Data, diagnosis, drugs, and dedication
In Osterholm and Olshaker’s book Deadliest Enemy: Our War Against Killer Germs, readers are exposed to the ugly reality of what life could be like if antibiotics no longer can save us from common infections. The authors tell us, “Microbes move in the direction of resistance in order to survive. And that movement, increasingly, threatens our survival. … With each passing year, we lose a percentage of our antibiotic firepower. In a very real sense, we confront the possibility of revisiting the Dark Age where many infections we now consider routine could cause severe illness, when pneumonia or a stomach bug could be a death sentence.”
The authors go on to say that, without antibiotics, any surgery would be so risky that only the most critical would be performed. The risks of open-heart surgery, organ transplants, or joint replacements could outweigh the benefits. “There would be no more in vitro fertilization,” said Osterholm and Olshaker. “Caesarian delivery would be far more risky. Cancer chemotherapy would take a giant step backwards, as would neonatal and regular intensive care … no one would go into a hospital unless they absolutely had to because of all the germs … Rheumatic fever would have lifelong consequences. TB sanitaria could be back in business. You could just about do a post-apocalyptic sci-fi movie on the subject.”
The Review on Antimicrobial Resistance describes some of the more global effects of antimicrobial resistance: “… 300 million people may die prematurely because of drug resistance over the next 35 years and the world’s GDP will be 2 to 3.5% lower than it otherwise would be in 2050. This means that between now and 2050 the world can expect to lose between 60 and 100 trillion USD worth of economic output if antimicrobial drug resistance is not tackled. This is equivalent to the loss of around one year’s total global output over the period, and will create significant and widespread human suffering. Furthermore, in the nearer term we expect the world’s GDP to be 0.5% smaller by 2020 and 1.4% smaller by 2030 with more than 100 million people having died prematurely.”
When asked what makes a successful antimicrobial stewardship program, Steve Gallion, CEO, MedTrainer, responded, “An organization should start by analyzing the current patient population and the processes involved with prescribing antibiotics, then determine the opportunities for intervention and decision support, including training. Results should be shared in the aggregate and at the clinician/physician level, with the goal of reinforcing appropriate antibiotic prescribing.
“MedTrainer provides a compliance management system that can be used to distribute protocols and elicit support among leaders, physicians, and clinicians, and allows leadership and stakeholders to access pieces of critical information,” stated Gallion. “This all-in-one system offers a streamlined solution that is more efficient than current sharing programs and email trails. When healthcare providers are working toward a goal to reduce antibiotic prescribing, they must provide guidelines, training, and a format for feedback that is easy to use, flexible, and informative for the initiative to be effective.”