A strategy for tackling antimicrobial resistance: It's more than a prescribing problem

摘要

The 20-year vision for antimicrobial (AM) resistance published by the UK Government on 24 January 2019 recognises the importance of a global approach to tackling the problem. However, it also points to the immense challenges this presents, with the global consumption of AM agents in humans predicted to increase by 30%, and in animals by 67%, over the next 20 years (Global & Public Health Group, 2019).The accompanying UK 2019-2024 five-year national action plan for tackling AM resistance aims to put some 'flesh on the bones' of the nine ambitions outlined in the 'vision'. It is focused on three key aims: ?lowering the burden of infection; ?optimal use of antimicrobials; and ?developing new diagnostics, treatments and vaccines. However, as was the case with the 2013-2018 strategy, while infection prevention is recognised as an essential component it is not accompanied by specific plans as tohow such goals are to be achieved. Rather, it highlights generic regulations and activities that have been in place for many years in UK hospitals such as the Health and Social Care Act, healthcare worker training in hand hygiene and aseptic technique, and audit. Similarly, while the World Health Organization (WHO) components of an infection prevention and control (IPC) programme are cited as a useful structure, they are primarily focused on systems and processes for establishing IPC programmes rather than spe- cific strategies for preventing healthcare-associated infec- tion (HCAI) (WHO, 2018). Such systems are already well established in the UK.