scholarly journals Optimising the use of antimicrobial medicines in Sudan

2021 ◽  
Vol 6 (1) ◽  

Antimicrobial resistance (AMR) has been a priority area identified by the Government of Sudan and development partners. This paper is part of a study in Sudan using the available documents covering relevant fields pertaining to AMR and interviews with key informants from World Health Organization (WHO) office Sudan, Federal Ministry of Health and other relevant entities. Documents were obtained from related websites for policies, strategies, guidelines, reports, and plans as well relevant international and government agencies in Khartoum. The study was guided by the WHO’s five strategic objectives of Global Action Plan on Antimicrobial Resistance. This paper focuses on the fourth objective on optimising the use of antimicrobial medicines in human health and animal health. The study revealed the presence of numerous policies and guidelines on antibiotic use and generic prescribing at different levels with little evidence of their implementation. There were a lack of supervisory or monitoring systems to ensure proper and rational prescribing, and appropriate dispensing of antimicrobials in both public and private sectors. The system is weakened due to low capacity for monitoring and checking as a result of limited resources both in terms of human resources, skills, tools and quality checks to ensure the quality of medicines post-marketing. There is a need to set up a quality management system within the existing structures for the distribution, prescription and dispensing of antibiotics in both public and private institutions. The system should clearly define the processes and provide adequate resources to ensure appropriate monitoring and control of antibiotic distribution, prescription and dispensing

2021 ◽  
Vol 26 (4) ◽  
Author(s):  
Rodolphe Mader ◽  
Peter Damborg ◽  
Jean-Philippe Amat ◽  
Björn Bengtsson ◽  
Clémence Bourély ◽  
...  

Antimicrobial resistance (AMR) should be tackled through a One Health approach, as stated in the World Health Organization Global Action Plan on AMR. We describe the landscape of AMR surveillance in the European Union/European Economic Area (EU/EEA) and underline a gap regarding veterinary medicine. Current AMR surveillance efforts are of limited help to veterinary practitioners and policymakers seeking to improve antimicrobial stewardship in animal health. We propose to establish the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet) to report on the AMR situation, follow AMR trends and detect emerging AMR in selected bacterial pathogens of animals. This information could be useful to advise policymakers, explore efficacy of interventions, support antimicrobial stewardship initiatives, (re-)evaluate marketing authorisations of antimicrobials, generate epidemiological cut-off values, assess risk of zoonotic AMR transmission and evaluate the burden of AMR in animal health. EARS-Vet could be integrated with other AMR monitoring systems in the animal and medical sectors to ensure a One Health approach. Herein, we present a strategy to establish EARS-Vet as a network of national surveillance systems and highlight challenges of data harmonisation and bias. Strong political commitment at national and EU/EEA levels is required for the success of EARS-Vet.


2015 ◽  
Vol 370 (1670) ◽  
pp. 20140082 ◽  
Author(s):  
Laura J. Shallcross ◽  
Simon J. Howard ◽  
Tom Fowler ◽  
Sally C. Davies

Antibiotics underpin all of modern medicine, from routine major surgery through to caesarean sections and modern cancer therapies. These drugs have revolutionized how we practice medicine, but we are in a constant evolutionary battle to evade microbial resistance and this has become a major global public health problem. We have overused and misused these essential medicines both in the human and animal health sectors and this threatens the effectiveness of antimicrobials for future generations. We can only address the threat of antimicrobial resistance (AMR) through international collaboration across human and animal health sectors integrating social, economic and behavioural factors. Our global organizations are rising to the challenge with the recent World Health Assembly resolution on AMR and development of the Global Action plan but we must act now to avoid a return to a pre-antibiotic era.


Livestock ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 176-179
Author(s):  
Chris Lloyd

The Responsible Use of Medicines in Agriculture Alliance (RUMA) was established to promote the highest standards of food safety, animal health and animal welfare in the British livestock industry. It has a current focus to deliver on the Government objective of identifying sector-specific targets for the reduction, refinement or replacement of antibiotics in animal agriculture. The creation and roll out of sector specific targets in 2017 through the RUMA Targets Task Force, has helped focus activity across the UK livestock sectors to achieve a 50% reduction in antibiotic use since 2014. This has been realised principally through voluntary multi-sector collaboration, cross sector initiatives, codes of practice, industry body support and farm assurance schemes. This article provides an overview of RUMA's work to date providing insight into the methods used to create the targets, why they are so important, the impact they are having and how ongoing support and robust data are vital components in achieving the latest set of targets.


2018 ◽  
Vol 23 (42) ◽  
Author(s):  
Hyukmin Lee ◽  
Eun-Jeong Yoon ◽  
Dokyun Kim ◽  
Seok Hoon Jeong ◽  
Jong Hee Shin ◽  
...  

Surveillance plays a pivotal role in overcoming antimicrobial resistance (AMR) in bacterial pathogens, and a variety of surveillance systems have been set up and employed in many countries. In 2015, the World Health Organization launched the Global Antimicrobial Resistance Surveillance System (GLASS) as a part of the global action plan to enhance national and global surveillance and research. The aims of GLASS are to foster development of national surveillance systems and to enable collection, analysis and sharing of standardised, comparable and validated data on AMR between different countries. The South Korean AMR surveillance system, Kor-GLASS, is compatible with the GLASS platform and was established in 2016 and based on the principles of representativeness, specialisation, harmonisation and localisation. In this report, we summarise principles and processes in order to share our experiences with other countries planning to establish a national AMR surveillance system. The pilot operation of Kor-GLASS allowed us to understand the national burden of specific infectious diseases and the status of bacterial AMR. Issues pertaining to high costs and labour-intensive operation were raised during the pilot, and improvements are being made.


Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 453
Author(s):  
Usman O. Adekanye ◽  
Abel B. Ekiri ◽  
Erika Galipó ◽  
Abubakar Bala Muhammad ◽  
Ana Mateus ◽  
...  

Antimicrobial resistance (AMR) is a global health concern and the inappropriate use of antibiotics in animals and humans is considered a contributing factor. A cross-sectional survey to assess the knowledge, attitudes and practices of veterinarians regarding AMR and antimicrobial stewardship was conducted in Nigeria. A total of 241 respondents completed an online survey. Only 21% of respondents correctly defined the term antimicrobial stewardship and 59.8% were unaware of the guidelines provided by the Nigeria AMR National Action Plan. Over half (51%) of the respondents indicated that prophylactic antibiotic use was appropriate when farm biosecurity was poor. Only 20% of the respondents conducted antimicrobial susceptibility testing (AST) frequently, and the unavailability of veterinary laboratory services (82%) and the owner’s inability to pay (72%) were reported as key barriers to conducting AST. The study findings suggest strategies focusing on the following areas may be useful in improving appropriate antibiotic use and antimicrobial stewardship among veterinarians in Nigeria: increased awareness of responsible antimicrobial use among practicing and newly graduated veterinarians, increased dissemination of regularly updated antibiotic use guidelines, increased understanding of the role of good biosecurity and vaccination practices in disease prevention, and increased provision of laboratory services and AST at affordable costs.


2019 ◽  
Vol 5 (3) ◽  
pp. eaau9124 ◽  
Author(s):  
Katariina M. M. Pärnänen ◽  
Carlos Narciso-da-Rocha ◽  
David Kneis ◽  
Thomas U. Berendonk ◽  
Damiano Cacace ◽  
...  

Integrated antibiotic resistance (AR) surveillance is one of the objectives of the World Health Organization global action plan on antimicrobial resistance. Urban wastewater treatment plants (UWTPs) are among the most important receptors and sources of environmental AR. On the basis of the consistent observation of an increasing north-to-south clinical AR prevalence in Europe, this study compared the influent and final effluent of 12 UWTPs located in seven countries (Portugal, Spain, Ireland, Cyprus, Germany, Finland, and Norway). Using highly parallel quantitative polymerase chain reaction, we analyzed 229 resistance genes and 25 mobile genetic elements. This first trans-Europe surveillance showed that UWTP AR profiles mirror the AR gradient observed in clinics. Antibiotic use, environmental temperature, and UWTP size were important factors related with resistance persistence and spread in the environment. These results highlight the need to implement regular surveillance and control measures, which may need to be appropriate for the geographic regions.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Louise Munkholm ◽  
Olivier Rubin

Abstract Background Antimicrobial resistance (AMR) is a growing problem worldwide in need of global coordinated action. With the endorsement of the Global Action Plan (GAP) on AMR in 2015, the 194 member states of the World Health Organization committed to integrating the five objectives and corresponding actions of the GAP into national action plans (NAPs) on AMR. The article analyzes patterns of alignment between existing NAPs and the GAP, bringing to the fore new methodologies for exploring the relationship between globally driven health policies and activities at the national level, taking income, geography and governance factors into account. Methods The article investigates the global governance of AMR. Concretely, two proxies are devised to measure vertical and horizontal alignment between the GAP and existing NAPs: (i) a syntactic indicator measuring the degree of verbatim overlap between the GAP and the NAPs; and (ii) a content indicator measuring the extent to which the objectives and corresponding actions outlined in the GAP are addressed in the NAPs. Vertical alignment is measured by the extent to which each NAP overlaps with the GAP. Horizontal alignment is explored by measuring the degree to which NAPs overlap with other NAPs across regions and income groups. In addition, NAP implementation is explored using the Global Database for Antimicrobial Resistance Country Self-Assessment. Findings We find strong evidence of vertical alignment, particularly among low-income countries and lower-middle-income countries but weaker evidence of horizontal alignment within regions. In general, we find the NAPs in our sample to be mostly aligned with the GAP’s five overarching objectives while only moderately aligned with the recommended corresponding actions. Furthermore, we see several cases of what can be termed ‘isomorphic mimicry’, characterized by strong alignment in the policies outlined but much lower levels of alignment in terms of actual implemented policies. Conclusion To strengthen the alignment of national AMR policies, we recommend global governance initiatives based on individualized responsibilities some of which should be legally binding. Our study provides limited evidence of horizontal alignment within regions, which implies that regional governance institutions (e.g., WHO regional offices) should primarily act as mediators between global and local demands to strengthen a global governance regime that minimizes policy fragmentation and mimicry behavior across member states.


2017 ◽  
Vol 15 (2) ◽  
pp. 175-184 ◽  
Author(s):  
Susanne Wuijts ◽  
Harold H. J. L. van den Berg ◽  
Jennifer Miller ◽  
Lydia Abebe ◽  
Mark Sobsey ◽  
...  

Clinically relevant antimicrobial resistant bacteria, genetic resistance elements, and antibiotic residues (so-called AMR) from human and animal waste are abundantly present in environmental samples. This presence could lead to human exposure to AMR. In 2015, the World Health Organization (WHO) developed a Global Action Plan for Antimicrobial Resistance with one of its strategic objectives being to strengthen knowledge through surveillance and research. With respect to a strategic research agenda on water, sanitation and hygiene and AMR, WHO organized a workshop to solicit input by scientists and other stakeholders. The workshop resulted in three main conclusions. The first conclusion was that guidance is needed on how to reduce the spread of AMR to humans via the environment and to introduce effective intervention measures. Second, human exposure to AMR via water and its health impact should be investigated and quantified, in order to compare with other human exposure routes, such as direct transmission or via food consumption. Finally, a uniform and global surveillance strategy that complements existing strategies and includes analytical methods that can be used in low-income countries too, is needed to monitor the magnitude and dissemination of AMR.


2018 ◽  
Vol 33 (4) ◽  
pp. 114-117
Author(s):  
Olga Perovic ◽  
Husna Ismail ◽  
Erika Van Schalkwyk ◽  
Warren Lowman ◽  
Elizabeth Prentice ◽  
...  

Aim: The relevance of surveillance for antimicrobial resistance is increasingly recognised in the light of a global action plan to combat resistance. This report presents antimicrobial susceptibility testing on ESKAPE pathogens from private sector laboratories in South Africa for 2016.Methods: Antimicrobial susceptibility testing (AST) performed on ESKAPE organisms (Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae and Escherichia coli) isolated from blood cultures at four private pathology laboratories in 2016 were analysed. Analysis and reporting of data were done via a uniform platform created by the NICD for national AST data.Results: AST were reported on 9 029 ESKAPE organisms including 58% Enterobacteriaceae, 28% Gram-positive bacteria and 14% Gram-negative bacteria and drug-bug combination was performed following the Global Antimicrobial Surveillance System (GLASS) guidelines by the World Health Organization.Conclusions: The most important resistance to address is a high level of ESBL in Enterobacteriaceae, which necessitates the use of carbapenems for treatment. Resistance to carbapenems is recorded in this report but not confirmation of genes by genotypic methods. During this period, no increase in vancomycin-resistant Enterococci was observed.


Author(s):  
Doaa Saleh ◽  
Rana Abu Farha ◽  
Tareq Mukattash ◽  
Muna Barakat ◽  
Eman Alefishat

The Center for Disease Control and Prevention and the World Health Organization issued a practical approach and Global Action Plan to control the threatening emerging antibacterial resistance. One of the main basis of this plan is the Antimicrobial Stewardship Program (ASPs). This study aimed to evaluate community pharmacists’ awareness and perception towards antimicrobial resistance and ASPs in Jordan. Thus, a qualitative study was conducted through in-depth interviews with twenty community pharmacists. Convienience sampling was used in the study. Qualitative analysis of the data yielded four themes and eleven sub-themes. All the respondents showed good understanding about the causes of antimicrobial resistance. The most important causes reported by them was the non-restricted prescription of antimicrobials. Most of the pharmacists believed that they are competent to provide ASPs, however, they believed that there are several barriers against the implementation of ASPs in community pharmacies in Jordan. Barriers demonstrated by the pharmacists, including organizational obstacles, resources obstacles, and personal obstacles. As a conclusion, this study revealed several barriers against the implementation of ASPs in community pharmacies in Jordan. Incorporating ASPs in the community pharmacy settings requires proper pharmacist training, several academic disciplines team efforts, and good pharmacy practice of antimicrobial guidelines.


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