Antibiotic Resistance
Antibiotic resistance is a global threat to the treatment of bacterial infectious diseases.
The discovery of antibiotic drugs to treat infections caused by bacteria has been an important development of modern medicine. (Antibiotics are ‘antimicrobial’ drugs. Other antimicrobials include antivirals that kill viruses, anti-fungals that kill fungi, as well as other antimicrobials that kill worms or any other intracellular or extracellular parasite.)
However, when exposed to antibiotic drugs, bacteria can develop resistance requiring the use of a different and sometimes more toxic and expensive treatments of infections.
Some strains of antibiotic resistant bacteria are well-established in New Zealand, occurring not only in infections treated in hospitals and medical facilities but also in the community.
Examples of antibiotic resistant bacteria
Examples of antibiotic resistant bacteria, which although comparatively rare are of concern, include:
- MRSA – methicillin/oxacillin-resistant Staphylococcus aureus
- EMRSA – a strain of MRSA
- VRE – vancomycin-resistant enterococci
- ESBLs – extended-spectrum beta-lactamases (which are resistant to cephalosporins and monobactams)
- PRSP – penicillin-resistant Streptococcus pneumoniae.
Factors contributing to the prevention of development and spread of antibiotic resistant bacteria include prudent use of antibiotics and effective infection control practices.
Prescribing of antibiotics
The discovery of antibiotic drugs to treat infections caused by bacteria has been an important development of modern medicine.
When exposed to antibiotic drugs, bacteria can develop resistance requiring the use of a different and sometimes more toxic and expensive treatments of infections. (Antibiotics are "antimicrobial" drugs.
Over-prescribing
Over-prescribing, that is prescribing antibiotics when they are not necessary to treat the infection, has been a factor worldwide in development and spread of antibiotic resistant bacteria.
Preventing over-use of antibiotics in the community is important in slowing the development and spread of antibiotic resistant bacteria and the Ministry of Health, Independent Practitioner Associations, Pharmac, the Medical Association and other groups contribute to raise awareness amongst GPs and other prescribers to limit antibiotic use.
Monitoring and control of antibiotic resistance
Factors contributing to the prevention of development and spread of antibiotic resistant bacteria include prudent use of antibiotics and effective infection control practices.
Activities to monitor and control antibiotic resistant bacteria in New Zealand health services include Infection control and antibiotic prescribing policies and monitoring of antibiotic resistant bacteria:
Infection control and antibiotic prescribing policies
All hospitals and health services in New Zealand are expected to have infection control policies and consistent standards for patient safety.
Each public hospital has its own infection control committee. These infection control committees provide feedback to clinicians and give advice on care of the patient and control of infection within the hospital and the community.
Antibiotic resistance - guidance for the public
People prescribed antibiotics should complete the full course of the medicine.
Individuals who stop taking the antibiotics once the symptoms have lessened but before they have finished their complete course of medication often have not killed all the bacteria. Surviving bacteria can cause a reinfection, often with increased resistance to the antibiotic used in the attempt to control them.
Many common diseases are caused by viruses against which antibiotics, and most medicines, are ineffective. Prescribing and taking antibiotics in these instances increase the exposure of bacteria to antibiotics and may unnecessarily increase resistance to antibiotics.
Who is most at risk?
People most at risk from an infection with antibiotic resistant bacteria are often hospital patients who are elderly or very sick, or who have an open wound (such as a bedsore) or a tube (such as a urinary catheter) going into their body.
When visiting someone hospitalized with an infection caused by antibiotic resistant bacteria, healthy people are usually at very little risk of getting infected. Visitors should follow the instructions of staff about hygiene measures.
Unless otherwise indicated by hospital staff, casual contact, such as touching or hugging, is safe but any visitors must wash their hands before leaving the hospital room or patient's home.
For further information in caring for a person with antibiotics resistant bacteria, ask the health care professional caring for the patient.