Understanding Antibiotic Resistance: Are We in Trouble?

Anti-Microbial ResistanceAre we in trouble?[For use with lay audience] [insert CCG] Medicines Optimisation Team Presented by: [insert name here] [insert role here]

“ There are few public health issues of potentially greater importance for society than antibiotic resistance” Prof. Dame Sally Davies. CMO, 2013

Context Quiz Background Antimicrobial Resistance – How do antibiotics work? Antimicrobial Resistance – How do they become resistant? Antimicrobial Resistance – Post antibiotic era Antibiotic Guardianship Self-care and OTC

Myth Buster Quiz1. Antibiotics are powerful medicines that help to fight: Viruses Bacteria All microbes Source: WHO global health days, World Antibiotic Awareness Week, 13-19 November 2017

1. Antibiotics are powerful medicines that help to fight: Viruses Bacteria All microbes Source: WHO global health days, World Antibiotic Awareness Week, 13-19 November 2017

2. Antibiotic resistance happens when my body becomes resistant to antibiotics. a)True b) False Source: WHO global health days, World Antibiotic Awareness Week, 13-19 November 2017

3. Antibiotic-resistant bacteria can spread to humans through: Contact with a person who has an antibiotic-resistant infection Contact with something that has been touched by a person who has an antibiotic-resistant infection (e.g. a health-workers' hands or instruments in a health facility with poor hygiene) Contact with a live animal, food or water carrying antibiotic-resistant bacteria. All of the above Source: WHO global health days, World Antibiotic Awareness Week, 13-19 November 2017

4. Antibiotic-resistant bacteria can make me: Sick for longer Have to visit my doctor more or be treated in hospital Need more expensive medicine that may cause side effects All of the above Source: WHO global health days, World Antibiotic Awareness Week, 13-19 November 2017

5. Antibiotic resistance is already out of control and it's only getting worse. There's nothing I can do. True False Source: WHO global health days, World Antibiotic Awareness Week, 13-19 November 2017

6. I can help tackle antibiotic resistance if I: Share my antibiotics with my family when they are sick Get antibiotics as soon as I feel sick - either directly from the pharmacy or a friend Keep my vaccinations up to date Source: WHO global health days, World Antibiotic Awareness Week, 13-19 November 2017

Over 100 trillion microorganisms in YOUR body • They HELP digest our food, regulate our IMMUNE system, PROTECT against other bacteria that cause disease and produce VITAMINS • Some diseases such as diabetes, and arthritis are associated with a dysfunction in the microbiome • Antibiotics DESTROY your microbiome • Source: The Center for Ecogenetics and Environmental Health, University of Washington Background – Your Bacteria

If we don’t tackle drug resistant infections now, they could kill an across the world each year by 2050. In the UK, 80% of antibiotic prescribing occurs in community. extra 10 million people Background – Antimicrobial Resistance Public Health threat Antibiotics leading cause of ADEs Antibiotics over-use RESISTANCE At least 30% inappropriate use Post antibiotic era

Background

Background - UK Prescribing: 80% of antibiotics are prescribed in general practice DDD = Defined Daily Doses

DDD = Defined Daily Dose Background - Europe Prescribing:EU Community Antibiotic Consumption

Background - Symptom Benefit from Antibiotics NNT = Number Needed to Treat. The average number of patients who need to be treated to prevent one additional bad outcome

Background - The Patient Perspective: A 2017 survey showed patients trust healthcare professionals advice

Background - Evidence:Risk of resistance persists for at least 12 months after prescribing

Resistance – How do Antibiotics work? Destroys the cell wall of a bacterium Prevents protein formation of bacterium Destroys bacterial DNA Source: https://learn.genetics.utah.edu/content/microbiome/antibiotics/

Resistance – How do They Become Resistant? Overusing antibiotics 2 ways bacteria develop resistance: Stop antibiotic reaching the bacteria (i.e. pumps) Modify their structure (the antibiotic’s target)

“ A Post-antibiotic era - in which common infections and minor injuries can kill – far from being an apocalyptic fantasy, is instead a very real possibility for the twenty-first century” – Keija Fukuda, WHO Assistant Director General for Health Security Resistance – Post Antibiotic Era

Resistance – What can I do about it? Do not use/request antibiotics for common colds and self-limiting conditions (i.e. runny nose, sore throat) Antibiotics do not treat VIRUSES (i.e. most coughs/colds) If eligible ensure you have your annual FLU JAB If you are prescribed antibiotics for an infection, take the full course. Do not share your antibiotics Use antibiotics only when your doctor prescribes them Sign up to become an ANTIBIOTIC GUARDIAN

https://youtu.be/HN5ultN7JaM Antibiotic Guardianship

GPs in [insert borough name]are no longer recommended to prescribe medications for short term minor illnesses. • Patients are recommended to self-care and use their pharmacy • Self care is about keeping fit and healthy and understanding when to look after yourself • *Insert CCG self care webpage link here* • Please see the nhs.uk website for information on how to treat everyday ailments at home: • https://www.nhs.uk/live-well/healthy-body/home-remedies-for-common-conditions/ Self-Care and OTC

Thank you.

Understanding Antibiotic Resistance: Are We in Trouble?