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Antibiotics are essential to be able to treat and prevent bacterial infections. “Without active antibiotics, we are all at risk of dying of bacterial infections.
It is of utmost importance that we only use antibiotics when necessary to slow down the development of resistance to these precious medications,” explains Andriette van Jaarsveld, Clinical Pharmacy Specialist at Mediclinic Southern Africa.
According to the Centers for Disease Control and Prevention, about one-third of antibiotic use in people is not needed or appropriate. “Antimicrobial resistance is a global threat because what each individual does, has an influence on the rest of the world.”
“To ensure that the active antibiotics are well managed, Mediclinic implemented Antibiotic Stewardship Programmes in our hospitals where we work together as a multi-disciplinary team of doctors, pharmacists, microbiologists, infection prevention and control practitioners, infectious diseases specialists and nurses, to ensure that we use antibiotics in the best possible manner to ensure the best outcome for current patients while protecting their activity for the future,” van Jaarsveld expands.
Mediclinic aligned its approach to the management of new antibiotics, to that of the World Health Organization (WHO) which made the classification of ‘Reserved drugs’. Mediclinic supports this approach to limit the use of these antibiotics to a last resort to treat severe infections caused by multidrug-resistant pathogens.
“It is important that antibiotic prescribing, especially for difficult to treat infections should be done in a multidisciplinary team approach to ensure that the best possible treatment is provided for the patient,” van Jaarsveld explains. “Everyone should use fewer antibiotics, and when we need to use them, make sure that we use the correct drug, at the correct dose and for the shortest possible time.”
Mediclinic’s formal Antibiotic Stewardship Committees in hospitals provide a structure to guide and monitor antibiotic (or antimicrobial) usage. These committees oversee patient rounds and interventions to optimise antibiotic use in the hospital as well as measure antibiotic use according to the WHO standards as part of Clinical Performance Indicators. Doctors are key members of these Antibiotic Stewardship Committees and collaborating with them is key in optimising antibiotic prescriptions while ensuring the best possible care and outcomes for patients.
According to Van Jaarsveld, the implications are severe if this stewardship is not maintained, as vulnerable people such as those who are immunocompromised are more at risk than others because their bodies can’t fight the infection as well as others. They tend to get sicker quicker and tend to have antibiotics more readily prescribed to them, resulting in the organisms that cause their infections becoming very resistant very quickly. In South African hospitals, there are some patients that clinicians are unable to cure as infections caused by resistant germs are difficult – sometimes impossible to treat. They die of infections that could have been treated 5 years ago but not now because the antibiotics no longer work.
Ultimately, it is vital that clinical teams and patients work together to decrease the development of antibiotic resistance. This can be done by patients talking to their doctor about antibiotic resistance and the best treatment options. It is also important to remember that not all infections are caused by bacteria, antibiotics don’t work for viral illnesses such as flu.
Hand hygiene remains a simple and practical measure. By washing your hands regularly each individual can play a key role in preventing infections and their spread. Vaccination is another step as it prevents secondary bacterial infections, such as pneumonia and otitis, which can easily occur following viral infection. By inhibiting secondary infections after vaccination, the inappropriate consumption of antibiotics is averted. The last principle is to never share antibiotics with other people and take them exactly as prescribed.