Stemming the superbug tide : just a few dollars more / by Organisation for Economic Co-operation and Development.

Format:

Book

Author/Creator:

Organisation for Economic Co-operation and Development, author.

Contributor:

Organisation for Economic Co-operation and Development, issuing body, sponsoring body, author.

Language:

English

Subjects (All):

Anti-infective agents.

Antibiotics.

Physical Description:

1 online resource (224 pages) : illustrations

Edition:

1st ed.

Place of Publication:

Paris, France : Organisation for Economic Co-operation and Development, [2018]

Summary:

Antimicrobial resistance (AMR) is a large and growing problem with the potential for enormous health and economic consequences, globally. As such, AMR has become a central issue at the top of the public health agenda of OECD countries and beyond. In this report, OECD used advanced techniques.

Contents:

Intro

Foreword

Acknowledgements

Acronyms and abbreviations

Executive summary

The challenge of growing resistance

AMR will have an enormous impact on population health and healthcare budgets

Policy solutions exist

Key findings

Notes

Chapter 1. Antimicrobial resistance: A large and growing problem

1.1. Antimicrobial resistance: a growing threat to modern medicine

1.1.1. Almost one in five infections is caused by bacteria resistant to specific antibiotics in OECD and European Union (EU) countries and resistance proportions are expected to grow further if no effective action is put in place

1.1.2. AMR is projected to keep growing at least until 2030, with resistance to second and third-line antibiotics expected to grow the most

1.2. Factors underpinning the growth of AMR rates

1.2.1. Inappropriate use of antimicrobials: a leading cause of AMR

1.2.2. Cross-country differences in AMR rates can be explained by key determinants but no single factor stands out for all the antibiotic-bacterium combinations

1.3. AMR is a significant burden on population health

1.4. AMR is a significant source of welfare loss

1.4.1. AMR has a greater impact on the economy of a country than its health care budget

1.5. A strong economic rationale for taking action

1.6. Governments need to put in place a comprehensive set of public health actions to tackle AMR

1.6.1. Global policy responses to tackle AMR is growing

1.6.2. Public health actions to tackle AMR have a positive impact on population health and are an excellent investment for OECD countries

References

Chapter 2. Antimicrobial resistance: A frightening and complex public health challenge

2.1. Infectious disease in the 20th century: Rise of resistance

2.2. What is antimicrobial resistance (AMR)?.

2.3. Why should we be worried about AMR?

2.3.1. Antibiotics and the effects on the microbiota

2.4. How did AMR originate?

2.5. What are the priority pathogens?

2.6. How do AMR bacteria spread and infect humans?

2.7. How does each sector contribute to resistance development?

2.7.1. Animal sector

2.7.2. Community

2.7.3. Hospitals

2.7.4. Natural environment

2.7.5. Spread between sectors

2.8. Use and misuse of antibiotics

2.8.1. High antibiotic use across OECD countries

2.8.2. Antibiotic misuse

2.8.3. Factors related to misuse

Prescriber factors

Patient factors

Health care organisation factors

Industry factors

2.9. Other public health factors that influence infection rates and AMR

2.9.1. Vaccination coverage

2.9.2. Hygiene

2.9.3. Access to medicines

2.9.4. General health status

2.10. How can promoting prudent use of antimicrobials decrease AMR?

2.10.1. Reducing "upward" resistance selection

2.10.2. Increase "downward" selection for susceptibility

Note

Chapter 3. Trends in antimicrobial resistance in OECD countries

3.1. Measuring and understanding international data on AMR is challenging

3.2. Predicted resistance proportions increased between 2005 and 2015 in a majority of countries and for most antibiotic-bacterium combinations

3.3. The emergence and spread of AMR is a complex phenomenon with multiple interrelated causes and drivers

3.4. Should current trends continue into the future, resistance proportions will grow moderately in most countries, but there will be significant heterogeneity

3.5. Growing resistance to third-line treatments and difficult-to-treat microorganisms are a concern for the coming years

Conclusion: More and better data needed for robust policy making

References.

Chapter 4. Health and economic burden of antimicrobial resistance

4.1. Quantifying the burden of AMR

4.2. What does the current evidence tell us?

4.3. The OECD Strategic Public Health Planning for AMR (SPHeP-AMR) model

4.4. The heavy burden of AMR on population health

4.4.1. Mortality

4.4.2. Disease burden of AMR

4.5. Impact on hospital resources and health care expenditure

4.5.1. Stretched hospital resources

4.5.2. Health care expenditure

4.6. AMR jeopardises the safety of many medical procedures

4.6.1. AMR threatens the safety of many medical procedures

4.7. What is the worst-case scenario for AMR?

Conclusion: still time to react!

Annex 4.A.

Chapter 5. Policies to combat antimicrobial resistance

5.1. Introduction

5.2. Effective antimicrobial policy requires global coordination

5.3. Strategies to reduce antimicrobial resistance address varied goals

5.4. Policies may target specific stakeholders, care settings, and microbes

5.5. Specific interventions in toolkit: Prevent or reduce emergence of resistance

5.5.1. Stewardship programmes

5.5.2. Delayed prescribing

5.5.3. Limiting use of antimicrobials without prescription and counterfeit and substandard antimicrobials

5.5.4. Mass media campaigns

5.5.5. Prescriber education

5.5.6. Use of existing and new medical technologies such as rapid diagnostic tests

5.5.7. Economic incentives

5.6. Specific interventions in toolkit: Prevent spread or transmission of resistance in health care settings

5.6.1. Improved environmental hygiene in health care settings

5.6.2. Improved hand hygiene

5.6.3. Screening and isolation of infected patients

5.6.4. Decolonisation

5.7. Specific interventions in toolkit: Vaccination

Conclusions

Chapter 6. Cost-effectiveness of antimicrobial resistance control policies

6.1. Determining the opportunity cost due AMR

6.2. How to tackle AMR

6.3. Healthcare-based interventions

6.3.1. Improved hand hygiene

6.3.2. Stewardship programmes

6.3.3. Enhanced environmental hygiene

6.4. Community-based interventions

6.4.1. Delayed antimicrobial prescription

6.4.2. Mass media campaigns

6.4.3. Rapid Diagnostic Tests (C-reactive protein tests)

6.5. The impact of interventions on AMR

6.6. The majority of deaths due to AMR can be prevented

6.7. AMR control can deliver substantial health gains

6.8. Reduced burden on hospital resources

6.9. Lower health expenditure

6.10. The cost-effectiveness of AMR control

6.11. More effective AMR control through combined policies

6.12. Strengths and limitations of the findings

Conclusion: Tackling AMR is an excellent investment

Annex 6.A. Sensitivity analysis of cost-effectiveness profiles.

Notes:

Includes bibliographical references.

Description based on print version record.

Description based on publisher supplied metadata and other sources.

OCLC:

1132388980