Majumder Md Anwarul Azim, Rahman Sayeeda, Cohall Damian, Bharatha Ambadasu, Singh Keerti, Haque Mainul, Gittens-St Hilaire Marquita
Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados.
School of Medicine, American University of Integrative Sciences, Bridgetown, Barbados.
Infect Drug Resist. 2020 Dec 29;13:4713-4738. doi: 10.2147/IDR.S290835. eCollection 2020.
Antimicrobial resistance (AMR) is a serious threat to global public health. It increases morbidity and mortality, and is associated with high economic costs due to its health care burden. Infections with multidrug-resistant (MDR) bacteria also have substantial implications on clinical and economic outcomes. Moreover, increased indiscriminate use of antibiotics during the COVID-19 pandemic will heighten bacterial resistance and ultimately lead to more deaths. This review highlights AMR's scale and consequences, the importance, and implications of an antimicrobial stewardship program (ASP) to fight resistance and protect global health. Antimicrobial stewardship (AMS), an organizational or system-wide health-care strategy, is designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health. ASP has been very successful in promoting antimicrobials' appropriate use by implementing evidence-based interventions. The "One Health" approach, a holistic and multisectoral approach, is also needed to address AMR's rising threat. AMS practices, principles, and interventions are critical steps towards containing and mitigating AMR. Evidence-based policies must guide the "One Health" approach, vaccination protocols, health professionals' education, and the public's awareness about AMR.
抗菌药物耐药性（AMR）是对全球公共卫生的严重威胁。它会增加发病率和死亡率，并且由于其医疗负担而带来高昂的经济成本。多重耐药（MDR）细菌感染也对临床和经济结果有重大影响。此外，在新冠疫情期间抗生素的过度使用将加剧细菌耐药性，最终导致更多死亡。本综述强调了AMR的规模和后果、抗菌药物管理计划（ASP）对抗击耐药性和保护全球健康的重要性及影响。抗菌药物管理（AMS）是一种组织或全系统范围的医疗保健策略，旨在促进、改善、监测和评估抗菌药物的合理使用，以保持其未来的有效性，同时促进和保护公众健康。ASP通过实施循证干预措施，在促进抗菌药物的合理使用方面非常成功。应对AMR日益严重的威胁还需要“同一健康”方法，这是一种全面的多部门方法。AMS的实践、原则和干预措施是遏制和缓解AMR的关键步骤。循证政策必须指导“同一健康”方法、疫苗接种方案、卫生专业人员教育以及公众对AMR的认识。
