Resistance to change: how much longer will our antibiotics work?

Abstract

Antimicrobial resistance (AMR) is the ability of bacteria to change, rendering antimicrobials (such as antibiotics, antivirals and antimalarials) ineffective in treating common infections, or as prophylaxis after major surgery or cancer treatment. The World Health Organization (WHO) predicts that these ‘superbugs’ will become a major threat to public health. 1

Think before you prescribe: how dentistry contributes to antibiotic resistance

“…Three audit cycles conducted over 3 years at a British emergency dental service found that by reinforcing correct documentation (e.g. entering prescriptions into clinical notes with a diagnosis) and instituting a prescription logbook, the number of antibiotic prescriptions was reduced (dropping from 62% to 16%) with a commensurate increase in the use of local surgical intervention from 22% to 68% over the 3 year period …”

“…As prescribing health care professionals, dentists should not underestimate their contribution to antibiotic resistance -66% of antibiotics prescribed in a dental setting are not clinically indicated. 1 Dentists should be powerful advocates for change by challenging the prevailing attitudes to the use of antibiotics in the community and limiting our role in exacerbating resistance. Prevention is central to disease control in modern dentistry, thus, we are well placed to embrace the challenge of antibiotic resistance at the chairside by following guidelines 46 which emphasize:…”

“…entering prescriptions into clinical notes with a diagnosis) and instituting a prescription logbook, the number of antibiotic prescriptions was reduced (dropping from 62% to 16%) with a commensurate increase in the use of local surgical intervention from 22% to 68% over the 3 year period. 1 There are several strategies that can be considered to improve responsible antibiotic use in dentistry, such as:…”

“…Antibiotic resistance threatens effective health care as an increased number of pathogens are becoming multi‐ or completely resistant to all types of currently available antibiotics. Antibiotic resistance is no longer a prediction that threatens our modern way of life, it is the reality and exacts a significant burden worldwide, with 70 000 lives estimated to be lost due to resistance globally each year . The National Health and Medical Research Council estimated that antimicrobial resistance costs Australia AUD$250 million annually …”

“…Antibiotic resistance is no longer a prediction that threatens our modern way of life, it is the reality and exacts a significant burden worldwide, with 70 000 lives estimated to be lost due to resistance globally each year. 1 The National Health and Medical Research Council estimated that antimicrobial resistance costs Australia AUD$250 million annually. 2 Resistance is conferred by antibiotic resistance genes (ARGs), which are pervasive in microbial communities of the environment (soil, waterways), food, animals and in various parts of the human body.…”