You can produce sophisticated and comprehensive antimicrobial resistance surveillance data.
You can adhere to the best infection control policies in the country.
You can have a “search and destroy” policy for multi-resistant organisms.
and you can even develop and bring out a new antibiotic every couple of years….
But unless you control antibiotic consumption (usage), you will always be fighting an uphill battle.
In order to control antibiotic consumption you need to know how many antibiotics are being used in the first place.
One of the problems is that antimicrobial resistance surveillance data is produced by microbiologists. Antibiotic consumption data is produced by pharmacists. Antibiotic consumption data even in this day and age can still be difficult to get hold of. Sometimes I wonder if the companies selling the antibiotics to the hospitals have a much better handle on consumption data than the microbiologists do!
Microbiologists and pharmacists need to talk to each other more. It is such a key relationship in the antimicrobial stewardship world.
Antibiotic usage needs to be surveyed and controlled not only at an individual level, but at a national level. Communities and hospitals, humans and animals. It all adds up… Too often I have sat in conferences and seen pretty graphs of antimicrobial resistance data, without complementary antibiotic consumption data to put the resistance data into context. I find it all a bit frustrating…
If reducing antibiotic usage was easy it would already have happened. It’s not easy , and there are good reasons for this. (See this article). This is where objective data is key to monitoring and measuring change. Feedback to the “prescriber” is critical.
Every antimicrobial stewardship committee in the world needs to be aware of their consumption data. Otherwise they are simply not doing their job. Surveillance of antibiotic consumption does not seem to get the same profile as resistance data. This is a shame. I would actually argue that it is the more important of the two….