists accounted for 7% of all community prescriptions of antimicrobials Antibiotic Guardian has created a pledge specifically for dentists 1Dar-Odeh, Najla Saeed et al. “Antibiotic Prescribing Practices by Dentists: A Review.” Therapeutics and Clinical Risk Management 6 (2010): 301–306. Print.
  29. 29. 29 |
  30. 30. National (not including the territories) and regional rates of health care–associated Clostridium difficile infection in adults per 10 000 patientdays from 2009 to 2015. Kevin C. Katz et al. CMAJ 2018;190:E758-E765 ©2018 by Canadian Medical Association
  31. 31. 31 | Antibacterial agents in clinical development • 51 new antibiotics in the clinical pipeline • 33 against priority pathogens • ~9 are innovative  Pipeline is insufficient to treat priority pathogens & TB • Of 10 phase-I antibiotics to tackle gram-negative bacteria only 1-2 will make it to market in 7 years Source: http://apps.who.int/iris/bitstream/10665/258965/1/WHO-EMP-IAU-2017.11- eng.pdf?ua=1
  32. 32. 32 | "One Health" Approach AMR affects humans, animals, and the environment Partnering with FAO and OIE on a comprehensive approach WHO is collaborating with UNEP to develop evidence base on AMR’s impact on the environment
  33. 33. 33 | Recommendations 1. Overall use 2. Growth promotion use 3. Prevention use (without disease) 4a. Control use (with disease) 4b. Treatment use (with disease) Best practice statements 1. About new class of antibiotics 2. About antibiotics currently not being used in food production
  34. 34. 34 | British Poultry Council BPC reduced antibiotic use by weight by 71% Poultry meat production increased by 11%
  35. 35. 35 |
  36. 36. 36 |
  37. 37. 37 | Increasing Consumer Demand… Public Interest Research Group, 2016Public Interest Research Group, 2015
  38. 38. 38 | Global Action Plan's 5 Strategic Objectives 1. Improve awareness and understanding 2. Strengthen knowledge through surveillance & research 3. Reduce the incidence of infection 4. Optimize the use of antimicrobial medicines 5. Ensure sustainable investment Develop National Action Plan
  39. 39. 39 | National Action Plans AMR (030518) 1. 100 countries have approved NAP* 2. 67 countries in progress 3. 154 countries submitted Tri-partite survey (June) 4. 88 countries involved in community of practice 5. 470 implementers in community of practice *Small island states, West and Central Africa, Fragile states
  40. 40. 40 | The other part of the world
  41. 41. 41 | Escalating number of deaths in developing countries Source: Review on Antimicrobial Resistance : Tackling drug- resistant infections globally. O’Neill report 2016.
  42. 42. 42 | Highest burden of infectious disease
  43. 43. 43 | Burden of infectious disease is in low income countries Burden of Infectious Disease Progress in developing an AMR National Action Plans
  44. 44. 44 | Water and Sanitation 40% of health facilities in LMICs have no source of water – Impossible to prevent infection Source: Emory University
  45. 45. 45 | Dr Kamini Walia (Paris 20/3/18)c Cephalosporines
  46. 46. 46 | Dr Kamini Walia (Paris 20/3/18)
  47. 47. 47 | Reality of medical practice (Rachel Glogowski)
  48. 48. 48 |
  49. 49. 49 |
  50. 50. 50 |
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  52. 52. 52 |
  53. 53. 53 |
  54. 54. 54 |
  55. 55. 55 |
  56. 56. 56 | Limited staff, 10 fte 3000 beds
  57. 57. 57 | Antibiotics as a substitute for decent infrastructure
  58. 58. 58 | Antibiotics as a substitute for decent hygiene
  59. 59. 59 | Antibiotics as a substitute for decent care
  60. 60. 60 | For animals as well as humans
  61. 61. 61 | Can you make a difference?...Yes! 1. Prescribe antimicrobials only when necessary 2. Educate patients on AMR & resist pressure to prescribe 3. Vaccinate patients 4. Follow diagnostic procedures 5. Political commitment is essential!: reach out to your government officials
  62. 62. 62 | Making a difference! Dame Sally Davies & Lord Jim O’Neill Wellcome Trust Fleming Fund Many more (Wateraid)
  63. 63. 63 | Conclusion 1. You are needed 2. No silver bullet, multiple actions required 3. Substantial progress made, countries involved 4. Political attention is pivotal (WHA) 5. Resources needed, all levels Its is all about implementation in health system!
  64. 64. 64 | For More Information Please visit: http://www.who.int/antimicrobial-resistance/en/ On Twitter: @Marcsprenger4PH

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