Genesis of Antibiotic Resistance (AR) XXXIII Obdurate Implementations of Preventive Measures to Abjure Antibiotics for Treating Primary Fungal Infection (S) Ebb Antibiotic(Ab), Antifungal(AF) Resistance(R) Pandemic(P) (Ab‐AF: RP): A Global Concern.

Abstract

Based on the analysis of clinical mycology data on treatment of fungal infection, following preventive measures are suggested to avoid the use of Antibiotics for treating primary Fungal Infection(s): a. Clinical diagnosis matching the microbial sensitivity assay specific for fungal infections data confirmed and reviewed by pharmacists; b. Mandatory implementation of ATO across the globe in particular Intensive Care Unit, (ICU) & Emergency Room (ER) and infectious diseases ward; c. Cessation of antibiotic prophylactic therapy in the surgical ward, ICU, ER unless a team of a pharmacist, clinical microbiologist, and physician with infectious disease specialization to provide mandatory evaluation of need and beneficial impact analysis report to the attending physician with appropriate guidelines for the treatment option, d. mandatory antibiogram (preparation and analysis) from the antibiotic culture sensitivity of specimens from primary infection, during the treatment progressions and also secondary infection during the post‐surgical treatment, e. confirmation with data on file delineating accurate diagnosis whether bacterial/fungal/secondary infection) prior to administration of broad‐spectrum antibiotics, f. periodic review of colonization pressure in the concerned health care facility, g. global effort to implement medical testing technology for clinical microbiology lab diagnostic tool for identification and characterization of bacterial vs. fungal infections in particular third world countries; h: increase the awareness across the globe on the need for differential diagnosis on the fungal infection, bacterial infections (primary vs secondary), appropriate use of antifungal vs. antibacterial vs. antiviral vs. anti‐parasitic vs. anti‐helminthic infections among the third world countries, i. monitoring the use of antifungal pesticides in agricultural practices, j. analysis of particulate matter (PM) in the air quality for residual fungicides and determination of fungicides in the soil, water and plants( during the development and after harvesting), k. Establish and implement an effective strategy to rule out the, “Antibiotic‐Resistant Bacterium”(ARB). as per the need during the primary, secondary and pre‐surgery, post‐surgery treatment. l. Antibiogram based differential diagnosis of fungal vs. bacteria including sepsis/septicemia/septic shock; smear‐negative pulmonary tuberculosis must be tested for aspergillosis; differential diagnosis of fungal asthma, invasive aspergillosis with a comorbidity of chronic obstructive pulmonary disease, Pneumocystis pneumonia in HIV‐positive patients; universal availability of nonculture fungal diagnostics, m. universal adoption of “Antibiotic Time Out” (ATO) prior to definitive diagnosis of bacterial (culture sensitivity assay, n. Establishment of Clinical Patterns: Primary resistance (organisms never exposed in that host to the drug of interest)/Secondary resistance, (acquired resistance, arises only after exposure of the organism to the drug)/Intrinsic resistance ( resistance of all or almost all isolates of one species to a certain drug)/Clinical resistance; o. global moratorium on the practice of empirical antibacterial/antifungal therapy including topical application of antibacterial/antifungal and also in Intensive Care Unit (ICU). Taken together, adopting the aforesaid measure would plausibly mitigate the Ab‐AF:RP.Support or Funding InformationSupported by the Professional Development Funds by SWTJC to Subburaj Kannan.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.