Antimicrobial Resistance (AMR) and Prescribing Sian Williams Clinical Pharmacist

Hot Topic What is AMR? Why is this a problem? What can we / I do? Signposting links AMR is when bacteria adapt and develop a way to protect themselves from being killed by antibiotics. This is a problem as infections caused by antibiotic resistant bacteria are more difficult to treat leading to increased levels f disease and death and longer hospital stays. We / I can become and antibiotic Guardian and pledge to undertake a simple action that can prevent the development and spread of antimicrobial resistance.

Professor Dame Sally Davies, Chief Medical Officer “Antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics.” Deaths worldwide pa from tetanus, RTA’s, measles, diarrhoea, diabetes, cholera, cancer and AMR now and projected for 2050. If we don’t tackle drug resistant infections now, they could kill an extra 10 million people across the world each year by 2050. In the UK, 80% percent of antibiotic prescribing occurs in the community, with over half for respiratory tract infections. The inappropriate use of antibiotics is related to bacterial resistance, so using antimicrobials responsibly should help control it Antimicrobial resistance occurs when microorganisms such as bacteria change in ways that render the medications used to cure the infections they cause ineffective. When the microorganisms become resistant to most antimicrobials they are often referred to as “superbugs”. This is a major concern because a resistant infection may kill, can spread to others, and imposes huge costs to individuals and society.

Why is it a problem? It is 30 years since a new class of ABX was introduced AMR resistance is here – ‘superbugs’ Chemotherapy + effective ABX =  Surgery + effective ABX =  It is 30 years since a new class of Abx was introduced despite the fact that growing numbers of infections are resistant to antibiotics and nothing new in the pipeline. MRSA Cancer chemotherapy and effective abx go hand in hand to further our survivorship rates. Emergency, heart and bone etc surgery depend on effective abx otherwise too risky and we are returned to pre 1930’s medicine before abx were discovered 25,000 people die each year across Europe from infections resistant to abx. 1.5billion euros = cost of healthcare expenses and lost productivity due to antibiotic resistant bacteria

What can we do? - Antibiotic Guardianship Do not expect antibiotics Take ABX exactly as prescribed Share with colleagues, friends and family Sign up

What can we do? – TARGET Treat Antibiotics Responsibly Guidelines Education Tools

And finally…. 'No action today means no cure tomorrow' – Dr Margaret Chan, WHO Director General, 2011 And Prof David Haslam, Chairman NICE offers ideal GP consultation as - Shut Up Listen Care Know something

Signposting Links TARGET –http://www.rcgp.org.uk/clinical-and-research/toolkits/target-antibiotics-toolkit.aspx Antibiotic Guardian - https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/469374/EAAD___Antibiotic_Guardian_Resources_Toolkit_2015_FINALv2.pdf Start Smart then Focus a tool for prescribers - https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/417032/Start_Smart_Then_Focus_FINAL.PDF Gloucestershire Joint Formulary – Management of Infection Primary Care https://ccglive.glos.nhs.uk/intranet/media/k2/attachments/Prescribing%20Guidance/Management_of_Infection_Guidance_v3_web.pdf