A common fight against Antimicrobial Resistance: how can we react and what should we do

This article was exclusively written for The European Sting by Ms. Oumaima Mazouz, a third-year medical student in the Faculty of Medicine and Pharmacy of Marrakesh, Morocco. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

---

At a time when many alerts are issued, sometimes without any real basis or with a speculative signification, when fear prevails over reason and facts, it seems important to devote attention, time and resources to expose what is today an important health problem and could tomorrow become a major crisis: Antimicrobial resistance the growing threat. What is antimicrobial resistance? According to WHO: “Antimicrobial resistance occurs when microorganisms such as bacteria, viruses, fungi, and parasites change in ways that render the medications used to cure the infections they cause ineffective.” In fact, resistant microorganisms cause infections in humans or animals that are more difficult to treat than those caused by non-resistant ones, which are referred to as “antimicrobial resistance” AMR. AMR and global health Antimicrobial resistance, its emergence and spread as well as the development of pathogens that are resistant to antimicrobials are a worldwide growing concern and it is reflected in the selective bacterial statistics made by WHO. Resistance in tuberculosis: In 2014, there were about 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB), a form of tuberculosis that is resistant to the 2 most powerful anti-TB drugs. Resistance in HIV: in 2010, an estimated 7% of people starting antiretroviral therapy (ART) in developing countries had drug-resistant HIV. Some countries have recently reported levels at or above 15% amongst those starting HIV treatment, and up to 40% among people re-starting treatment. Resistance in influenza: antiviral drugs are important for the treatment of epidemic and pandemic influenza. So far, virtually all influenza A viruses circulating in humans were resistant to one category of antiviral drugs – M2 Inhibitors. What can we do?  The AMR challenges must be faced with immediate actions. In fact, doctors play an important role in decreasing and improving the good use of antimicrobials and they must imperatively behave according to the following instructions:

•       Distinguish viral infections from bacterial infections because antibiotics do not affect viruses. Doctors can actually avoid prescribing antibiotics simply by using rapid screening tests that already exist for many diseases.
•       Choose a relevant antibiotic: in case of bacterial infection, it is better to avoid the systematic use of recent antibiotics or broad-spectrum when other more common or narrower-spectrum antibiotics are sufficient and equally effective. To do this, the doctor must know to which molecules the bacteria responsible for the patient’s disease reacts.
•       Adapt the treatment to needs, in particular, limit the duration of treatments to the strict minimum, to disseminate the policy of proper use and its practical application for healthcare professionals, based on recommendations developed by the various authorities.

The role of the environment in the emergence and spread of antimicrobial resistance is increasingly being taken into account in control strategies. Numerous researche, expertise, and reviews of the scientific literature aim to better understand this role, motivated by new missions and preventive measures to improve the quality of prescriptions. In May 2015, WHO, the FAO and the OIE adopted a Global Action Plan to Combat Antimicrobial Resistance. It is divided into five areas:

•   Raise awareness among health workers and the public.
•   Enhance monitoring and research.
•   Take sanitation, hygiene and infection control measures.
•   Optimize the use of antimicrobials in human and animal health.
•   Support sustainable investments in the development of new treatments, diagnostics or vaccines.

As citizens and individuals who are largely concerned by this matter, we must take a radical stand against this threat, follow the instructions of these organizations and contribute actively in raising awareness about this subject. About the author Oumaima Mazouz a third-year medical student in the Faculty of Medicine and Pharmacy of Marrakesh, Morocco, and a member of the International Federation of Medical Students of Morocco. I believe that the steady increase in antimicrobial resistance poses an exceptionally high threat to public health. Therefore, a good understanding of the fact at the beginning and then awareness and radical solution for it would stand against this problem.