The reverberation of permanent multiprofessional education in combating antimicrobial resistance: future generation prognostic change

This article was exclusively written for The European Sting by Mr. Natanias Macson da Silva, a brazilian and biomedicine graduate from the Federal University of Pernambuco. He 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.

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Treatment of infections was revolutionized by the emergence of antimicrobials, which significantly reduced the morbidity and mortality of the world population. However, in recent decades, the scientific development of improved drugs has not accompanied, to the same extent as the genetic selection and development of biochemical defense mechanisms against antimicrobial agents. These processes are accelerated by the unbridled use of these medicines (by health professionals and by population in general) and that confer, according to Burnham and collaborators, a lower therapeutic efficiency of these drugs ¹. From this perspective, the rise of multidrug-resistant strains presents a growing threat to the effective treatment of infections, which may be devastating for future generations. According to the first global report on bacterial antimicrobial resistance, in 2014, the World Health Organization concluded that it is a global threat to public health ². The following year the Pan American Health Organization issued Resolution CD54.R15. and supported the need to preserve the effectiveness of antimicrobials and mitigate the impact of infectious diseases through education and communication by the world’s population ³. Given this, the continuing education of health professionals and the general population must be guaranteed in all health services, enabling valuable future gains. Therefore, educational and continuous training of diagnostic and therapeutic conduct for health professionals will lead to the reduction of errors such as confusion between etiological agents of infections, and inappropriate use of medications. The reverberation of this permanent education will reach the general population through the health professionals themselves, whether those who work directly with patients in medical services or those who work in administrative and governmental bodies, who are active in the planning or execution of educational actions. Thus, these actions will allow the patient to become an active subject of their self-care and to understand the importance of conscious use of antimicrobials, which will also act in the deconstruction of the self-medication culture. Although it is impossible to prevent the emergence of antimicrobial resistance in light of the natural evolution of microorganisms, we can act on the root cause of the acceleration of this process, which is deficient education, either by professionals or the general population. Therefore, so we cannot rely solely on the development of new innovative and potent antimicrobial formulas, because we know that antimicrobial resistance is very fast. In addition, new drugs go through various commercial phases until they are made available to the poor, which would support the selection of more resistant strains. Knowledge, throughout the history of mankind, has always proved to be the solution for various threatening situations of world health and, therefore, we need to resort to it through continuing education. This is an indispensable tool in any medical service, regardless of its complexity, and will enable a better prognosis for future generations regarding the superninfections that will exist. References

1. Burnham CD, Leeds J, Nordmann P, O’Grady J, Patel J. Diagnosing antimicrobial resistance. Nat Rev Microbiol. 2017;15(11):697-703.
2. World Health Organization. Antimicrobial resistance: global report on surveillance [Internet]. 2014 [accessed 14/11 nov. 2019]. Available in: http://apps.who.int/iris/bitstream/10665/112642/1/9789241564748_eng.pdf? ua=.
3. Organização Pan-Americana da Saúde. Organização Mundial da Saúde. Resolução CD54.R15: Plano de Ação para a Resistência Antimicrobiana. Washington (DC): OMS; 2015. 54º Conselho Diretor.

About the author Natanias Macson da Silva is a brazilian and biomedicine graduate from the Federal University of Pernambuco. Today, at the age of 23, he is a third-year medical student at the University of the State of Rio Grande do Norte (UERN). He is currently a member of IFMSA and was LPR-D of the Local Committee (2017-2018). Passionate about the medical sciences, he develops activities of university extension, with actions aimed at the community, coordinating two extension projects linked to IFMSA. It also acts as a topography anatomy monitor and develops as following lines of research: research of biomarkers for Chagas Disease and clinical investigation-diagnosis of liver cirrhosis.