2. " Antimicrobial resistance is a crisis that
must be managed with the utmost
urgency. …We cannot allow hard-won
gains for health to be eroded by the
failure of our mainstay medicines.”
Dr. Margaret Chan
2015 WHO Global
Action Plan on
Antimicrobial
Resistance
1
5. 1) Improve awareness and understanding of AMR through effective
communication, education and training
2) Strengthen knowledge through surveillance and research
3) Reduce the incidence of infection
4) Optimize the use of antimicrobial medicines in human and animal
health
5) Develop the economic case for sustainable investment (in AMR)
4
6. 1) Improve awareness and understanding of AMR through
effective communication, education and training
2) Strengthen knowledge through surveillance and research
3) Reduce the incidence of infection
4) Optimize the use of antimicrobial medicines in human and animal
health
5) Develop the economic case for sustainable investment (in AMR)
5
7. 1) Improve awareness and understanding of AMR through
effective communication, education and training
2) Strengthen knowledge through surveillance and research
3) Reduce the incidence of infection
4) Optimize the use of antimicrobial medicines in human and
animal health
5) Develop the economic case for sustainable investment (in AMR)
6
10. We must all be antimicrobial stewards
Stewardship:
the careful and responsible
management of natural
resources
9
11. We must all be antimicrobial stewards
Drug
Dose
Duration
Route
prescription
.............
.............
.............
10
12. Microbiology guides therapy wherever possible
Indications should be evidence based
Narrowest spectrum required
Dosage appropriate to the site and type of infection
Minimise duration of therapy
Ensure monotherapy in most cases
We must all be antimicrobial stewards
11
25. Principles of optimal antimicrobial use
Initial evaluation
Subsequent evaluation
Initial evaluation
Clinical
assessment
Diagnostic
work-up
Patient
education
Therapeutic
decisions
Modify
antimicrobials
Data
review
Clinical
re-assessment
24
26. Core competencies for antimicrobial
prescribing
C1: Understands the patients and their clinical needs
C2: Understands treatment options and how they support the
patient’s clinical needs
C3: Works in partnership with the patient and other healthcare
professionals to develop and implement a treatment plan
C4: Communicates the treatment plan and its rationale clearly to
the patient and other health professionals
C5: Monitors and reviews the patient’s response to treatment
25
30. Questions for front-line clinician
If yes, what drug is the best choice?
Are antimicrobials indicated?
29
31. Questions for front-line clinician
How can I limit the societal impact of this
antimicrobial use?
If yes, what drug is the best choice?
Are antimicrobials indicated?
30
33. References: General
• World Health Organization. Global Action Plan on Antimicrobial Resistance. Sixty-
eighth World Health Assembly (document WHA68/2015/REC/1, Annex 3.
http://www.wpro.who.int/entity/drug_resistance/resources/global_action_plan_eng.pdf
• Fleming-Dutra KE, et al. Prevalence of Inappropriate Antibiotic Prescriptions Among
US Ambulatory Care Visits, 2010 – 2011. JAMA 2016 May 3; 315(17):1864-73. doi:
10.1001/jama.2016.4151.
• The Review on Antimicrobial Resistance Chaired by Jim O’Neill. Tackling drug-
resistant infections globally: Final report and recommendations. May 2016.
http://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf
• Centers for Disease Control and Prevention. ANTIBIOTIC RESISTANCE THREATS
in the United States, 2013. http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-
508.pdf
32
