Flowers Paul
Glasgow Caledonian University, Glasgow, UK.
J Infect Prev. 2018 Jul;19(4):195-199. doi: 10.1177/1757177418755308. Epub 2018 Feb 16.
To date, antimicrobials have been understood through largely biomedical perspectives. There has been a tendency to focus upon the effectiveness of pharmaceuticals within individual bodies. However, the growing threat of antimicrobial resistance demands we reconsider how we think about antimicrobials and their effects. Rather than understanding them primarily within bodies, it is increasingly important to consider their effects between bodies, between species and across environments. We need to reduce the drivers of antimicrobial resistance (AMR) at a global level, focusing on the connections between prescribing in one country and resistance mechanisms in another. We need to engage with the ways antimicrobials within the food chain will impact upon human healthcare. Moreover, we need to realise what happens within the ward will impact upon the environment (through waste water). In the future, imaginative interventions will be required that must make the most of biomedicine but draw equally across a wider range of disciplines (e.g. engineering, ecologists) and include an ever-increasing set of professionals (e.g. nurses, veterinarians and farmers). Such collective action demands a shift to working in new interdisciplinary, inter-professional ways. Mutual respect and understanding is required to enable each perspective to be combined to yield synergistic effects.
迄今为止,人们主要从生物医学角度来理解抗菌药物。一直以来都倾向于关注药物在个体体内的有效性。然而,日益增长的抗菌药物耐药性威胁要求我们重新思考我们对抗菌药物及其作用的看法。与其主要在个体体内去理解它们,越来越重要的是考虑它们在个体之间、物种之间以及不同环境中的作用。我们需要在全球层面减少抗菌药物耐药性(AMR)的驱动因素,关注一个国家的药物处方与另一个国家的耐药机制之间的联系。我们需要关注食物链中的抗菌药物将如何影响人类医疗保健。此外,我们需要认识到病房内发生的情况将对环境产生影响(通过废水)。未来,需要有富有想象力的干预措施,这些措施必须充分利用生物医学,但也要同样广泛地借鉴其他学科(如工程学、生态学)的知识,并纳入越来越多的专业人员(如护士、兽医和农民)。这种集体行动需要转变为以新的跨学科、跨专业方式开展工作。需要相互尊重和理解,以便将每个观点结合起来产生协同效应。