Strategies for the Prevention and Containment of Antibiotic Resistance

Antibiotic resistance may emerge by antibiotic selection pressure but is perpetuated by diverse risk factors and maintained within environments as a result of poor infection control. Population-specific drug pharmacokinetics and pharmacodynamics also play a role. The WHO, US, UK and EU have initiate...

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Main Author: S.Y. Essack
Format: Article
Language:English
Published: AOSIS 2006-02-01
Series:South African Family Practice
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Online Access:https://safpj.co.za/index.php/safpj/article/view/460
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author S.Y. Essack
author_facet S.Y. Essack
author_sort S.Y. Essack
collection DOAJ
description Antibiotic resistance may emerge by antibiotic selection pressure but is perpetuated by diverse risk factors and maintained within environments as a result of poor infection control. Population-specific drug pharmacokinetics and pharmacodynamics also play a role. The WHO, US, UK and EU have initiated strategies for the containment of resistance, with surveillance and delineation of the cause(s) cited as essential. Surveillance of antibiotic efficacy should be disease-based, establishing sensitivity profiles of common causative organisms to inform the development of or amendment to standard treatment guidelines and essential drugs lists adopted within the national drug policy. The manner of antimicrobial use (overuse, underuse, inadequate dosing) associated with resistance should be established for appropriate intervention in terms of rational drug use, a reduction in use and dosing regimens based on population-specific pharmacokinetics and pharmacodynamics. Risk factors unique to South African communities (poverty, HIV) and hospitals (duration of hospitalisation, location within the hospital, intensive care unit stay, surgery, wounds, previous and current antimicrobial therapy, mechanical ventilation, urinary catherterisation, nasogastric intubation, central venous and peripheral catheters, previous hospitalisation and transfer from another unit or hospital) must be determined and due vigilance exercised in patients exhibiting classical risk factors for the acquisition of or colonisation with resistant pathogens. Hygiene and sanitation (in communities) and infection control (in hospitals) status must be determined and interventions initiated to prevent the spread of resistance. Pharmacokinetics and pharmacodynamics specific to diverse populations must be devised to optimise antimicrobial therapy. South Africa has unique needs in the antimicrobial resistance arena, needs to be addressed in the context of severe financial, human resources and technological challenges.
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spelling doaj-art-8c4670bb5ad94a09bfa01ec03d65e8382025-08-20T04:03:17ZengAOSISSouth African Family Practice2078-61902078-62042006-02-0148110.1080/20786204.2006.10873321459Strategies for the Prevention and Containment of Antibiotic ResistanceS.Y. Essack0University of KwaZulu-NatalAntibiotic resistance may emerge by antibiotic selection pressure but is perpetuated by diverse risk factors and maintained within environments as a result of poor infection control. Population-specific drug pharmacokinetics and pharmacodynamics also play a role. The WHO, US, UK and EU have initiated strategies for the containment of resistance, with surveillance and delineation of the cause(s) cited as essential. Surveillance of antibiotic efficacy should be disease-based, establishing sensitivity profiles of common causative organisms to inform the development of or amendment to standard treatment guidelines and essential drugs lists adopted within the national drug policy. The manner of antimicrobial use (overuse, underuse, inadequate dosing) associated with resistance should be established for appropriate intervention in terms of rational drug use, a reduction in use and dosing regimens based on population-specific pharmacokinetics and pharmacodynamics. Risk factors unique to South African communities (poverty, HIV) and hospitals (duration of hospitalisation, location within the hospital, intensive care unit stay, surgery, wounds, previous and current antimicrobial therapy, mechanical ventilation, urinary catherterisation, nasogastric intubation, central venous and peripheral catheters, previous hospitalisation and transfer from another unit or hospital) must be determined and due vigilance exercised in patients exhibiting classical risk factors for the acquisition of or colonisation with resistant pathogens. Hygiene and sanitation (in communities) and infection control (in hospitals) status must be determined and interventions initiated to prevent the spread of resistance. Pharmacokinetics and pharmacodynamics specific to diverse populations must be devised to optimise antimicrobial therapy. South Africa has unique needs in the antimicrobial resistance arena, needs to be addressed in the context of severe financial, human resources and technological challenges.https://safpj.co.za/index.php/safpj/article/view/460antibiotic resistancerational drug useinfection controlrisk factorspharmacokineticspharmacodynamics
spellingShingle S.Y. Essack
Strategies for the Prevention and Containment of Antibiotic Resistance
South African Family Practice
antibiotic resistance
rational drug use
infection control
risk factors
pharmacokinetics
pharmacodynamics
title Strategies for the Prevention and Containment of Antibiotic Resistance
title_full Strategies for the Prevention and Containment of Antibiotic Resistance
title_fullStr Strategies for the Prevention and Containment of Antibiotic Resistance
title_full_unstemmed Strategies for the Prevention and Containment of Antibiotic Resistance
title_short Strategies for the Prevention and Containment of Antibiotic Resistance
title_sort strategies for the prevention and containment of antibiotic resistance
topic antibiotic resistance
rational drug use
infection control
risk factors
pharmacokinetics
pharmacodynamics
url https://safpj.co.za/index.php/safpj/article/view/460
work_keys_str_mv AT syessack strategiesforthepreventionandcontainmentofantibioticresistance