May 2014 Health-e; “Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” said Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security.
The report draws on data from 114 countries, and focuses on antibiotic resistance in bacteria that cause common but serious diseases such sepsis, diarrhoea, pneumonia, urinary tract infections and gonorrhoea.
One South Asian child dies every five minutes from drug-resistant bacteria, while around 25 000 Europeans die every year from similar infections.
About half of all antibiotic prescriptions are estimated to be unnecessary, and this is driving the development of drug-resistant “super-bugs.” In India, Thailand and Vietnam, people can buy antibiotics without a prescription.
Threat hits close to home
Resistance to carbapenem, the last resort for treating Klebsiella pneumonia, has been recorded throughout the world. Klebsiella pneumonia is a major cause of hospital-acquired infections such as pneumonia, sepsis, infections in newborns and intensive-care unit patients.
In some countries, more than half of people are already resistant to carbapenem. The first patient with Klebsiella pneumonia who was resistant to all antibiotics was recorded in South Africa last year.
Resistance to fluoroquinolones, used to treat urinary tract infections caused by E. coli, is very widespread. In many parts of the world, this treatment is now ineffective in more than half of patients.
“Treatment failure to the last resort of treatment for gonorrhea – third generation cephalosporins – has been confirmed in Austria, Australia, Canada, France, Japan, Norway, South Africa, Slovenia, Sweden and the United Kingdom,” according to the report.
“Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating,” said WHO’s Fukuda.
WHO, South Africa move to tackle issue
This report is kick-starting a global effort led by WHO to address drug resistance. This will involve the development of tools and standards and improved collaboration around the world to track drug resistance, measure its health and economic impacts, and design targeted solutions.
It recommends that ordinary people can help tackle resistance by using antibiotics only when prescribed by a doctor, completing the full prescription, even if they feel better and never sharing antibiotics with others.
Dr Jennifer Cohn, from humanitarian organisation Medicines Sans Frontieres’ Access Campaign, said her organisation was seeing “horrendous rates of antibiotic resistance wherever we look in our field operations, including children admitted to nutritional centres in Niger, and people in our surgical and trauma units in Jordan.”
“Ultimately, WHO’s report should be a wake-up call to governments to introduce incentives for industry to develop new, affordable antibiotics that do not rely on patents and high prices and are adapted to the needs of developing countries,” said Cohn.
South Africa is in the process of setting up a Ministerial Advisory Committee, including representatives from the public and private sector, to help the health department to deal with drug-resistance, according to Health Director General Precious Matsoso.