Antimicrobial resistance: how can an intersectoral approach between society and healthcare professionals be developed and applied?

nurse

(Credit: Unsplash)

This article was exclusively written for The European Sting by Ms Fernanda Melo Gadelha Sarmento, a student from the fourth period of Medicine
of the State University of Rio Grande do Norte-UERN. 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.


In the last century, the development of several drugs able to directly fight infections revolutionized the Healthcare Area, specially Medicine and Pharmacology. In the other hand, the dissemination and indiscriminate use of this drugs opened a window to a quick growth of microbial resistance mechanisms that the humanity can’t control yet. Therefore, this phenomenon presents itself as one of the majors challenges imposed by the nature nowadays.

The genetic mutation capacity of micro-organisms is a known and considered fact by the science since the antibiotical drugs breakthrough. However, the resistance that we fight today has reached a “boost” from a tripod of inconsequent human actions: indiscriminate prescription of broad-spectrum antibiotics, patients that self-medicate themselves or don’t respect the medicine’s posology and the lack of control at the commercialization of these drugs, especially in under-developed countries; consequently, it turned to be a global public health problem. A strategy that is well accepted is the commercialization of some medications only by prescription, but it is not enough, since superbacteria already cause 23000 deaths per year in Brazil, besides a huge burden on the public health budget.

Whereas pharmaceutical industries take 10 years to develop a medicine, some bacteria like Escherichia coli can divide itself every 20 minutes when conditions are favorable such as the right temperature and nutrients are available. This means that in just 7 hours one bacterium can generate 2,097,152 bacteria. That said, the most reasonable solution seems to come from the agents that sustain the mentioned tripod: physicians, patients and health surveillance institutions, in a cooperative effort.

First of all, as a large fraction of the blame is in doctors’ hands, that many times prescribe antibiotics on an indiscriminate way, the first part of the solution would be the use of microbiological tests at the consult to identify the etiologic agent causing the patient’s disease. These tests come as kits and can be made at the doctor’s office; they can identify the most frequent bacteria such as E. coli and Salmonella. The costs are a downside, but it would allow the healthcare system to have accurate diagnoses, avoiding prescriptions of broad-spectrum antibiotics and even prescriptions of antibiotics in non-bacterial infections, that frequently occurs. However, this isn’t enough. This approach’s focus places at the patients, so the general population can have knowledge of what is being fought. Therefore, the second part meets with a coordinated action of pharmacists and patients, taking place at the pharmacists informing and raising social awareness about respecting the medication’s posology (doses and treatment duration) and the risks of resistance, avoiding self-medication and treatment disruption. The last vertex of the mentioned tripod is the adequate monitoring by national institutes (FDA in US, ANVISA in Brazil etc) of drugs commercialization, especially in remote locations of the countries, ensuring the correct sell of antibiotics, with right prescription retaining.

In light of the above, microbial resistance can only be controlled with an intersectoral approach, involving not just the physician, but different areas, as a public health common problem worldwide.

References

LIVERMORE, DAVID M. Bacterial Resistance: Origins, Epidemiology and Impact. Clinical Infectious Diseases, Volume 36, Issue Supplement_1, January 2003, Pages S11–S23, https://doi.org/10.1086/344654

Microbiology Online: Acess on 19 Nov. 2019. Available at https://microbiologyonline.org/about-microbiology/introducing-microbes/bacteria

SILVEIRA, Gustavo Pozza et al . Estratégias utilizadas no combate a resistência bacteriana. Quím. Nova,  São Paulo ,  v. 29, n. 4, p. 844-855,  July  2006 .   Available from <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-40422006000400037&lng=en&nrm=iso&gt;. access on  20  Nov.  2019.  http://dx.doi.org/10.1590/S0100-40422006000400037.

About the author

Fernanda Melo Gadelha Sarmento is a student from the fourth period of Medicine
of the State University of Rio Grande do Norte-UERN. Member of the Social and
Cultural Committee of the Ernani Rosado Academic Center of Medicine and IFMSA
Brasil-UERN Trainee. She believes that information generation and dissemination
above from science community and aiming towards the population is the key to improve
the society, Healthcare Area included.

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

COP22 addresses a strong global pledge to effectively implement the Paris Agreement

Financial support for workers affected by no-deal Brexit

UN’s Bachelet addresses progress and setbacks in human rights worldwide

The European Union continues to lead the global fight against climate change

Shaping the future of democracy in Armenia

Why the agtech boom isn’t your typical tech disruption

What’s really driving corporate climate action?

These innovations could keep us cool without warming the planet

In West Africa, UN Security Council visits Côte d’Ivoire and Guinea-Bissau

UNICEF reports uneven progress in 30 years of child rights treaty

Friday’s Daily Brief: hunger in North Korea, human rights in Iran, updates on DR Congo and Benin

Multilateralism’s ‘proven record of service’ is focus of first-ever International Day

China hopes EU Commissioner De Gucht drops super anti-dumping tariff on solar panels

Restoring prospect of peace in Middle East is ‘our shared responsibility’ UN envoy tells Security Council

Industrial price dive may lead to point of no return

Alcoholic drinks: Commission tables update of rules governing alcohol excise duties

Anti-vaccination: a private choice leading to collective outcomes

UN appeals for international support as flood waters rise in wake of second Mozambique cyclone

UN condemns deadly attack against G5 Sahel force headquarters in Mali

UN chief calls for ‘immediate end’ to escalation of fighting in southwestern Syria, as thousands are displaced

This app uses augmented reality to rewrite ‘herstory’

Cocaine and opium production worldwide hit ‘absolute record highs’ – major threat to public health says UN study

Greece: The new government of Alexis Tsipras shows its colors

The world’s landmine stockpiles in numbers

A Sting Exclusive: “Climate Change needs to be demystified”, Anneli Jättenmäki Vice President of European Parliament underscores from Brussels

3 ways to make the 2020s the decade we close the gender gap

“Our house is on fire.” 16 year-old Greta Thunberg wants action

How cocoa farming can help stop deforestation

So, what is your favourite Sustainable Development Goal?

AI-driven companies need to be more diverse. Here’s why

Cameron readies to support ‘yes’ for Britain in the EU

MEPs boost support for EU research and Erasmus

EU adopts retaliative measures in response to US steel and aluminum tariffs

In Finland, speeding tickets are linked to your income

‘Negative developments’ undermining two-State solution in Middle East

EU Court of Justice invalidates Safe Harbour and the game for thousands US businesses suddenly changes

EU and UK soon to be in a post-Brexit rush over free trade agreement with Australia

Conflict diamonds and climate change: Cooperate, don’t compete over natural resources urges Guterres

‘Transformational benefits’ of ending outdoor defecation: Why toilets matter

Protecting whistle-blowers: new EU-wide rules approved

Trump’s Russophiles under investigation, Europe remains ‘en garde’

Mental health: what can be done to diminish increasing suicide rates?

4 ways 3D printing can revolutionize manufacturing

Water supply a human right but Greeks to lose their functioning utilities

Gender equality: an issue much talked about but less acted upon

10 tonnes of trash was taken off Everest – and repurposed

“None of our member states has the dimension to compete with China and the US, not even Germany!”, Head of EUREKA Pedro Nunes on another Sting Exclusive

CDU-SPD agree the terms for EU’s Banking Union

This is how people in Europe are helping lead the energy charge

Terrorist content online should be removed within one hour, says EP

A Sting Exclusive: “Climate change and youth inaction: oblivion or nonchalance?”, AIESEC wonders from Brussels

In Washington D.C., Guterres signs pact with World Bank, meets US President Trump

Eurozone’s credibility rock solid

Medical ethics in the age of the social media influencers

Fairness in the Food Supply Chain: Commission welcomes Member States’ support for greater price transparency

This is what the world’s waste does to people in poorer countries

Time to be welcome: Youth work and integration of young refugees

Why the ECB had to clarify it caters for the entire Eurozone not just Germany?

A seafood fraud investigation DNA tested fish sold in the US. Here’s what they found

Revolutionary technologies will drive African prosperity – this is why

More Stings?

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s