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TODAY’S CHART: The Inappropriate Use of Antimicrobials.

June 3, 2017

 

This chart is very frightening. For someone like me, whose childhood saw the vanquishing of those plagues that have hounded humankind throughout history and that could kill more in a few decades than all the wars of history, finds it heartbreaking that now at the end of that life those plagues, now resistant to all our antimicrobials may soon hound the people of the earth again. Only last year, the last effective antimicrobial was proven impotent against a mutated resistant organism it was designed to kill. Somewhere in the world today there exists mutated organisms resistant to one or another antimicrobial successfully used to halt plagues of the past. They are awaiting only the appropriate conditions to spread death and anguish across the globe

There are some still fighting to protect humanity from this threat. (The US Department of Defense considers the potential spread of drug-resistant organisms to be a national security issue) They should be honored by us all. Alas, like first responders, and other selfless people like them, there are few if any parades in their honor, nor many Facebook and similar remembrances. It saddens me that we publicly honor those trained to kill to protect us from real or imagined enemies but rarely those who daily put their lives on the line or dedicate themselves to protect their fellow humans from disease, injury or death.

 

Estimated proportion of inappropriate antimicrobial use by type of health care service
Inappropriate use of antimicrobials
Pasted Graphic
The inappropriate use of antimicrobials is perhaps one of the most threatening forms of wasteful clinical care because it encourages the development of antimicrobial resistance. Inappropriate use represents about 50% of all antimicrobial consumption by humans, but may be as high as 90% in general practice.

 
More rational antimicrobial consumption can be achieved with behavioral change interventions, notably antimicrobial stewardship programs which combine multidisciplinary activities to steer both prescribers and the public towards appropriate use of antimicrobials. Mandating the use of rapid diagnostic testing can help clinicians target their antibiotic use. Economic incentives for providers and care seekers can also encourage appropriate antimicrobial consumption.

 
Note: Numbers in brackets indicate the number of studies used to determine the range of inappropriate use. Source: OECD analysis of available evidence published in the literature.
Source: Tackling Wasteful Spending on Health, OECD, January 2017.

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