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It is now accepted that increased antimicrobial resistance (AMR) in bacteria affecting humans and animals in recent decades is primarily influenced by an increase in usage of antimicrobials for a variety of purposes, including therapeutic and non-therapeutic uses in animal production. Antimicrobial resistance is an ancient and naturally occurring phenomenon in bacteria. But the use of antimicrobial drugs – in health care, agriculture or industrial settings – exerts a selection pressure which can favour the survival of resistant strains (or genes) over susceptible ones, leading to a relative increase in resistant bacteria within microbial communities.
This Open Access volume provides in-depth analysis of the wide range of ethical issues associated with drug-resistant infectious diseases. Antimicrobial resistance (AMR) is widely recognized to be one of the greatest threats to global public health in coming decades; and it has thus become a major topic of discussion among leading bioethicists and scholars from related disciplines including economics, epidemiology, law, and political theory. Topics covered in this volume include responsible use of antimicrobials; control of multi-resistant hospital-acquired infections; privacy and data collection; antibiotic use in childhood and at the end of life; agricultural and veterinary sources of resistance; resistant HIV, tuberculosis, and malaria; mandatory treatment; and trade-offs between current and future generations. As the first book focused on ethical issues associated with drug resistance, it makes a timely contribution to debates regarding practice and policy that are of crucial importance to global public health in the 21st century.
An accessible overview of the challenges in tackling AMR, and the economic and policy responses of the 'One Health' approach. It will appeal to policy-makers seeking to strengthen national and local polices tackling AMR, as well as students and academics who want an overview of the latest scientific evidence regarding effective AMR policies.
Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.
The global spread of antimicrobial-resistant pathogenic bacteria is a continuing challenge to the health care of humans and domesticated animals. With no new agents on the horizon, it is imperative to use antimicrobial agents wisely to preserve their future efficacy. Led by Editors Stefan Schwarz, Lina Maria Cavaco, and Jianzhong Shen with Frank Møller Aarestrup, an international team of experts in antimicrobial resistance of livestock and companion animals has created this valuable reference for veterinary students and practitioners as well as researchers and decision makers interested in understanding and preventing antimicrobial resistance.
One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. The approach mobilizes multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate changes and contributing to sustainable development." FAO, OIE, WHO, UNEP
The author sets the discovery and use of penicillin in the broader context of social and cultural changes across the world. He examines the drug's contributions to medicine and agriculture, and investigates the global spread of resistant bacteria as antibiotic use continues to rise.
WHO has launched new guidelines on use of medically important antimicrobials in food-producing animals, recommending that farmers and the food industry stop using antibiotics routinely to promote growth and prevent disease in healthy animals. These guidelines aim to help preserve the effectiveness of antibiotics that are important for human medicine by reducing their use in animals.
This comprehensive, up-to-date volume defines the issues and offers potential solutions to the challenges of antimicrobial resistance. The chapter authors are leading international experts on antimicrobial resistance among a variety of bacteria, viruses including HIV and herpes, parasites and fungi. The chapters explore the molecular mechanisms of drug resistance, the immunology and epidemiology of resistance strains, clinical implications and implications on research and lack thereof, and prevention and future directions.
Antimicrobial resistance (AMR) is a biological mechanism whereby a micro-organism evolves over time to develop the ability to become resistant to antimicrobial therapies such as antibiotics. The drivers of and potential solutions to AMR are complex, often spanning multiple sectors. The internationally recognised response to AMR advocates for a 'One Health' approach, which requires policies to be developed and implemented across human, animal, and environmental health. To date, misaligned economic incentives have slowed the development of novel antimicrobials and limited efforts to reduce antimicrobial usage. However, the research which underpins the variety of policy options to tackle AMR is rapidly evolving across multiple disciplines such as human medicine, veterinary medicine, agricultural sciences, epidemiology, economics, sociology and psychology. By bringing together in one place the latest evidence and analysing the different facets of the complex problem of tackling AMR, this book offers an accessible summary for policy-makers, academics and students on the big questions around AMR policy. This title is available as Open Access on Cambridge Core.