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抗微生物药物耐药性和后抗生素时代:亡羊补牢,为时未晚。

Antimicrobial resistance and the post antibiotic era: better late than never effort.

机构信息

Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte University, Deralakatte, Mangaluru, Karnataka, India.

出版信息

Expert Opin Drug Saf. 2021 Nov;20(11):1375-1390. doi: 10.1080/14740338.2021.1928633. Epub 2021 Jul 22.

Abstract

: Antimicrobial resistance (AMR) is a multi-layered problem with a calamitous impact on humans, livestock, the environment, and the biosphere. Initiatives and action plan to preclude AMR remain poorly implemented in India.: This review highlights essential factors contributing to AMR, epidemiology of the resistant bacteria, current treatment options, economic impact, and regulatory efforts initiated by the Indian government to tackle AMR.: Health-care professionals, hospitals, and the general public must understand and cooperatively implement the 'One Health approach,' which entails judicious use of antibiotics in humans, animals, and the environment. Neglecting the AMR problem predicts the expansion of the 'Post-antibiotic era' characterized by drying antibiotic discovery pipelines, overuse of 'Watch' and 'Reserve' groups, coupled with underuse of 'Access' antibiotics, increased daily defined doses, increased healthcare cost, rise in morbidity, mortality, and environmental degradation. The Indian case study elucidates a looming international crisis that demands global attention and commitment for envisaging and implementing locally relevant solutions.

摘要

抗微生物药物耐药性(AMR)是一个多层次的问题,对人类、牲畜、环境和生物圈都造成了灾难性的影响。印度在预防 AMR 的举措和行动计划方面执行不力。

本文重点介绍了导致 AMR 的重要因素、耐药细菌的流行病学、当前的治疗选择、经济影响以及印度政府为解决 AMR 而启动的监管工作。

医疗保健专业人员、医院和公众必须理解并共同实施“同一健康”方法,即在人类、动物和环境中合理使用抗生素。忽视 AMR 问题预示着“后抗生素时代”的到来,其特征是抗生素研发管道枯竭、“观察”和“储备”类抗生素过度使用,同时“准入”类抗生素使用不足,每日规定剂量增加,医疗保健费用增加,发病率、死亡率上升,以及环境恶化。印度的案例研究阐明了一个迫在眉睫的国际危机,需要全球关注和承诺,以制定和实施具有地方相关性的解决方案。

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