Antibiotic stewardship is a multi-sector responsibility

Despite years of antibiotic-stewardship efforts, resistance to these potentially life-saving medications is reaching dangerously high levels around the world, according to Margaret Chan, M.D., director-general of the World Health Organization (WHO), which has released results of a multi-country survey that reveal profound levels of public misunderstandings surrounding the problem.

Although healthcare providers are educated about the benefits and drawbacks of antibiotics, they nonetheless frequently acquiesce to patients' uninformed demands.

"Clinicians bear some responsibility for this problem because we ourselves are not always prudent in our use of antibiotics," Jerome Paulson, M.D., of the Committee on Environmental Health, told MedPage. "Unfortunately, too many people still prescribe antibiotics for colds or sore throats without having an appropriate bacterial diagnosis. So, since clinicians are part of the problem, they can be part of the solution."

And that solution goes beyond changing prescribing patterns and educating patients about the reasons. Organized medicine is also taking on contributors to resistance less under their control, such as the use of antibiotics in livestock as growth stimulants, the subject of a separate report co-authored by Paulson and published in Pediatrics.

In addition to taking a stand against large-scale use of nontherapeutic antibiotics by farmers, the American Academy of Pediatrics has also urged pediatricians to talk to parents about how purchasing antibiotic-free meat and poultry can protect their children from food-related illness, MedPage reported.

The American Medical Association (AMA) has also announced its continued dedication to combating antibiotic resistance. A new policy adopted at the physician group's interim meeting this week encourages improved surveillance of antimicrobial resistance that includes veterinary health agencies, supports implementation of antibiotic stewardship programs across the spectrum of care and renews existing support to provide incentives for further development of antibiotics.

"We are currently faced with not only a decline in the effectiveness of available antibiotics, but also a decline in the development of new antibiotics," said AMA Board Member William E. Kobler, M.D.

"That's why it is extremely important that we continue to take steps to ensure the appropriate use of antibiotics across all healthcare settings," he said. "It will take a coordinated, multi-sector, and multi-pronged approach to address this public health epidemic."

To learn more:
- see the AMA announcement
- read the WHO announcement
- read the story from MedPage
- here's the abstract from Pediatrics