Antibiotic Resistance: Implications for Global Health and Novel Intervention Strategies:
Eileen R. Choffnes, David A. Relman, and Alison Mack, Rapporteurs
Forum on Microbial Threats; Institute of Medicine IOM - ISBN: 0-309-15612-2 - (2010)
US Board on Global Health
Available online at: http://bit.ly/8ZDOPK
“……Infectious diseases remain among the leading causes of morbidity and mortality on our planet. The development of resistance in microbes—bacterial, viral, or parasites—to therapeutics is neither surprising nor new. However, the scope and scale of this phenomenon is an ever increasing multinational public health crisis as drug resistance accumulates and accelerates over space and time.
Today some strains of bacteria and viruses are resistant to all but a single drug, and some may soon have no effective treatments left in the “medicine chest.” The disease burden from multidrug-resistant strains of organisms causing AIDS, tuberculosis, gonorrhea, malaria, influenza, pneumonia, and diarrhea is being felt in both the developed and the developing worlds alike.
The accelerating growth and global expansion of antimicrobial1 resistance (hereinafter referred to as AMR) is a demonstration of evolution in “real time” in response to the chemical warfare waged against microbes through the therapeutic and non-therapeutic uses of antimicrobial agents. After several decades in which it appeared that human ingenuity had outwitted the pathogens, multidrug-resistant “superbugs” have become a global challenge, aided and abetted by the use, misuse, and overuse of once highly effective anti-infective drugs. …”
“…..Pathogens resistant to multiple antibacterial agents, while initially associated with the clinical treatment of infectious diseases in humans and animals, are increasingly found outside the healthcare setting. Therapeutic options for these so-called community-acquired pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA) are extremely limited, as are prospects for the development of the next generation of antimicrobial drugs.
On April 6 and 7, 2010, the Institute of Medicine’s (IOM’s) Forum on Microbial Threats convened a public workshop in Washington, DC, to consider the nature and sources of AMR, it implications for global health, and strategies to mitigate the current and future impacts of AMR.
Through invited presentations and discussions, participants explored the evolutionary, genetic, and ecological origins of AMR and its effects on human and animal health worldwide.
Participants also discussed host and environmental factors associated with the expansion of AMR; strategies for extending the useful life of antimicrobials; alternative approaches for treating infections; incentives and disincentives for prudent antimicrobial use; and prospects for the discovery and development of ”next generation” antimicrobial therapeutics. While it was the “intent” of the workshop planners and organizers to cover the phenomenon of AMR broadly, workshop presentations and discussions focused almost exclusively on bacterial resistance to antibacterial drugs……”
Workshop Overview References
- The Case for Pathogen-Specific Therapy
- Waves of Resistance: Staphylococcus aureus in the Antibiotic Era
- Sublethal Antibiotic Treatment Leads to Multidrug Resistance via Radical-Induced Mutagenesis
- Antibiotic-Induced Resistance Flow
- Actinobacteria: The Good, The Bad, and The Ugly
- Antibiotics for Emerging Pathogens
- Averting a Potential Post-Antibiotic Era
- Antibiotic Effectiveness: New Challenges in Natural Resource Management
- The Role of Health Care Facilities
- Challenges and Opportunities in Antibiotic Discovery
- Responding to the Global Antibiotic Resistance Crisis: The APUA Chapter Network
- Population Mobility, Globalization, and Antimicrobial Resistance
- Population Mobility, Globalization, and Antimicrobial Drug Resistance
- The Bacterial Challenge: A Time to React, Executive Summary
- The Effects of Antibiotic and Pesticide Resistance on Public Health
- Clinical Issues and Outcomes Associated with Rising Antimicrobial Resistance
- WHO Activities for Control of Antimicrobial Resistance Due to Use of Antimicrobials in Animals Intended for Food
- The Antibacterial Pipeline: Why Is It Drying Up, and What Must Be Done About It?
- Challenges in Antimicrobial Susceptibility Testing of Clinical and Environmental Isolates
- Measuring the Cost of Antimicrobial-Resistant Infections: The Feasibility and Accuracy of Economic Analysis Using Electronic Medical Record Databases
- The Antibiotic Resistome
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