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They are working with more than 50 hospitals throughout the country, sharing best practices that will allow PAST to be performed and medical records updated. In a grant-funded study, Bland and Jones found that PAST done on patients who believed that they were allergic to penicillin -- the most effective antibiotic available with the least side effects -- demonstrated no real allergy. These research findings were published in Open Forum Infectious Diseases. The duo worked with nurses at Candler Hospital and found that skin testing can be done safely in a community hospital setting. When skin testing was performed at the hospital by trained nurses, 98 out of 100 patients in the study who had a penicillin allergy on their medical record were deemed not be allergic to the antibiotic. This allowed for an immediate change to a penicillin type antibiotic for most patients, which is often safer and cheaper, improves outcomes and reduces adverse effects, the goal of the federal antimicrobial stewardship program requiring hospitals to ensure that antibiotics are used only when necessary. In addition to the public health benefit, Bland estimated that health care savings would be in the tens of millions of dollars annually if patients could be switched back to penicillin from more costly antibiotic treatments. The study at Candler Hospital found an average cost savings of $350 a patient, which includes the cost of the skin test. "Our goal is that every penicillin allergy is questioned and reconciled, with most coming off medical records and allowing patients to get the best antibiotic for their particular infection, which is often a penicillin." Antibiotic resistance. Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change in response to the use of these medicines. Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria. Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality. The world urgently needs to change the way it prescribes and uses antibiotics. Even if new medicines are developed, without behaviour change, antibiotic resistance will remain a major threat. Behaviour changes must also include actions to reduce the spread of infections through vaccination, hand washing, practising safer sex, and good food hygiene. Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases. A growing list of infections – such as pneumonia, tuberculosis, blood poisoning, gonorrhoea, and foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective. Where antibiotics can be bought for human or animal use without a prescription, the emergence and spread of resistance is made worse. Similarly, in countries without standard treatment guidelines, antibiotics are often over-prescribed by health workers and veterinarians and over-used by the public. Without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill. Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as poor infection prevention and control. Steps can be taken at all levels of society to reduce the impact and limit the spread of resistance. To prevent and control the spread of antibiotic resistance, individuals can: Only use antibiotics when prescribed by a certified health professional. Never demand antibiotics if your health worker says you don’t need them. Always follow your health worker’s advice when using antibiotics. Prevent infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date. Prepare food hygienically, following the WHO Five Keys to Safer Food (keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials) and choose foods that have been produced without the use of antibiotics for growth promotion or disease prevention in healthy animals. To prevent and control the spread of antibiotic resistance, policy makers can: Ensure a robust national action plan to tackle antibiotic resistance is in place. Improve surveillance of antibiotic-resistant infections. Strengthen policies, programmes, and implementation of infection prevention and control measures. Regulate and promote the appropriate use and disposal of quality medicines. Make information available on the impact of antibiotic resistance. To prevent and control the spread of antibiotic resistance, health professionals can: Prevent infections by ensuring your hands, instruments, and environment are clean. Only prescribe and dispense antibiotics when they are needed, according to current guidelines. Report antibiotic-resistant infections to surveillance teams. Talk to your patients about how to take antibiotics correctly, antibiotic resistance and the dangers of misuse. Talk to your patients about preventing infections (for example, vaccination, hand washing, safer sex, and covering nose and mouth when sneezing). To prevent and control the spread of antibiotic resistance, the health industry can: Invest in research and development of new antibiotics, vaccines, diagnostics and other tools. To prevent and control the spread of antibiotic resistance, the agriculture sector can: Only give antibiotics to animals under veterinary supervision. Not use antibiotics for growth promotion or to prevent diseases in healthy animals. Vaccinate animals to reduce the need for antibiotics and use alternatives to antibiotics when available. Promote and apply good practices at all steps of production and processing of foods from animal and plant sources. Improve biosecurity on farms and prevent infections through improved hygiene and animal welfare. While there are some new antibiotics in development, none of them are expected to be effective against the most dangerous forms of antibiotic-resistant bacteria. Given the ease and frequency with which people now travel, antibiotic resistance is a global problem, requiring efforts from all nations and many sectors. When infections can no longer be treated by first-line antibiotics, more expensive medicines must be used. A longer duration of illness and treatment, often in hospitals, increases health care costs as well as the economic burden on families and societies. Antibiotic resistance is putting the achievements of modern medicine at risk. Organ transplantations, chemotherapy and surgeries such as caesarean sections become much more dangerous without effective antibiotics for the prevention and treatment of infections. Tackling antibiotic resistance is a high priority for WHO. A global action plan on antimicrobial resistance, including antibiotic resistance, was endorsed at the World Health Assembly in May 2015. The global action plan aims to ensure prevention and treatment of infectious diseases with safe and effective medicines. The “Global action plan on antimicrobial resistance” has 5 strategic objectives: To improve awareness and understanding of antimicrobial resistance. To ensure sustainable investment in countering antimicrobial resistance. A political declaration endorsed by Heads of State at the United Nations General Assembly in New York in September 2016 signaled the world’s commitment to taking a broad, coordinated approach to address the root causes of antimicrobial resistance across multiple sectors, especially human health, animal health and agriculture. WHO is supporting Member States to develop national action plans on antimicrobial resistance, based on the global action plan. WHO has been leading multiple initiatives to address antimicrobial resistance: World Antimicrobial Awareness Week. Held annually since 2015, WAAW is a global campaign that aims to increase awareness of antimicrobial resistance worldwide and to encourage best practices among the general public, health workers and policy makers to avoid the further emergence and spread of drug-resistant infections. Antimicrobials are critical tools in helping to fight diseases in humans, animals and plants. They include antibiotics, antivirals, antifungals and antiprotozoa. WAAW takes place every year from 18 to 24 November. The slogan has previously been, “Antibiotics: Handle with Care” but changed to “Antimicrobials: Handle with Care” in 2020 to reflect the broadening scope of drug resistant infections. The Global Antimicrobial Resistance Surveillance System (GLASS) The WHO-supported system supports a standardized approach to the collection, analysis and sharing of data related to antimicrobial resistance at a global level to inform decision-making, drive local, national and regional action. Global Antibiotic Research and Development Partnership (GARDP) A joint initiative of WHO and Drugs for Neglected Diseases initiative (DNDi), GARDP encourages research and development through public-private partnerships. By 2023, the partnership aims to develop and deliver up to four new treatments, through improvement of existing antibiotics and acceleration of the entry of new antibiotic drugs. Interagency Coordination Group on Antimicrobial Resistance (IACG) The United Nations Secretary-General has established IACG to improve coordination between international organizations and to ensure effective global action against this threat to health security. The IACG is co-chaired by the UN Deputy Secretary-General and the Director General of WHO and comprises high level representatives of relevant UN agencies, other international organizations, and individual experts across different sectors.
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