Antimicrobial resistance is a global problem that needs long term solutions and major resource investments
The importance and scope of the problem of antimicrobial resistance (AMR) and its impact on human health have been increasingly recognised in the past decade, including by the World Health Organization1 and major national bodies such as the Centers for Disease Control and Prevention in the United States2 and the Department of Health in the United Kingdom.3 A 2016 report estimated that AMR would be responsible for 10 million excess deaths globally, and a cumulative cost of US$100 trillion by 2050 if current evolution and spread of the problem is not abated.4 Australia is not immune to these threats and some of the most pressing ones are highlighted in a review in this issue of the Journal.5 A recent study estimated that Australian hospitals spend an additional $11.3 million annually treating just two of our many AMR threats, such as ceftriaxone‐resistant Escherichia coli bloodstream infections and methicillin‐resistant Staphylococcus aureus (MRSA) infections.6 MRSA and vancomycin‐resistant enterococcus have been established in Australian hospitals for decades, and while some progress has been made in reducing MRSA infections, Australia has one of the highest rates of vancomycin‐resistant enterococcus infection in the world. We are increasingly faced with simple urinary tract infections that are untreatable with oral antibiotics, and cases of gonorrhoea that are essentially untreatable have also been reported. Australia is in the top 10% for per‐capita antibiotic consumption in the world,7 and almost one in two Australians is prescribed at least one course of antibiotics on the Pharmaceutical Benefits Scheme each year.8
- 1. World Health Organization. Global action plan on antimicrobial resistance. [WHA68.7; Agenda item 15.1]. WHO, 2015. http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_R7-en.pdf?ua=1 (viewed June 2019).
- 2. Centers for Disease Control and Prevention. Antibiotic/antimicrobial resistance (AR/AMR) [website]. Atlanta, GA: CDC, 2018. https://www.cdc.gov/drugresistance/index.html (viewed June 2019).
- 3. United Kingdom Department of Health and Social Care. UK 5‐year action plan for antimicrobial resistance, 2019 to 2024. London: Crown, 2019. https://www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2019-to-2024 (viewed June 2019).
- 4. O'Neill J. Tackling drug‐resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance, 2016. https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf (viewed June 2019).
- 5. Williamson DA, Howden BP, Paterson DL. The risk of resistance: what are the major antimicrobial resistance threats facing Australia? Med J Aust 2019; 211: 103–105.
- 6. Wozniak TM, Bailey EJ, Graves N. Health and economic burden of antimicrobial‐resistant infections in Australian hospitals: a population‐based model. Infect Control Hosp Epidemiol 2019; 40: 320–327.
- 7. Van Boeckel TP, Gandra S, Ashok A, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis 2014; 14: 742–750.
- 8. Pharmaceutical Benefits Scheme Drug Utilisation Sub‐committee. Antibiotics: PBS/RPBS utilisation, 2015. http://www.pbs.gov.au/industry/listing/participants/public-release-docs/antibiotics/antibiotics-dusc-prd-02-2015.pdf (viewed June 2019).
- 9. Cheng AC, Turnidge J, Collignon P, et al. Control of fluoroquinolone resistance through successful regulation, Australia. Emerg Infect Dis 2012; 18: 1453–1560.
- 10. Australian Government. Antimicrobial Resistance Strategy; objective 7: governance [website]. Canberra: Commonwealth of Australia, 2018. https://www.amr.gov.au/australias-response/objective-7-governance; (viewed June 2019).
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