International Perspectives and Future Directions
African Journal of Laboratory Medicine | Vol 7, No 2 | a770 | 06 December 2018
The Infection Prevention and Control (IPC) Assessment Framework (IPCAF) is a tool to support the implementation of the World Health Organization (WHO) Guidelines on core components of IPC programmes at the acute health care facility level. The user should be familiar with the contents of these guide...lines, including the Interim practical manual supporting the implementation of the IPC core components at the facility level before using this tool. The IPCAF is a systematic tool that can provide a baseline assessment of the IPC programme and activities within a health care facility, as well as ongoing evaluations through repeated administration to document progress over time and facilitate improvement.
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This guideline provides advice in regards to applications for Marketing Authorisations for antimicrobial veterinary medicinal products (VMPs) on the data required and the methodology to be used for performing an assessment of the risk to public health from antimicrobial resistance (AMR) due to use o...f the product. The scope of the guidance extends to VMPs intended for food producing species and to the transmission of AMR by the foodborne route or through direct contact with treated animals.
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Guía práctica para mejorar la calidad de la atención mediante los servicios de agua, saneamiento e higiene en los establecimientos de salud
Guide pratique pour l'amélioration de la qualité des soins grâce à de meilleurs services d'eau, d'assainissement et d'hygiène dans les établissements de santé
Antibiotic Stewardship (AS) is a coordinated program that promotes the appropriate use of antimicrobials to improve patient outcomes, reduce microbial resistance, and decrease the spread of multi-drug resistant organisms. In clinical settings, stewardship activities focus on measuring and improving ...how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro...bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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The WHO CIA List should be used as a reference to help formulate and prioritize risk assessment and risk management strategies for containing antimicrobial resistance. The WHO CIA List supports strategies to mitigate the human health risks associated with antimicrobial use in ...food-producing animals and has been used by both public and private sector organizations. The list helps regulators and stakeholders know which types of antimicrobials used in animals present potentially higher risks to human populations and how use of antimicrobials might be managed to minimize antimicrobial resistance of medical importance. The use of the WHO CIA List, in conjunction with the OIE list of antimicrobials of veterinary importance (1) and the WHO Model Lists of Essential Medicines (2) , will allow for prioritization of risk management strategies in the human sector, the food animal sector, inagriculture (crops) and horticulture, through a coordinated multisectoral One Health approach.
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WHO CIA list categorizes all antimicrobials used in human medicine into 3 groups based on their importance to human medicine. The current scope is limited to antibacterial drugs of which most are also used in veterinary medicine. The list assists in man...aging antimicrobial resistance, ensuring that all, especially critically important antimicrobials, are used prudently both in human and veterinary medicine
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La lista OMS de AIC categoriza la totalidad de los antimicrobianos utilizados en el ser humano en tres grupos en función de su importancia para la medicina humana. Por el momento se limita a los fármacos antibacterianos, muchos de los cuales también se utilizan en la medicina v...eterinaria.El objetivo de la lista es contribuir a gestionar la resistencia a los antimicrobianos y garantizar que todos los antimicrobianos, sobre todo los de importancia crítica, se utilicen de forma prudente en la medicina tanto humana como veterinaria.
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La liste CIA de l’OMS catégorise tous les antimicrobiens utilisés en médecine humaine en 3 groupes, selon leur importance pour la médecine humaine. Elle se limite actuellement aux médicaments antibactériens, dont la plupart sont également employés en médecine vété...rinaire.Cette liste est destinée à aider à la gestion de la résistance bactérienne, en veillant à ce que l’ensemble des antimicrobiens, surtout ceux d’importance critique, sont utilisés prudemment aussi bien en médecine humaine qu’en médecine vétérinaire.
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A regional guide for governments in Asia and the Pacific to review, update and develop policies to address antimicrobial resistance and antimicrobial use in animal production
Using antimicrobials responsibly is an essential component ofefforts to contain antimicrobial resistance (AMR), and to ensurethat patients receive appropriate treatment. The WHO global action plan on AMR emphasizes the importance of training healthcare professionals in antimicrobial prescribing and ...stew-ardship (AMPS). There are several challenges, however, such asthe wide range of healthcare professionals involved in the pre-scribing process, and the heterogeneity of prescribing rights and practices of different professional groups within and between countries. One way to address these challenges is through developing competencies, which define the minimum standards that all antimicrobial prescribers should reach.
Clinical Microbiology and Infection 25 (2019) 13e19
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A guide for practical implementation in adult and pediatric emergency department and urgent care settings
Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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This small scale project aimed to optimize antibiotic prescriptions for Urinary Tract Infections (UTI) at Okhaldhunga Community Hospital in Nepal. A review of 18 months data from urine cultures taken in the hospital was completed in 2017. Presentations about antibiotic resistance, the local bacteria...l culture results and possible ways of changing prescription pattern were given for doctors, lab staff and community medical assistants (CMA). 16 months later the prescription rate of antibiotics frequently used for UTIs was followed up, with a 57% reduction of ciprofloxacin consumption!
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The global emergence of antimicrobial resistance (AMR) is posing a threat to human health. Putting resources into the containment of AMR – including surveillance – is one of the highest-yield investments a country can make to mitigate its impact. In 2015, WHO launched the Global Antimicrobial Re...sistance Surveillance System (GLASS), the first global collaborative effort to foster AMR surveillance in bacteria causing acute infections. As of December 2018, 71 countries are enrolled in GLASS. The aim of this report is to document participation efforts and outcomes across these countries, and highlight differences and constraints identified to date. This report follows on from the first GLASS Report – Early implementation 2016-17, published in January 2018, and drawing on data from GLASS first data call in 2017.
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Event-based surveillance (EBS) is defined as the organized collection, monitoring, assessment and interpretation of mainly unstructured ad hoc information regarding health events or risks, which may represent an acute risk to health. Both indicator-based and event-based surveillance components serve... the early warning and response (EWAR) function of the public health surveillance system. The Framework for Event-based Surveillance offers guidance to public health practitioners seeking to implement EBS at each administrative level in their countries.
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La surveillance basée sur les événements est définie comme la collecte, le suivi, l'évaluation et l'interprétation organisés d'informations ponctuelles non structurées concernant des événements ou des risques de santé, qui peuvent représenter un risque aigu pour la santé. Les composant...es de surveillance axées sur les indicateurs et sur les événements servent à la fonction d'alerte précoce et de réponse du système de surveillance de la santé publique. Le cadre de la surveillance axée sur les événements offre des conseils aux praticiens de la santé publique qui cherchent à mettre en œuvre une surveillance axée sur les événements à chaque niveau administratif de leur pays.
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