ICAAP12 Secretariat
Partners in population and development, Dhaka, Bangladesh June 2016
World's largest Science, Technology & Medicine Open Access book publisher
Chapter 7 from the book People's Movements in the 21st Century - Risks, Challenges and Benefits
South Africa has faced many challenges over the past two decades, accomplishing profound positive changes in the social structure and government of
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the nation. This has not yet fully translated into better health for the population, however, particularly the poorest segment. In fact, the population has lost ground since the 1990s in virtually all important health indicators, leaving South Africa with a high burden of infectious disease.
August 2011, Vol. 101, No. 8 SAMJ
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Objective: To review the effectiveness of antibiotic stewardship interventions in hospitals in low- and middle-income countries.
National Tuberculosis Control Program; Mycobacterial Disease Control National AIDS/STD Program
Amsterdam, the Netherlands, 23 July 2018
Meeting Report
Vanquishing violence and vulnerability in humanitarian settings
Background paper for the joint African Union–UNAIDS (in capacity of serving
Chair of H6) high-level side event at the 73rd Unite
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d Nations General Assembly,
24 September 2018, at UNHQ, Conference Room 3
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These Guidelines on prudent use of antimicrobials in human health are based on a technical report prepared by the European Centre for Disease Preve
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ntion and Control (ECDC) with input from EU Member States experts and stakeholders, which should be referred to for details of the methodology used in creating the guidelines as well as for additional references
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Confronted with the important issue of patient safety, in 2002 the Fifty-fifth World Health Assembly adopted a resolution urging countries to pay the
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closest possible attention to the problem and to strengthen safety and monitoring systems. In May 2004, the Fifty-seventh World Health Assembly approved the creation of an international alliance as a global initiative to improve patient safety. The World Alliance for Patient Safety was launched in October 2004 and currently has its place in the WHO Patient Safety programme included in the Information, Evidence and Research Cluster.
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The authors conduct an integrated survey of Antimicrobial Resistant Organisms (AMR) in drinking water, wastewater and surface water in three settings in Bangladesh: rural households, rural poultry f
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arms, and urban food markets. Results show that untreated water discharged from rural households, poultry farms and urban markets are major contributors to surface water pollution and antibiotic resistant bacteria genes, calling for increased surveillance and monitoring.
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The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some
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of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
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The era of effective antibiotics is coming to a close. In just a few generations, many “miracle medicines”have been beaten into ineffectiveness by the bacteria they were i
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ntended to eradicate. Bacteria quickly adapt to the presence of antibacterial agents in order to survive. The misuse of antibiotics,which is an international problem, only exacerbates the steady evolution of resistance. In August 2010, the journal Lancet Infectious Diseases posed the question "Is this the end of antibiotics?" documentingthe rapid spread of multidrug-resistant bacteriaand predicting that 10 years remain in the useful life of many agents.
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This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements.
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The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and critical access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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The guidelines are to be used to guide the management of adults with lower respiratory tract infection (LRTI). As will be seen in the following tex
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t, this diagnosis, and the other clinical syndromes within this grouping, can be difficult to make accurately. In the absence of agreed definitions of these syndromes these guidelines are to be used when, in the opinion of a clinician, an LRTI syndrome is present. The following are put forward as def-initions to guide the clinician, but it will be seen in the ensuingtext that some of these labels will always be inaccurate. These definitions are pragmatic and based on a synthesis of available studies. They are primarily meant to be simple to apply in clinical practice, and this might be at the expense of scientific accuracy. These definitions are not mutually exclusive, with lower respiratory tract infection being an umbrella term that includes all others, which can also be used for cases that cannot be classified into one of the other groups. No new evidence has been identified that would lead to a change in the clinical definitions,which are therefore unchanged from the 2005 publication.
Clin Microbiol Infect 2011;17(Suppl. 6): 1–24 The full version of these guidelines can be found on Wiley Online Library.
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Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for opt
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imizing antimicrobial use, termed “antimicrobial stewardship” (AMS). Stewardship has since been applied in the context of governance of the health sector as a whole, taking responsibility for the health and well-being of the population and guiding health systems at the national and global level.
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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
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the burden of antibiotic resistance while 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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