NATIONAL INFECTION PREVENTION AND CONTROL REFERENCE MANUAL FOR HEALTHCARE SERVICE PROVIDERS AND MANAGERS

Abstract

Critical aspects of the broader global response to AMR are efforts to minimize the emergence and transmission of resistance to drugs used to treat tuberculosis (TB), HIV, and malaria. The use and misuse of antimicrobials have led to the persistent expansion of AMR, thereby lowering the effectiveness of some of these drugs (e.g., chloroquine and penicillin). Resistance to the most commonly available antimicrobials requires the use of more expensive alternative regimens. Unfortunately, although resistance has created a demand for new treatment options, there has been a significant drop in the development of new antimicrobial agents in recent decades. This has compromised the ability of healthcare workers (HCWs) to treat infectious diseases and has increased healthcare costs. It is critical that necessary measures to respond to the resistance crisis be taken at all levels (by institutions and by local and national governments). Measures should include the rational use of antimicrobials through the incorporation of careful antimicrobial stewardship (AMS) activities and programs. Ultimately, improving antimicrobial use involves actions at the national level to guide treatment decisions made by informed HCWs and by the awareness and cooperation of patients. Although this chapter focuses on antibiotics, its recommendations can be applied to all antimicrobials (World Health Organization [WHO] 2015; WHO 2021).