WHO calls for rational use of medicines

Thursday, September 9th, 2010

Concerned about the problem of antimicrobial resistance, WHO has called for efforts at the national and international level to preserve the efficacy of antimicrobial agents through the rational use of antibiotics.

“Microorganisms are showing resistance to medicines, posing a threat to the treatment and control of many infectious diseases. The development of resistance to medicines used to treat malaria, tuberculosis and HIV infection is of particular concern”, said Dr Samlee Plianbangchang, WHO’s Regional Director for South-East Asia. “This resistance is caused largely due to the incorrect use of medicines, including use for too short a time, too low a dose, inadequate potency or for a wrong disease” he added. He was speaking at the WHO’s Sixty-third Regional Committee session in Bangkok. WHO has chosen antimicrobial resistance as the theme for World Health Day 2011 (7 April) to highlight this issue.

The consequences of resistance in microorganisms are severe in terms of cost, livelihood and lives, besides undermining the effectiveness of health delivery programmes.

Because the resistant microbes do not respond to treatment, this results in prolonged illness and greater risk of death; the resistant strains also are able to infect more people. For example, despite a well performing TB programme in WHO’s South-east Asia Region, and a rate of Multidrug resistant TB (MDR TB), of less than 3% in sheer numbers, every year there are an additional 180000 new patients with (MDR TB). The cost of treatment of one patient with MDR TB is estimated to be 100 times that of treating a patient with ordinary TB. Due to the high costs, many such cases may remain untreated.  Besides greater disease and deaths, this also increases the overall burden on health services.

Hospitalization itself can be a major threat to patients because of the risk of acquiring multi-resistant and potentially non-treatable infections. Often such resistance can appear in hospitals, where patients with lowered immunity who have been exposed to earlier prolonged use of antimicrobials could become cross-infected with any of these highly resistant bacterial pathogens.  Often up to 50% of patients in hospitals who get infected with a resistant bacterium will succumb to infection, as a large number of drugs may already be ineffective against it.

WHO is calling for policies like combination therapy, rational prescription, patient adherence to the full course of treatment, infection control practices, prudent use of antibiotics in veterinary practice, cultivation of aquatic food and an efficient surveillance system to monitor the emergence and spread of resistance.

WHO is working with Member States on legislation and policies governing the use of antimicrobial agents, establishing laboratory-based networks for surveillance of resistance and ensuring the rational use of these medicines.

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