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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 optimizing antimicrobial use, termed “antimicrobial stewardship” (AMS). Stewardship has since be
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en 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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This book provides significantly expanded content and experience in relation to a broader stewardship context- for example, stewardship in specific populations, different countries as well as the role of different professions in stewardship to political and media engagement. We hope this book has so
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mething to offer everyone practicing in this area. Therefore, The British Society for Antimicrobial Chemotherapy [BSAC] in collaboration with ESGAP are very pleased to present this e-book on Global Antimicrobial Stewardship that is relevant to health care professions working in preventing and managing infection across the healthcare communities and health care facilities. It aims to support health care professionals, or teams, or policy makers interested in learning about bringing the principles of stewardship to the bed side
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This guideline covers making people aware of how to correctly use antimicrobial medicines (including antibiotics) and the dangers associated with their overuse and misuse. It also includesmeasures to prevent and control infection that can stop people needing antimicrobials or spreadinginfection to o
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thers. It aims to change people's behaviour to reduce antimicrobial resistance and thespread of resistant microbes.
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Updated with information on Ebola virus disease and Middle East respiratory syndrome coronavirus
A wide variety of health events ranging in severity may occur related to air transport, requiring different responses or, perhaps, no response at all. The target audience for this guidance document incl
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udes the national focal points (NFP) for the IHR and public health authorities at PoE, as well as national aviation regulatory authorities, airport operators and personnel, aircraft operators, air crew and other stakeholders involved in air transport and emergency preparedness and response to public health events
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Handbook of COVID-19 Prevention and Treatment
recommended
Handbook of COVID-19 Prevention and Treatment, expecting to share their invaluable practical advice and references with medical staff around the world. This handbook compared and analyzed the experience of other experts in China, and provides good reference to key departments such as hospital infect
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ion management, nursing, and outpatient clinics. This handbook provides comprehensive guidelines and best practices by China's top experts for coping with COVID-19.
This handbook, provided by the First Affiliated Hospital of Zhejiang University, describes how organizations can minimize the cost while maximizing the effect of measures to manage and control the coronavirus outbreak. The handbook also discusses why hospitals and other healthcare institutions should have command centers when encountering a large-scale emergency in the context of COVID-19. This handbook also includes the following：
- Technical strategies for addressing issues during emergencies.
- Treatment methods to treat the critically ill.
- Efficient clinical decision-making support.
- Best practices for key departments like inflection management and outpatient clinics.
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La evolución de los acontecimientos y el esfuerzo conjunto de la comunidad científica mundial, hangeneradogran cantidad de información que se modificarápidamente con nuevas evidencias. Este documento pretende hacer unresumen analítico de la evidencia científica dispo
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niblehasta el momento en torno a la epidemiología, características microbiológicas y clínicas del COVID-19.En esta actualización se añaden los hallazgos acerca de la transmisiónen periodo asintomático y a partir de aerosoles y superficies inanimadas, así como las características de los principales grupos de riesgo. Para información relativa a medicamentos relacionados con COVID-19 se puede consultar la web de la Agencia Española del Medicamento y ProductosSanitarios: https://www.aemps.gob.es/
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Last updated Friday 20 March
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 intended to eradicate. Bacteria quickly adapt to the presence of antibacterial agents in order
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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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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
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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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This working paper was conceived to offer practical tips and suggestions on how to establish and sustain the multisectoral coordination needed to develop and implement National Action Plans on AMR (NAPs). It is intended for anyone with responsibility for addressing AMR at country level. Drawing on b
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oth the published literature and the operational experience of four ‘focal countries’ (Ethiopia, Kenya, Philippines and Thailand), it summarizes lessons learned and the latest thinking on multisectoral working to achieve effective AMR action. The experience in focal countries points to a number of tools and tactics that can be used to help establish and enhance sustainable multisectoral collaboration for AMR action. These can be grouped into four categories: political commitment, resources, governance mechanisms, and practical management.
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This paper was developed to support AMR coordination committees and others tasked with addressing AMR at country level to do just that. Drawing on the published literature and the operational experience and expertise of different LMICs, the paper points to six key strategies for success and offers a
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series of practical tips and suggestions on how to implement each one.
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The product of all this work is the Standard Treatment Guideline and Essential Medicines List of Common Medical Conditions in the Kingdom of Swaziland. These systematically developed statements are designed to assist practitioners in making decisions about appropriate treatment for specific clinical
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conditions. They are meant to reflect expert consensus based on a review of current and published scientific evidence of acceptable approaches to diagnosis, man-agement, or prevention of specific conditions.It is enlightening to note that section A of the document contains the STG, and effort has been made to have the conditions commonly encountered in Swaziland classified according to systems. Written in simple, clear language, each section consists of a short definition followed by common symptoms and signs of the disease or condition and then management (pharmacological and nonpharmacological)
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An essential participant in antimicrobial stewardship who has been unrecognized and underutilized is the“staff nurse.”Although the role of staff nurses has not formally been recognized in guidelines for implementing and operating antimicrobial stewardship programs (ASPs) or defined in the medica
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l literature, they have always performed numerous functions that are integral to successful antimicrobial stewardship. Nurses are antibiotic first responders, central communicators, coordinators of care, as well as 24-hour monitors of patient status, safety, and response to antibiotic therapy. An operational analysis of inpatient admissions evaluates these nursing stewardship activities and analyzes the potential benefits of nurses’formal education about, and inclusion into, ASPs.
Clinical Infectious Diseases - CID 2016:62 (1 January)•CLINICAL PRACTICE
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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 of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly
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certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
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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 the burden of antibiotic resistance wh
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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 situation analysis has gathered information about the current state of AMR, contributing factors and antimicrobial use in Zimbabwe from the human, animal, agricultural and environmental sectors. Data has been gathered from different sectors such as the general public, academia, the Ministry of
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Health and Child Care, the Ministry of Agriculture Mechanization and Irrigation Development and the Ministry of Environment, Water and Climate. It shows that AMR is a real concern in Zimbabwe and a threat to the health outcomes of humans, to the economic productivity of the livestock industry and a risk to the environment.
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South Africa has faced many challenges over the past two decades, accomplishing profound positive changes in the social structure and government of the nation. This has not yet fully translated into better health for the population, however, particularly the poorest segment. In fact, the p
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opulation 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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In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric bacterial pathogens such as typhoid,
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diarrhoeagenic Escherichia coli and invasive non-‐typhi salmonella, penicillin-‐resistant Streptococcus pneu-‐moniae, vancomycin-‐resistant enterococci, methicillin-‐resistant Staphylococcus aureus and multidrug-‐re-‐sistant Mycobacterium tuberculosis. Resistance to medicines commonly used to treat malaria is of particu-‐lar concern, as is the emerging resistance to anti-‐HIV drugs. Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-‐poor settings.
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Antimicrobial resistant (AMR) organisms are increasing globally, threatening to render existing treatments ineffective against many infectious diseases. In Africa, AMR has already been documented to be a problem for HIV and the pathogens that cause malaria, tuberculosis, typhoid, cholera, meningitis
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, gonorrhea, and dysentery. Recognizing the urgent need for action, the World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance in May 2015. In accordance with the Global Action Plan and to meet needs specific to Africa, Africa CDC will establish the Anti-Microbial Resistance Surveillance Network (AMRSNET). AMRSNET is a network of public health institutions and leaders from human and animal health sectors who will collaborate to measure, prevent, and mitigate harms from AMR organisms.
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Jin et al. Military Medical Research (2020) 7:4 https://doi.org/10.1186/s40779-020-0233-6
Position Article und Guideline
