Chapter 14 AMR (1).pptx drug resistance I

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1. Chapter 14: Antimicrobial Resistance (ARM) and Rational use of antibiotics Infection Prevention and Control Training for Healthcare Centers

2. Chapter Objective Explain the basic concept of antimicrobial resistance and rational use of antibiotics to minimize the resistant of microbes in healthcare facilities.

3. Enabling Objectives Explain the Consequences and magnitude of antibiotic resistance Classify the Causes of antibiotic resistance Describe Rational use of antibiotics Apply Strategies to promote rational use of antibiotic

4. Outline 1.1. Overview of Antimicrobial Resistance and rational use of antibiotics 1.2. Consequences and magnitude of antibiotic resistance 1.3. Causes of antibiotic resistance 1.4. Rational use of antibiotics 1.5. Promotion of rational use of antibiotics 1.6.Summary

5. Session 14.1: Overview of Antimicrobial Resistance and rational use of antibiotics

6. Overview of AMR and Rational use of antibiotics Reflect and share to larger group Go to activity 14.1 in your participant manual page 169 How do you describe ‘Antimicrobial Resistance’ How does this differ from antibiotics resistance

7. Overview of AMR and Rational use of antibiotics … AMR is the ability of a microorganism (such as bacteria, viruses, fungi, and parasites) to resist the effects of an antimicrobial agent using various resistance mechanisms. Rational use of antibiotics ensures that patients receive antimicrobial agent(s) that are appropriate to their clinical needs, adequate doses and period of time.

8. Overview of AMR and Rational use of antibiotics … Antimicrobial resistance (AMR   ) along with irrational use of antibiotics is a major threat to health and human development, affecting our ability to treat a range of infections.   When an infection is no longer treatable by an antibiotic or antiviral, it has developed antimicrobial resistance (AMR).  Anti  means “against,”  micro means “small,” and bial refers to life.

9. Overview of AMR and Rational use of antibiotics … AMR is a broad term that applies to: Fungi becoming resistant to antifungals; Parasites becoming resistant to antiparasitic drugs; Bacteria becoming resistant to antibiotics; and Viruses becoming resistant to antivirals.

10. Overview of AMR and Rational use of antibiotics … Antibiotic resistance is a specific term that refers to a subset of AMR; it refers to bacteria becoming resistant to antibiotics. The overuse ,misuse ,irrational prescribing, dispensing, poor patient adherence and self-medication with antimicrobials have led to persistent expansion of antimicrobial resistance.

11. Session 14.2: Consequences and Magnitude of Antibiotic Resistance

12. Consequences and Magnitude of Antibiotic Resistance Reflect and share to larger group Time : 10 Minutes Go to activity 14.2 in your participant manual page 169

13. Consequence of ABR Clinical Consequence Economic Consequence Social consequence

14. Consequences and Magnitude of Antibiotic Resistance… Antibiotic resistance has a significant impact not only on patients, but also on the health care facility and system . Increase Patient  morbidity , mortality  longer hospital stays Greater burden to the facilities , the health care system and Increases health care costs Complications of treatment, increased toxicity and adverse effects to the patients

15. Consequences and Magnitude of Antibiotic Resistance… Magnitude of Antibiotic Resistance WHO has classified priority pathogens into three categories for which new antibiotics should be developed (page number 172) Priority 1: Critical Priority 2: High Priority 3: Medium

16. Session 14.3:Cause of Antibiotics

17. Cause of Antibiotics Educating and empowering patients and clients to actively participate in their care help reduce a patient's risk of hospital acquired infections. Creating an open dialogue, however, can be a challenge in today's healthcare system.

18. Cause of Antibiotics Reflect and share to larger group Time : 10 Minutes Go to activity 14.3 in your participant manual page 171

19. Cause of Antibiotics… 1. Natural causes:-

20. Cause of Antibiotics… 2. Societal Contributions:- Some antibiotic use practices by HCWs and communities create pressure that allows resistant organisms to survive and grow. Inappropriate selection, dosage, and duration of antibiotics prescribed by clinicians Prescribers not complying with prescribing the right drug (only when indicated), in the right dose, for the right duration, and with the right route of administration. Prescription of broad-spectrum antibiotics rather than a specific antibiotic Poor compliance with recommended infection prevention and control (IPC) practices Lack of policies and regulatory frameworks to control misuse of antibiotics

21. Session 14.4:Rational use of Antibiotics

22. Rational use of Antibiotics Group work Time : 14 Minutes Go to activity 14.4 in your participant manual page 173

23. Rational use of Antibiotics… Medications are used rationally when they are: Clinically appropriate for the patient Prescribed in doses that meet the patient‘s requirements Taken for the recommended time period Taken at the recommended frequency The lowest cost option for the patient and the community

24. Rational use of Antibiotics… Medications are not used rationally in the following circumstances: Excessive use of multiple medicines (polypharmacy) Use of injections when oral formulations would be an equally appropriate Inappropriate use of antibiotics, Antibiotic selection not on standard treatment guidelines Self-medication with antibiotics

25. Rational use of Antibiotics… Determinants of Irrational Use of Antibiotics Lack of provider knowledge Prescriber habits (prescribing without following the guidelines). Non-availability of standard treatment guidelines Non-availability of a specific drug to treat a clinical condition Lack of continuing medical education and supervision Excessive promotion and incentives for prescribing Perceived patient demand. Lack of diagnostic and laboratory support.

26. Session 14.5:Promoting Rational Use of Antibiotics

27. Promoting Rational Use of Antibiotics Promoting rational use of antibiotics and other medicines requires concerted efforts at all levels, starting from the Ministry of Health at the national level and extending out to the community

28. Promoting Rational Use of Antibiotics… WHO recommendation at:- National level Facility-level General public/community-level

29. Summary AMR along with irrational antibiotic use, is a major threat to health care. Antibiotic resistance affects not only patients, but also the health care facility and health system in various ways. Natural causes and societal contributions are the two most important causes of antibiotic resistance. Rational antibiotic use must be addressed at all levels: nations, facilities, individual clinicians, and the general public. Promoting rational use of antibiotics and applying good IPC practices is key.