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30 January 1998
EXECUTIVE BOARD CALLS FOR WORK
AGAINST ANTIMICROBIAL RESISTANCE
TO BE STEPPED UP
Antimicrobial resistance - the resistance of pathogenic microbes to treatment by antibiotics - has increased drastically in recent years. The increased resistance to these last-line-of-defence drugs is rapidly becoming a leading cause of concern for public health.
Moreover, resistance is a world problem, affecting developed and developing countries and being spread through international travel. Treatment of resistant infections is increasingly hampered either by the prohibitive cost of existing "new generation" agents or by a total lack of effective antimicrobial agents.
Noting this, the 101st session of the Executive Board of the World Health Organization (WHO) urged Member States and WHO to step up their efforts to control the growing resistance to these drugs.
The Executive Board requested WHO's Director-General, among other tasks, to: increase support to countries in their efforts to control antimicrobial resistance; assist in the development of sustainable national policies for rational antimicrobial use; develop information systems to gather and share data on resistance in specific pathogens and the usage of antimicrobials; and promote the research and development of new antimicrobial agents.
The Executive Board also urged Member States to: develop surveillance and monitoring systems for the detection of antimicrobial-resistant pathogens; develop educational programmes on the appropriate use of antimicrobial agents; improve practices to prevent the spread of infection and thereby the spread of resistant pathogens; strengthen legislation to counter the manufacture, sale and distribution of counterfeit antimicrobials; and take measures to control the dispensing of antimicrobials and their use both in food production and animal husbandry.
Some of the infections which are most affected by antimicrobial resistance include acute respiratory infections (ARI), bacterial meningitis, diarrhoea and bacterial dysentery, gonorrhoea, hospital-acquired infections, tuberculosis, malaria, intestinal helminth infections and HIV.
The prevalence of antimicrobial resistance varies greatly between and within countries and between different pathogens. Some examples of ranges in prevalence for bacterial infections include: ARI and bacterial meningitis: 12-55% penicillin resistance in Streptococcus pneumoniae; Bacterial dysentery: 10-90% ampicillin and 5-95% cotrimoxazole resistance in Shigella; Gonorrhoea: 5-98% penicillin resistance in Neisseria gonorrhoeae; Hospital-acquired infection: greater than 30% methicillin resistance (multiresistance) in Staphylococcus aureus; Tuberculosis: 2-40% primary drug resistance.
As of today, very few countries have effective national surveillance of resistance. A large number of surveillance projects exist but they are variable in the quality of data generated, there is no coordination between them (even within individual countries) and the data generated are rarely translated into actions which influence policy on antibiotic use. For patients to receive optimal treatment for their infections, doctors need up-to-date information on the prevalence of resistance.
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For further information, please contact Gregory Hartl, Health Communications and public Relations , WHO, Geneva. Telephone (+41 22) 791 4458. Fax (+41 22) 791 4859. Email hartlg@who.ch
All WHO Press Releases, Fact Sheets and features as well as other information on this subject can be obtained on the Internet on the WHO home page at http://www.who.ch/ .
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