Role of every Stakeholders

Everyone plays a role in the fight against antimicrobial resistance. Understanding your role and how you, specifically, can contribute in the fight against antimicrobial resistance is the first step in combating it. Understand what it is you can do to help combat AMR, and take the pledge today. Every part and every role matters, and together our roles make a difference.

Understanding your role in detecting, reducing and preventing the development of antimicrobial resistance (AMR) is key to combating this growing threat. Once we realize how our actions can impact AMR, we can then take appropriate actions to stop and reduce the development and spread of AMR. Acknowledging that certain current clinical, industrial, agricultural and veterinary practices may directly or indirectly lead to AMR is key to resolving the problem. The proper stewardship of our vital drugs is indisputably the most immediate way AMR—and the high financial cost of AMR—can be curtailed and ultimately reduced. The key to curbing resistance is to ensure that every patient receives the right antibiotic at the right time at the right dose for the right duration.

No single role within the public health continuum can solve the monumental problem of antimicrobial resistance. To have a positive and lasting impact everyone must work in concert to curb the overuse and misuse of antimicrobial agents, with the goal to ultimately reduce the spread and rates of antimicrobial resistance. When varied groups work together, AMR reduction can happen and the results can be truly remarkable.

Healthcare Providers

  • Essential action items include the prompt initiation of infection control practices, when indicated, and the judicious use of antibiotics, including a commitment to prescribe the narrowest spectrum antibiotic that is consistent with good medical practice.
  • Establishment and use of an antimicrobial stewardship program is helpful in the latter, especially when clinical decision teams consist of treating physicians, pharmacists, clinical care staff and microbiologists. Frequent and timely communication of critical results among health care providers is essential to achieve the goals of stewardship.
  • The rapid exchange of information relating to test results (pathogens, antimicrobial susceptibility data) can have a profound impact on patient management. It is essential to share this information and any other findings that could result in appropriate antimicrobial escalation or de-escalation, switching from IV to oral therapy, or to discontinuation of some or all antibiotics. Failure to rapidly communicate these results can delay appropriate changes in antimicrobial therapy for hours or days, thereby potentially promoting the development of AMR and increasing the risk subsequence consequences of antimicrobial therapy.

Researchers

  • Continued public and private support of academic research is essential not only for the discovery and development of new antimicrobial agents, but additionally to understand the underlying host responses to infections; define alternative pathways to control infections; and develop new improved rapid diagnostic technologies.
  • Diagnostic technologies should not only detect the causative pathogen and its drug susceptibility profile, but identify host susceptibilities to infections, host response biomarkers and differentiate between types of infections, such as viral versus bacterial.

Public

  • The role of the general public or patient is to stay well informed about the issues of AMR. Antibiotics are often very necessary to treat infections, but not all infections.
  • Most respiratory infections (85%) are caused by viruses yet antibiotics are generally prescribed. Requesting antibiotics from your doctor for colds, the flu, and other viral infections will not help you fight these infections but can lead to the development or acquisition of drug resistant pathogens that could do the you harm in the future.
  • It is important that patients advocate for themselves, but do so intelligently. Don’t insist on antibiotics if the doctor tells you they will not help.
  • If you are prescribed antibiotics, take the complete course and never give antibiotics prescribed to you to someone else or take antibiotics prescribed for someone else.

Educator

  • Everyone needs to be educated and everyone in turn can be an educator; clinical care providers, laboratorians, public health administrators, government officials, advocacy groups, teachers and even the general public.
  • Education is everyone’s responsibility including the parent teaching their children to wash their hands and cover their cough.

Pharmacists

  • The pharmacist should be an essential member of the stewardship team, by interacting with the clinical team, not only in the dispensing of initial therapies, but also in developing therapeutic strategies that are appropriate, cost effective and tailored so as to reduce the risk for the development of AMR.
  • The key to curbing resistance is to ensure that every patient receives the right antibiotic at the right time at the right dose for the right duration.

Laboratory Professionals

  • The responsibility is to share this vital information with the appropriate caregivers as soon as possible so that the overuse or misuse of antimicrobials is limited to the briefest possible time interval.
  • Clinical laboratory scientists must serve as sentinels keeping watch on the emergence of resistance pathogens in our health care institutions, by providing critical yearly antibiograms that report resistance rates within their institutions and also individual units.
  • Laboratorians must work to prevent any delays in reporting antibiotic resistance or the discovery of potential outbreaks that could result in the spread or emergence of resistance pathogens.
  • Laboratory professionals must ensure their laboratory adapts quickly to the challenges faced by the emergence of new pathogens, increase resistance rates, novel resistance mechanisms, and provide the most accurate antimicrobial susceptibility testing.

Veterinary Professionals

  • Animal health professionals should prescribe the optimal antibiotics to the animals. Sub-therapeutic doses of antibiotics should not be given to animals prophylactically.
  • Antibiotics should not be used in animal feed to promote “larger, plumper” food products. Animal health professionals also play a key role in the surveillance of antibiotic-resistant zoonotic and animal pathogens.
  • They must be engaged in employing the newest diagnostic technologies that identify these pathogens and AMR quickly