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Antimicrobial Drug Resistance (AMDR)

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     3. Policies and Best Practices

3. Policies and Best Practices

It is essential that governments, professional organizations, and individual practitioners seriously contemplate policies to contain the advance of resistant pathogens (Garrett 2001; Small and Fujiwara 2001; Podolsky 2005). Historical examples of successful approaches to the eradication or control of infectious diseases include improved basic hygiene, vaccination, and environmental practices combined with sustained effective educational and outreach campaigns. Today, strategies to lower microbial resistance are also linked to guiding the appropriate use of antibiotics and minimizing environmental contamination with AMDR pathogens (Dellit et al. 2007; Guidos 2011; Rybak et al. 2009; Schlaes et al. 1997; Siegel et al. 2006). Strategies can target either the prevention of the emergence of new resistance, or interruption of the transmission of existing resistance. Pursuing both approaches usually provides the best results. 

At the core of the major strategies nationally, regionally, and globally are (Smith and Coast 2002): 

  • Surveillance programs to monitor pathogen prevalence and susceptibility to antibiotics
  • Tracking of antimicrobial drug consumption
  • Incentives to encourage research and development of new antimicrobial preparations
  • Application of appropriate alternative treatments
  • Adoption of policies promoting antibiotic drug stewardship 

Successful implementation of public health policies is driven through the combined influences of formal legislation, practice regulations, professional standards and guidelines, and informal procedures and customs. Data from evidence-based literature serve as a starting point for developing healthcare policy, further molded by social (cultural or religious) beliefs, applicable models for delivering healthcare, and political perspectives.

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Table of Contents

SECTION ONE: The global threat of AMDR
SECTION TWO: Understanding AMDR
    1. Etiology and Epidemiology
    2. Incidence and Prevalence of Microbial Resistance
    3. Major AMDR Pathogens
       a. Acinetobacter baumanii
       b. Clostridium difficile
       c. Escherichia coli
       d. HIV/AIDS and Sexually Transmitted Infection
       e. Influenza virus
       f. Malaria (Plasmodium)
       g. Methicillin-resistant Staphylococcus aureus (MRSA)
       h. Streptococcus pneumoniae
       i. Tuberculosis and MDR-TB
       j. Vancomycin-Resistant Enterococcus (VRE)
SECTION THREE: Control and Prevention of AMDR
    1. Implications of Microbial Resistance
    2. Infections and Chronic Diseases
    3. Policies and Best Practices
       a. Antimicrobial Drug Stewardship
       b. Surveillance
       c. Environmental Decontamination
       d. Infection Control
       e. Patient Education
    4. Antibiotic Development Pipeline
SECTION FOUR: Conclusions
Test Questions
Program Evaluation
Self Assessment

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