BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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This briefing paper provides an overview of the approach underlying EA, how and by whom it is applied and its problems and consequence...s. It concludes that policy makers, rather than be guided by its assumptions and conclusions, must instead concentrate on understand-ing the confounding structural causes of interdependent global challenges and aim at their long-term solution, within an overarching human rights framework.
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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 Prevention 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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This curriculum can be used freely in order to stimulate means of ethical analysis, reflection and decision-making.
The extensive use of antimicrobials in human and veterinary medicine in recent years has accelerated the emergence and spread of resistant microorg...anisms. This situation has been worsened by the lack of investment in developing new effective antibiotics. The severity of the consequences is clear to see: it is estimated that each year, drug-resistant infections result in at least 25 000 patient deaths and cost the EU EUR 1,5 billion in healthcare costs and through loss of productivity
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This policy brief identifies and explains the main reasons behind the rise of antimicrobial resistance (AMR) associated with improper use of antibiotics in the livestock sector. Focusing on the low-... and middle- income country setting, this brief provides recommendations for a deliberated policy strategy aimed to prevent healthcare crisis that could happen as a result of AMR.
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This document should be used in conjunction with the WHO checklist for influenza preparedness planning published by the World Health Organization in 2005. Available in English; Chinese; French
The PHC STGs and EML should be used by healthcare workers providing care at clinics, community health centres, and gateway clinics at hospitals.
P...harmaceutical and Therapeutics Committees (PTCs) are responsible for ensuring the availability of medicines listed in the PHC EML at those facilities, as well as at higher levels of care.
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User GuideThe toolkit is composed of three sections: Hospital and Health System Resources - includes a readiness assessment tool, the starting point in developing or enhancing a successful Antimicr...obial Stewardship Program (ASP). The tool, a checklist developed by the CDC, should be shared with senior management, a senior leader for quality, purchasing directors, clinic managers, nurse managers, key physician leaders, risk managers, pharmacy leaders, infection preventionists and hospital epidemiologists, laboratory staff and information technology staff. For ease of use, it is divided into two sections, one for those just beginning a program, the other for those who wish to enhance an existing program. Clinician Resources - includes webinars, clinical evidence supporting appropriate use of antibiotics, implementation guides and related articles.Patient Resources - includes frequently asked questions, pamphlets and handouts on how patients can best engage in their care and resources on appropriate use of antibiotics.
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The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for common syndromes in India. These guidelines are targeted for the health care settings. It aims to rationali...ze the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
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The framework is to be used as a reference guide, applied according to local priorities and needs, and targeted at academic institutions, educators..., accreditation bodies, regulatory agencies and other users. The ultimate aim is to ensure that all health workers are equipped with the requisite competencies at pre-service education and in-service training levels to address AMR in policy and practice settings.
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Global actions to reduce antimicrobial resistance (AMR) include optimising the use of antimicrobial medicines in human and animal health. In countries with weak healthcare regulation, this requires ...a greater understanding of the drivers of antibiotic use from the perspective of providers and consumers. In Bangladesh, there is limited research on household decision-making and healthcare seeking in relation to antibiotic use and consumption for humans and livestock. Knowledge is similarly lacking on factors influencing the supply and demand for antibiotics among qualified and unqualified healthcare providers. The aim of this study is to conduct integrated research on household decision-making for healthcare and antibiotic use, as well as the awareness, behaviours and priorities of healthcare providers and sellers of antibiotics to translate into policy development and implementation
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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduc...e the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and technologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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This guideline for the prevention and control of chikungunya fever
(CF) is intended for use by all peripheral health workers in the Region and
is... based on the strategy outlined above. This document will focus mainly
on preventing, predicting and detecting outbreaks, and after detection,
investigating and containing them.
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The toolkit comprises ready-to-use material designed expressly for World Bank task managers working in the water and sanitation sector. It presents a range of tools for gender analysis ...attribute-to-highlight medbox">and practical “how-to” strategies collected from program and project experience around the world. It is one of a series of toolkits being designed to assist task managers in improving project performance by incorporating gender into their work.
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CHAPTER 206 | An Act to establish a national drug policy and a national drug authority to ensure the availability, at all times, of essential, efficacious and cost-effective drugs to the entire popu...lation of Uganda, as a means of providing satisfactory health care and safeguarding the appropriate use of drugs.
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The Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, presents evidence-
based recommendations on the preferred methods for cleaning, disinfection and sterilization of pa...tient-
care medical devices and for cleaning and disinfecting the healthcare environment. This document
supercedes the relevant sections contained in the 1985 Centers for Disease Control (CDC) Guideline for
Handwashing and Environmental Control. 1 Because maximum effectiveness from disinfection and
sterilization results from first cleaning and removing organic and inorganic materials, this document also
reviews cleaning methods. The chemical disinfectants discussed for patient-care equipment include
alcohols, glutaraldehyde, formaldehyde, hydrogen peroxide, iodophors, ortho-phthalaldehyde, peracetic
acid, phenolics, quaternary ammonium compounds, and chlorine. The choice of disinfectant,
concentration, and exposure time is based on the risk for infection associated with use of the equipment
and other factors discussed in this guideline. The sterilization methods discussed include steam
sterilization, ethylene oxide (ETO), hydrogen peroxide gas plasma, and liquid peracetic acid. When
properly used, these cleaning, disinfection, and sterilization processes can reduce the risk for infection
associated with use of invasive and noninvasive medical and surgical devices. However, for these
processes to be effective, health-care workers should adhere strictly to the cleaning, disinfection, and
sterilization recommendations in this document and to instructions on product labels.
LAST UPDATE 2019
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