Why we care about antimicrobials and antimicrobial resistance
- Antimicrobial resistance (also known as AMR) is one of the biggest threats to global health, food security, and the environment today. It can impact anyone, of any age, in any country.
- Antimicrobial resistance includes resistance to antibacterial (antibiotic), antiviral, antiparasitic and antifungal medications.
- Antimicrobial resistance stops antimicrobials from working effectively against microbes such as bacteria, viruses, parasites or fungi. It makes infections difficult, and sometimes impossible to treat.
- The more antimicrobials are used, the more microbes are able to adapt and find new ways to survive, becoming ‘resistant’ to antimicrobials. For example, using antibiotics when they are not needed drives bacteria to become more resistant.
- People don’t become resistant to antimicrobials, microbes do. Resistant microbes can spread between people, plants or animals, and are very difficult and expensive to treat.
- Antimicrobials are a precious resource. Today there are few new antimicrobials in development, so we must protect the antimicrobials that we have to ensure these life-saving medicines remain effective in the future.
- Without antimicrobials, we may face a situation where cancer treatments, organ transplants and other medical procedures are no longer possible, as they rely on antimicrobials to manage the risk of infection.
- Infections which are easily treatable today could become deadly in the future.
- Making sure antimicrobials are only prescribed when needed will reduce antimicrobial use in New Zealand and help us to keep antimicrobials working.
- We can all do something to help stop antimicrobial resistance. Together we can keep antimicrobials working.
Antimicrobial use in humans in Aotearoa New Zealand
- The level of consumption of antimicrobials in Aotearoa New Zealand is very high compared with many other countries. Aotearoa New Zealand has the fourth highest level of antibiotic prescription in the OECD.
- In Aotearoa New Zealand up to 95 percent of antibiotics are dispensed in the community.
- Almost every child in New Zealand has been exposed to antibiotics by the time they turn five.
- About half of the people who visited their GP in 2017 were dispensed at least one antibiotic.
- About one third of people were dispensed an antibiotic within 30 days of discharge from hospital in 2017.
Antimicrobial resistance in humans in New Zealand
- The rate of antimicrobial resistance (AMR) in New Zealand is currently relatively low compared with other countries. However, certain antibiotic-resistant infections are increasing, including resistant strains of Escherichia coli, Neisseria gonorrhoeae and Staphylococcus aureus.
- Rates of infection with highly-resistant Carbapenemase-producing Enterobacteriaceae (CPE) have increased sharply in recent years – with hospital and community outbreaks of CPE experienced in different parts of New Zealand.
- Māori and Pacific peoples are between two and four times more likely to be admitted to hospital for treatment of an infection than other New Zealanders. This means that Māori and Pacific peoples will be disproportionately impacted by worse health outcomes due to antimicrobial resistance.
- Children, older people, those who are hospitalised, immune-compromised and critically ill, all have a greater need for effective antimicrobials – and therefore are more likely to be impacted by antimicrobial resistance.
What consumers can do
- Preventing infections and their spread helps stop antimicrobial resistance by reducing the need for antimicrobials.
- Regularly wash your hands and keep up to date with vaccinations.
- Remember the 3Cs when cooking at home. Clean, Cook, Chill to prevent you and your family from getting food poisoning.
- Trust your health professional if they advise that you don’t need antimicrobials such as antibiotics. Ask them about other ways to relieve your symptoms.
- Only take antimicrobials if they are prescribed for you, don’t use or share leftover antimicrobials.
- If antimicrobials are prescribed for you, follow your health professional’s advice on when and how to take them.
- Take any unused antimicrobials back to your pharmacy so they are disposed of safely and don’t enter the environment.
What prescribers can do
- Prescribe antimicrobials only when needed, using your current antimicrobial treatment guidelines. Where possible, use diagnostics to inform treatment decisions.
- Prescribe narrow-spectrum rather than broad-spectrum antibiotics whenever you can.
- Check out the recommendations for using or avoiding antibiotics at Choosing Wisely. (See Choosing Wisely.)
- Talk to your patients about the importance of using antimicrobials as directed and the dangers of antimicrobial resistance.
- Help patients understand when and when not to use antimicrobials (for example, explain that antibiotics are not effective against viruses) and provide advice about other ways to manage symptoms. (See Choosing Wisely and BPAC and Goodfellow Unit resources.)
- Talk to patients about how to prevent infections and their spread – including making sure they are vaccinated, practice good hand hygiene, safe sex and proper food handling.
- Ask patients to return any unused antimicrobials they have to their pharmacy so they are disposed of correctly and don’t enter the environment. (See Amnesty information.)
- Support multi-disciplinary antimicrobial stewardship programmes with your technical expertise.
- Use hand hygiene to prevent the spread of infections. (See HQSC hand hygiene resources.)
What health professionals can do
- Practice good hand hygiene to prevent the spread of infections. (See HQSC hand hygiene resources.)
- Talk to patients about how to prevent infections and their spread – including making sure they are vaccinated, practice good hand hygiene, safer sex and proper food handling.
- Talk to your patients and other health professionals about the importance of appropriate antimicrobial use and the dangers of antimicrobial resistance.
- Help patients understand when and when not to use antimicrobials (for example, explain that antibiotics are not effective against viruses) and provide advice about other ways to manage symptoms. (See Choosing Wisely and BPAC and Goodfellow Unit resources.)
- When a prescriber has not prescribed antibiotics, provide reassurance, address concerns and provide advice about other ways to manage symptoms.
- Ask patients to return any unused antimicrobials they have to their pharmacy so they are disposed of correctly and don’t enter the environment. (See Amnesty information.)
- If you are a pharmacist or pharmacy employee, properly dispose of unused and expired antibiotics to reduce the chance of them entering the environment. (See Amnesty information.)
- Support multi-disciplinary antimicrobial stewardship programmes with your technical expertise.